Alexander ch12 lecture

Copyright © 2017, 2012 Pearson Education, Inc. All Rights Reserved.
Advanced EMT
A Clinical-Reasoning Approach, 2nd Edition
Chapter 12
Medication
Administration

• Applies fundamental knowledge of medications in
the Advanced EMT scope of practice to patient
assessment and management.
Advanced EMT
Education Standard

1. Define key terms introduced in this chapter.
2. Explain the medical direction mechanisms by which an
Advanced EMT may be authorized to administer a
medication.
3. Explain Advanced EMT practices that are necessary with
regard to medication administration safety.
4. Differentiate between enteral and parenteral routes of
drug administration.
Objectives (1 of 3)

5. Describe each of the following routes of medication
administration: inhaled (gases and nebulized
medications), intramuscular (IM), intraosseous infusion
(pediatric), intravenous bolus, intravenous infusion, oral
(PO), subcutaneous (subQ), and sublingual (SL).
6. Properly interpret verbal and written drug orders.
7. Use proper abbreviations and terminology with respect to
drug administration.
8. Calculate drug dosages from drug orders, including
proper use of the metric system.
Objectives (2 of 3)

9. Explain the concept of medical asepsis.
10.Demonstrate the following skills under instructor
supervision: administration of drugs by small-volume
nebulizer, administration of nitrous oxide, assistance for
patient with the use of a metered-dose inhaler,
intramuscular injection, intravenous access, intravenous
and intraosseous fluid administration, intravenous
medication bolus, oral medication administration,
pediatric intraosseous access, subcutaneous injection,
sublingual medication administration, and use of an
auto-injector device.
Objectives (3 of 3)

• Medications can be lifesaving but can also be
devastating
• Indications and contraindications of a drug and
aspects of drug profile
• Interpreting medication orders
• Advantages and disadvantages of routes of
medication administration
• Proper techniques and equipment
Introduction (1 of 2)

• You must be able to:
– Calculate drug dosages
– Select correct medication
– Prepare medication
– Adhere to principles of safe administration
Introduction (2 of 2)

• What equipment does Grant need to start an IV
and administer a medication intravenously?
• How can Grant and Loretta ensure patient safety
and minimize the risks of complications from IV
therapy and medication administration?
• What should Grant include in his documentation
about the IV and medication administration?
Think About It

• Knowledge
– Anatomy, physiology, pathophysiology, and
pharmacology
• Skills
– History taking, assessment, and clinical reasoning
• What are the most common types of medication
administration errors resulting in death?
Principles of Safe Medication
Administration (1 of 4)

• Phases of drug administration in which errors can
be made include
– Giving drug order
– Transcribing order
– Administering drug (dosage and route of administration
errors)
– Patient monitoring
– Documentation

• Six Rights of Medication Administration
– Right patient
– Right medication
– Right dose
– Right route
– Right time
– Right documentation

• Medication safety considerations
– Packaging
– Labeling
– Storing
– Dispensing
– Administering

• Medication shortages and substitutions are
occurring more frequently than in the past
• Packaging and concentrations may have changed
since your last administration of the medication
• Never assume that the box matches the vial inside
Think About It

• Enteral routes
– Access through vasculature of gastrointestinal system
– Liquid, solid, and semisolid
• Parenteral routes
– Bypass gastrointestinal tract
– Liquid, gas, and semisolid forms
Routes of Drug Administration (1 of 5)

• Parenteral routes
– Inhalation
– Sublingual
– Subcutaneous injection
– Intramuscular injection
– Intravenous bolus
– Intravenous infusion
– Intraosseous administration

