I.

V Drip & Injection techniques

By-
Dr. Gandham Ravi, MD
Vials Ampoules
 BMW management
Infectious waste: samples contaminated with blood & other body
fluids. trash from autopsies, culture media and stocks; waste from
animals, and sick patients' bodies (swabs, bandages, and disposable
medical equipment);
Pathological waste: human body parts, tissues, & fluids, and
contaminated animal carcasses
Sharps waste: syringes, needles, disposable scalpels and blades, etc.;
Chemical waste: all solvents and reagents used for laboratory
preparations, testing, disinfectants, sterilant and heavy metals
contained in medical device.
 BMW management
Pharmaceutical waste: pharmaceutical drugs, immunization vaccine
etc.
Cytotoxic waste: substances with genotoxic properties such as
cytotoxic drugs used in cancer treatment and their metabolites;
Radioactive waste: such as products contaminated by radionuclides
including radioactive diagnostic material or radiotherapeutic
materials.
 BMW management
Biomedical waste 2016 rules- Segregation of waste
1. Yellow bags- Infectious non- plastic waste
2. Red bags- Infectious plastic bags
3. White containers- Metal sharp, needles
4. Blue containers – Broken glass items, metal implants
 Intravenous canulation
1. Introduce yourself to the patient( confirm patient i.D)
2. Explain the procedure you are going to perform on him/her ( &reassure)
3. Wash hands & prepare the necessary material( syringes,cotton etc)
4. Check the doctor order& ensure correct drug & dosage
5. Take the consent
6. Wear sterile gloves (position the pt in a lying or sitting posture & uncover the arm completely)
7. Disinfect the area you want to canulate ( with Surgical spirit/Isopropyl alcohol from center to periphery)
8. Select the canula of appropriate size
9. Pierce the skin and enter the vein (15-25 degree angle depending on the vein depth)
10. Make sure the canula is inside the vein by pulling the needle slightly backwards holding the needle grip &
seeing the column of blood inside the plastic catheter ( or by seeing the blood oozing in to the flashback
chamber)
11. Push the needle back to its original position ( But not completely to avoid the needle coming out of the tip of
the plastic catheter in order to avoid the double puncture of the vein while proceeding further)
12. Hold the wings of the canula to push the canula forward until the entire plastic catheter sits inside the vein
13. Remove the needle ( press the proximal end of the canulating area to avoid blood loss during this step )
14. cap the distal end of the canula with luer lock plug & fix the canula with adhesive plaster
15. Discord the waste into the appropriate containers
 I.V Drip
1. Wear sterile gloves
2. Select the fluid of choice after securing the I.V line
3. Connect the spike end of the I.V set to the saline bottle
4. Remove the air bubbles from the I.V tube
5. Connect the luer connecter end of the I.V set to the canula
6. Set the number of drops/minute to be administered in the drip chamber
7. Finish the fluid within the stipulated time
8. Observe the patient for any reactions during process
 I.M Injection
• Wear the gloves
• Take the appropriate syringe based on the amount of drug to be administered
• Load the syringe with the drug
• Remove the air bubbles from the barrel by gentle tapping
• Disinfect the area you want to administer the drug from the center to periphery
• Hold the bulk of the muscle firmly with the non-dominant hand
• Hold the syringe in the dominant hand and pierce needle deeply
in to the bulk of the muscle at 90 degree angle
• Pull the plunger back to see whether the needle is inside the muscle or the blood vessel
• Inject the drug slowly & completely
• Cover the injecting area with sterile cotton and remove the needle
• Discord the waste in to the appropriate containers
 S.C Injection
1. Wear the gloves
2. Take the appropriate syringe ( 1ml/Insulin syringe)
3. Load the drug and remove the air bobbles from the barrel of the syringe by gentle tapping
4. Disinfect the area you want to administer the drug from the center to periphery
5. Pinch the skin using the thumb, middle & index fingers of the non-dominant hand to raise the
skin from the underlying muscle tissue
6. Insert the needle into the skin at an angle of 45 degrees
7. Pull the plunger back to make sure the needle is NOT inside the blood vessel
8. Administer the drug slowly
9. Cover the injecting area with sterile cotton and remove the needle
10. Discord the waste in to the appropriate containers
 Subcutaneous injection-Angle of the needle

• Angle is around 45° or 90° depending on needle length and the amount of
subcutaneous tissue at the injection site. A 45° injection angle is particularly
recommended when needles of 8 mm length or longer are used.

References:
• Cooper K, Gosnell K. Foundations of nursing. St. Louis: Elsevier; 2019.
• Australian Diabetes Educators Association (ADEA). Clinical guiding principles for subcutaneous injection technique. 2015.
 Intradermal Injection
1. Wear the gloves
2. Take the appropriate syringe based on the amount of drug to be administered (Tuberculin
syringe/Insulin syringe)
3. Load the syringe with the drug
4. Remove the air bubbles from the barrel by gentle tapping
5. Disinfect the area you want to administer the drug from the center to periphery
6. Stretch the skin slightly and pierce the needle at an angle of 5–15 degrees
7. Inject the drug and observe for bleb (small blister) formation
8. Cover the injecting area with sterile cotton and remove the needle
9. Discord the waste in to the appropriate containers

Reference:
• Yotam Levin, Efrat Kochba,Ivan Hung, Richard Kenney. Intradermal vaccination using the novel microneedle device
MicronJet600: Past, present, and future. Hum Vaccin Immunother. 2015 Apr; 11(4): 991–997.
Thank You