APhA Injection Technique Video 2018

[music playing]

Before you begin to provide
immunizations as a service

you will need to be in compliance
with the occupational safety and

health administration's blood
borne pathogens standard.

When preparing to give an injection, you
will first need to set up your supplies.

These items include
vaccine for injection,

alcohol swabs, cotton swabs or
gauze, adhesive bandages,

syringe and needle of appropriate
size, gauge, and length,

synthetic gloves, sharps container, absorbent
pad to cover the workspace,

emergency kit that
contains epinephrine.

Set up your supplies in a private or sem
i private area that includes a chair

and workspace for patient
comfort and safety.

Arrange the physical space to
allow for fainting without injury,

plus access to a hard
surface if CPR is needed.

Provide your patient with a current
vaccine information sheet, VIS,

as required by law, and review any
applicable screening questions and

updated information
with the patient.

Ask the patient if she or he has any
questions about the immunization.

You are now ready to prepare your
syringe and patient for injection.

To prepare your syringe for injection,
you will need to do the following.

Review what is in each vial. For example,
one vial may contain the antigen,

and one may contain a diluent or adjuvant.
Remove the plastic cap from the vial.

Swab the top of the vial with
alcohol with one swift motion.

Fill the syringe with air equivalent to the
volume of vaccine you need to withdraw.

Pull back plunger to certain mark. Insert
needle through stopper at the top of the vial.

Inject the air. Invert the syringe and vial and
withdraw the required amount of vaccine.

Remove any large air bubbles. Once you have
the correct volume of vaccine in the syringe,

remove the needle and
syringe from the vial.

At this point, you can do one of two
things, recap the syringe for later use

or inject the vaccine
directly into the patient.

If you are not injecting the vaccine into the
patient right away, you may recap the needle.

At this point, it is okay to recap
the needle since it has not

entered a patient
and is still sterile.

Never recap a needle that has
been inserted into a patient.

The following is a demonstration
of an intramuscular injection.

Once you are ready to inject the vaccine, proceed
as follows. Although gloves are not required,

it may be prudent to use gloves for your
protection and patient perceptions.

Follow your local
standards. Be sure

both you and your
patient are sitting.

Expose the injection site, which is the thickest
and central portion of the deltoid muscle.

The midpoint of the deltoid
is about two inches or

two to three fingers breath below
the acromion process

and above the armpit in the
middle of the upper arm.

Inject the vaccine into the middle and
thickest part of the deltoid muscle.

Swab the injection site with alcohol.
Allow the alcohol to dry.

Note that the sharps container is readily
accessible. Hold the syringe near the hub.

Insert the needle at a 90 degree angle
all the way to the hub of the needle.

Maintain contact with the patient at all times.
While supporting the patient and the syringe,

depress the plunger in a smooth
and coordinated manner.

Immediately activate
the safety device.

Dispose of the syringe and needle
into the sharps container.

Press the cotton or gauze over the injection
site and secure this to the patient

using the adhesive
bandage.

Remove your gloves and wash your hands.
Change your gloves between patients.

Provide your patient with post injection
counseling and follow-up instructions.

Document the injection given while maintaining
compliance with all legal requirements.

The following is a demonstration
of a subcutaneous injection.

Once you are ready to inject
the vaccine, proceed as follows.

Be sure both you and
your patient are seated.

Expose the injection site, which is on the
posterior lateral aspect of the upper arm.

Swab the injection site with alcohol.
Allow the alcohol to dry.

Note that the sharps container
is readily accessible.

Hold the syringe near the hub. Pinch
a fold of skin and insert the needle

at a 45 degree angle to
the hub of the needle.

Maintain contact with the patient at all times.
While supporting the patient and the syringe,

depress the plunger in a smooth
and coordinated manner.

Quickly withdraw the needle. Immediately
activate the safety device.

Dispose of the syringe and needle
into the sharps container.

Press the cotton or gauze over the injection
site, and secure this to the patient

using the adhesive bandage. Remove
your gloves and wash your hands.

Change your gloves between
patients. Provide your patient

with post injection counseling
and follow-up instructions.

Document the injection given while maintaining
compliance with all legal requirements.

If you need to give multiple vaccinations in
the same visit, give them in separate arms.

And if you need to administer in the
same arm, ensure you are giving at

least one
inch apart.

The following is a demonstration
of intranasal vaccine delivery.

Be sure your patient is sitting.
Hand your patient a

tissue to hold. Remove
the rubber tip protector.

As you can see, some degree of force is
needed to deliver the intranasal vaccine.

The patient should be in an upright position and
the patient's head should be tilted back slightly.

Place the tip inside one nostril. With a single motion,
depress the plunger as rapidly as possible

until the dose divider clip prevents
you from going further.

Remove the tip from the patient's nose
and then remove the dose divider clip.

Administer the remaining dose
into the other nostril.

Discard the syringe into
a biohazard container.

Provide your patient with post delivery
instruction and follow-up instructions.

Document the immunization
given while maintaining

compliance with all legal requirements
for documentation.

If you have questions regarding this instructional
video or would like additional information,

please contact the American Pharmacist
Association education department.