Table 12-1 Advanced EMT Routes of Medication Administration
Route Description
Enteral routes Oral (PO) Liquid, solid, or semisolid drugs are placed in the mouth and swallowed.
The speed of onset is slow and depends on the drug form, nature of the
drug, stomach contents, and rate of gastric emptying. The route is
contraindicated in patients who are restricted from oral intake. This route is
generally safe, and drug forms for oral administration are often less
expensive than other forms. The skills required to administer drugs orally
are relatively simple and the route is well accepted by most patients.
Parenteral routes:
Sublingual
Sublingual (SL) Many textbooks consider the sublingual route an enteral route, but drugs
given this way are absorbed directly into the systemic circulation,
bypassing the hepatic portal circulation. The thin, moist mucous membrane
beneath the tongue allows rapid absorption of drugs into the dense
network of capillaries beneath the tongue, allowing for a rapid onset of
action. Few drugs are available for administration by this route.
Parenteral routes:
Percutaneous
All percutaneous routes
require specialized skills
and equipment. These
routes of administration
may cause pain, fear,
and infection. In
general, the onset of
action is rapid.
Subcutaneous
(subQ or subcut)
Intramuscular (IM)
Intravenous (IV)
A short, fine needle is used to inject 1 mL or less of fluid into the
subcutaneous tissue. This route is slower than IM and IV routes, and the
predictability of absorption is affected by peripheral circulatory status.
A needle is used to inject up to 5 mL of fluid (depending on the site
selected) into skeletal muscle tissue. Greater circulation in the skeletal
muscle, compared to the subcutaneous tissues, results in a more rapid
onset of action, but absorption is affected by peripheral circulation.
Drugs are administered directly into the peripheral circulation by
intravenous injection or infusion (drip). The onset of action is nearly
immediate.
Parenteral routes:
Inhalation
Inhalation Gases, microdroplets, and fine powders are absorbed quickly across the
large surface area of the respiratory membrane. Onset of action is rapid.
Drug administration is impaired in patients with inadequate ventilation.

• Time to onset of action of parenterally
administered drugs depends on length of
time it takes medication to enter circulation
• Subcutaneous (subQ) route
– Slowest onset
– Peripheral perfusion affects absorption
• Intramuscular drugs
– Liquids injected into large skeletal muscle masses

• Intravenous (IV) drugs
– Liquids injected or infused directly into venous system
 Tubing filled with saline (saline lock)
 Tubing connected to bag of IV fluid (infusion)
 Rapid onset of action
• Intraosseous (IO) route
– Placing hollow needle into medullary cavity of a bone
 Tubing filled with saline
 Rapid onset of action

• Drugs for inhalation
– Gases
– Aerosolized liquids or powders
– Absorbed quickly across respiratory membrane

Drug Orders (1 of 2)
• AEMTs may only administer drugs on order of
licensed physician providing EMS medical
direction
– Standing orders
– Written orders
– Verbal orders
• Always repeat order back to physician, word for
word, to verify understanding

Drug Orders (2 of 2)
• Document all pertinent information about
– How you carried out order
– Any complications
– Patient’s response to medication
• What are you ethically obligated to do regarding
drug orders?

Think About It
• How would you expect the health care provider
to report the administration of a medication to
you?
• How should you acknowledge a medication order?

• Complete drug order information
– Drug name
– Drug concentration, if applicable
– Drug dosage
– Route of administration
– Rate or frequency of repetition, if applicable
• Standard abbreviations used to avoid confusion
• Place leading zero before dosages of less than
one unit
Interpreting Drug Orders

• Only use standard abbreviations that are accepted
by your agency
• If you do not understand a drug order, ask the
physician for clarification
Think About It

Drug Dosage Calculation (1 of 7)
• Mathematical operations required to convert drug
orders to units in which drug will be administered
• Drug dosages in metric units
• Metric system
– Base-10 system used in science and medicine

• Prefixes used for multiples and submultiples
• Whole numbers placed to left of decimal
• Fractions represented by place values to right of
decimal

Table 12-3
Metric System Bases and Multiples Commonly Used
in Pharmacology
Property
Base
Unit Abbreviation
1/1,000,000 (10–6
or 0.000.001)
1/1,000 (10–3
or 0.001)
1/100 (10–2
or 0.01) 1,000 (103)
Mass (weight) gram g microgram (mcg) milligram (mg) kilogram (kg)
Volume liter L milliliter (mL)
Length meter m millimeter (mm) centimeter (cm)

• Basic calculations
– To find amount of drug to administer when given
physician’s order and concentration of drug available
– Use fractions to compare information you know and
information you must find out
 Solved by cross-multiplying and dividing using x to represent
the unknown

• Weight-based dosage calculations
– Dosage calculated based on patient’s body weight
– Patient’s weight in kilograms
– Divide patient’s weight in pounds by 2.2
– Health care providers are not very accurate estimating
patient’s weight
– Ask patient weight or use length-based resuscitation
tape

Figure 12-5
Parts of an IV administration set.

• IV drip rate calculations
– Calculated using formula that includes drip factor
of IV tubing set
– Drip factor
 Number of drops needed to infuse 1 mL of IV fluid
– Drip factors of sets
 10 gtts/mL, 15 gtts/mL, 20 gtts/mL

• Check the time over which volume is to be infused
before calculating drip
• To keep open (TKO); keep vein open (KVO)
• Weight-based IV drip rate calculations
– Obtain patient’s weight; convert pounds to kilograms

• Setting the drip rate
– Adjust flow rate to calculated number of drops
– Adjust roller clamp (flow regulator) to increase or
decrease flow rate
– IV infusion pumps used to calculate and adjust IV
infusion rate

Think About It
• To test the accuracy of your math skills in drug
dosage calculation, use a calculator whenever
possible to calculate drug dosages
• Mobile device applications

Techniques of Medication
• Before giving any medication, perform history
and assessment to determine if medication is
indicated and not contraindicated
• Ask about
– Medications patient currently takes
– Drug allergies
– Conditions that could contraindicate a particular drug

• Obtain complete set of baseline vital signs
• Document procedure
• Reassess patient and document findings
• Ask patient if he has experienced a change in
symptoms for which medication was administered
and any new symptoms

• Aseptic technique
– Use isopropyl alcohol wipe or povidone iodine
– Identify site to puncture skin and swab in circular
motion; cleanest is point of insertion of needle
– Once disinfected, do not touch area
– Allow skin to dry completely
– Do not allow equipment to be contaminated

Figure 12-7
Use an alcohol wipe (shown) or povidone iodine swab to disinfect the skin prior to
percutaneous injection.

• EMS provider safety
– Always use Standard Precautions
– Never recap contaminated needles
– Dispose of needles in biohazard container
– Avoid performing percutaneous procedures in moving
ambulance

• Oral medication administration
– What is the most common medication administered
orally by AEMTs?
• Sublingual medication administration
– Introduce medication under the tongue
– What is the most common medication administered
sublingually by AEMTs?

• Nebulized medication administration
– Beta2 agonists and anticholinergics liquids that are
nebulized (turned into fine mist) by compressed air or
pressurized oxygen flowing through liquid
– Mist inhaled and droplets in contact with respiratory
membrane

Scan 12-1 (1 of 7)
Administering Medication by Small-Volume Nebulizer
1. Assemble all the equipment needed for the procedure.

Scan 12-1 (2 of 7)
2. Select and check the medication.

Scan 12-1 (3 of 7)
3. Assemble the nebulizer by connecting the mouthpiece to the “T” connector at the top of
the medication cup.

Scan 12-1 (4 of 7)
4. Unscrew the cap of the medication cup. Place the medication in the medication cup of
the small volume nebulizer.

Scan 12-1 (5 of 7)
5. Replace the cap on the nebulizer.

Scan 12-1 (6 of 7)
6. Connect the tubing from the nebulizer to oxygen and adjust the oxygen flow
rate to 8 L/minute.

Scan 12-1 (7 of 7)
7. Instruct the patient to place the mouthpiece in his mouth, breathe in the medication,
and breathe it out. Reassess the patient.

• Medication administration by metered-dose
inhaler (MDI)
– Many patients familiar with use of device; may need
to provide instruction
• Nitrous oxide administration
– Analgesic gas; 50:50 mix of oxygen and nitrogen
– Effects of drug is to alter mental status

• Equipment used for injections
– Gloves for standard precautions
– Alcohol or povidone iodine swabs
– Syringe of proper size and with proper graduations
– Needles or filter straws
– Small gauze square; small adhesive bandage
– Vial, ampule, prefilled syringe of medication
– Sharps disposal container

Figure 12-11
(A)
(B)
(A) Parts of a syringe. (B) Parts of a percutaneous needle.

Scan 12-2 (1 of 4)
Drawing Medication from an Ampule
1. Hold the ampule upright and gently tap the top until all medication has moved into the
bottom chamber of the ampule.

Scan 12-2 (2 of 4)
2. Grasp the top of the ampule with a piece of gauze or alcohol swab.

Scan 12-2 (3 of 4)
3. Snap off the top of the ampule, taking care not to spill any medication.

Scan 12-2 (4 of 4)
4. Draw the medication from the ampule.

• Drawing medication from a vial
– Inject a volume of air equal to volume of medication
you are going to withdraw
– Insert the needle into the vial
– Inject the air into the vial
– Draw the desired amount of medication into
the syringe

• Subcutaneous injection
– Epinepherine 1:1,000 for anaphylaxis
– Fold skin between thumb and forefinger
– Inject into subcutaneous tissue at 45° angle
– 1 mL maximum volume
– 25 ga. needle, ½–¾ inch long

Figure 12-12
Sites for subcutaneous injection.

• Subcutaneous injection (continued)
– Assemble equipment
– Verify medication
– Draw up medication
– Disinfect site and grasp skin
– Insert needle at 45° angle and inject medication
– After withdrawing needle apply bandage to site
– Reassess patient and document

Scan 12-3 (1 of 7)
Subcutaneous Injection

Scan 12-3 (2 of 7)
2. Verify the medication.

Scan 12-3 (3 of 7)
3. Draw up the medication into a syringe.

Scan 12-3 (4 of 7)
4. After disinfecting the skin, pinch up a fold of skin and position the needle at a 45-degree
angle to the skin.

Scan 12-3 (5 of 7)
5. Insert the needle into the skin and inject the medication.

Scan 12-3 (6 of 7)
6. After drawing out the needle, place an adhesive bandage over the injection site.

Scan 12-3 (7 of 7)
7. Reassess the patient.

• Intramuscular injection
– Two drugs
 epinephrine 1:1,000
 glucagon
– 21- or 23-guage needle, ¾ inch to 1½ inch in
length for deep IM
– Insert at 90° angle
– Injection sites
 Deltoid—1 mL maximum volume
 Thigh—2 mL maximum volume
 Gluteus—5 mL maximum volume

Figure 12-13 (1 of 3)
Sites for intramuscular injection—gluteus

Figure 12-13 (2 of 3)
Sites for intramuscular injection—thigh

Figure 12-13 (3 of 3)
Sites for intramuscular injection—deltoid

• Intramuscular injection (continued)
– Inject volume of air equal to volume of medication to be
drawn and draw from vial
– Disinfect site and stabilize skin
– Insert needle at 90° angle and aspirate needle for
presence of blood; if no blood, administer medication
– Withdraw needle and apply bandage

Scan 12-4 (1 of 8)
Intramuscular Injection

Scan 12-4 (2 of 8)
2. Select and verify the medication.

Scan 12-4 (3 of 8)
3. Inject a volume of air slightly greater than the volume of medication to be withdrawn and
draw the medication from the vial.

Scan 12-4 (4 of 8)
4. Disinfect the skin at the injection site.

Scan 12-4 (5 of 8)
5. Stabilize the skin over the site and place the needle at a 90-degree angle to the skin.

Scan 12-4 (6 of 8)
6. Insert the needle and inject the medication. Draw back on the syringe plunger slightly.
You should not be able to aspirate blood. If blood is aspirated, do not inject the
medication. Remove the needle from the skin and start over in another site.

Scan 12-4 (7 of 8)
7. After drawing out the needle, place an adhesive bandage over the site.

Scan 12-4 (8 of 8)

• Auto-injectors
– Packaged for rapid and easy administration
– Epi-Pen
– DuoDote

Figure 12-14
Epinephrine auto-injectors. (A) EpiPen auto-injector. (B) Twinject auto-injector.

• Auto-injector use
– 6 rights of medication administration
– Verify medication is not expired
– Remove safety cap
– Grasp body of auto-injector firmly
– Position tip to lateral aspect of thigh
– Apply pressure until device activates
– Hold for 10 seconds
– Remove device and properly dispose of it
– Documentation

• Intravenous injection
– Dextrose solutions
– Naloxone for suspected narcotic overdose
– Administration via intravenous line or saline lock
– Rate of administration
– Needleless system or syringes with needles

• Intravenous injection (continued)
– Prepare syringe
– Clean IV injection port
– Attach syringe to injection port and crimp tubing
– Inject medication at proper rate
– Discard syringe in sharps container
– Flush IV tubing and readjust drip rate

Scan 12-5 (1 of 9)
Intravenous Injection

Scan 12-5 (2 of 9)
2. Verify the medication.

Scan 12-5 (3 of 9)
3. Prepare the medication syringe.

Scan 12-5 (4 of 9)
4. Clean the IV injection port with an alcohol swab.

Scan 12-5 (5 of 9)
5. Attach the syringe to the injection port and crimp the IV tubing above the site of
administration.

Scan 12-5 (6 of 9)
6. Inject the medication at the proper rate.

Scan 12-5 (7 of 9)
7. Discard the syringe in a sharps disposal container.

Scan 12-5 (8 of 9)
8. Flush the IV tubing and readjust the drip rate.

Scan 12-5 (9 of 9)

Think About It
• After administering medications, you must
reassess the patient and document your findings
• Ask the patient if he has experienced a change in
the original symptoms or developed new
symptoms
• Compare subsequent sets of vital signs with their
baseline values

Establishing a Peripheral
Intravenous Line (1 of 12)
• Peripheral intravenous access for patient in
whom fluid administration or means for giving
emergency medicines required or anticipated
• Obtained by using catheter that surrounds
hollow needle
• Follow protocols regarding selection of fluids

Figure 12-15
Parts of a catheter-over-needle device for intravenous access.

• Equipment for establishing IV access
– Gloves for standard precautions
– Venous constricting band
– Alcohol or povodine iodine swab
– Saline lock and saline flush or IV fluid bag and
IV tubing
– Catheter-over-needle IV access device
– Small gauze squares; commercial IV dressing
– Adhesive tape
– Antibiotic ointment
– Tincture of benzoin

• Catheter size
– Needle is one size smaller than catheter
– Can be as small as 24-gauge, ¾ inch, or as large
as 14-gauge
– 20-gauge and 18-gauge, 1¼ inch suitable for
IV access in adults
– 16-gauge or 14-gauge when rapid infusion of
fluids required
– 22-gauge and 24-gauge for patients who have
extremely small diameter or fragile veins

• Setting up the IV fluid and tubing
– Check IV fluid bag for name of fluid, expiration date
– Inspect for damage or leakage
– Observe fluid for clarity, color, and visible contaminants
– Open IV tubing package and ensure the roller clamp is
turned off
– Remove seal from port on IV bag
– Remove cover from IV tubing spike

• Setting up the IV fluid and tubing (continued)
– Insert spike into IV bag port using a twisting motion
– Squeeze clear drip chamber to fill it ⅓ to ½
– Open roller clamp and flush tubing with fluid to remove
all air
– Place tubing where it is accessible and prepare for
venipuncture

• Selecting a suitable vein
– Back of hand and forearm; antecubital fossa of
anterior elbow
– Lower extremities; external jugular vein in neck
– Venous tourniquet to restrict venous return and
engorge veins
– Palpate vein
– Choose visible veins when possible
– Vein size specific to need

Figure 12-16
Sites for peripheral venous access.

• Performing the venipuncture
– Disinfect site
– Hold IV needle at 45-degree angle or less to skin
with bevel up
– Line up direction of needle with direction of vein
and puncture
– Once blood is visible in flash chamber, lower angle
of needle until almost flush with skin and advance
needle and catheter 1 to 2 mm further
– Push the catheter over the needle until hub is in
contact with skin

• Performing the venipuncture (continued)
– Never pull the catheter back over the needle
– Release the tourniquet
– Apply pressure to the end of the catheter with a finger
– Keeping a finger on the vein to occlude it, connect the
IV tubing to the catheter and adjust flow rate
– Secure IV tubing

Scan 12-6 (1 of 12)
Obtaining IV Access
1. Prepare all the necessary equipment before beginning the procedure.

Scan 12-6 (2 of 12)
Obtaining IV Access
2. Check the name of the fluid, inspect it for clarity, and ensure that it is not expired.

Scan 12-6 (3 of 12)
Obtaining IV Access
3. Insert the spike of the IV tubing into the fluid bag, squeeze the drip chamber, and then
allow it to fill about one third of the way.

Scan 12-6 (4 of 12)
Obtaining IV Access
4. Open the roller clamp and allow the fluid to fill the tubing, ensuring that all air bubbles are
expelled from the tubing.

Scan 12-6 (5 of 12)
Obtaining IV Access
5. Apply a venous constricting band above the venipuncture site.

Scan 12-6 (6 of 12)
Obtaining IV Access
6. Disinfect the venipuncture site using aseptic technique.

Scan 12-6 (7 of 12)
Obtaining IV Access
7. Stabilize the skin. Holding the IV access device, bevel up at no higher than a 45-degree
angle, insert the tip of the needle into the vein, and advance it until blood is seen in the
flash chamber.

Scan 12-6 (8 of 12)
Obtaining IV Access
8. When flashback occurs, advance the device 1 mL to 2 mL further. Stop advancing
the needle and push the catheter over the needle until the hub is in contact with the
patient’s skin.

Scan 12-6 (9 of 12)
Obtaining IV Access
9. Release the constricting band.

Scan 12-6 (10 of 12)
Obtaining IV Access
10. Occlude the vein above the end of the catheter. Withdraw the needle and discard it in a
sharps disposal container. Connect the IV tubing to the catheter hub. Wipe any blood from
the site using a gauze square.

Scan 12-6 (11 of 12)
Obtaining IV Access
11. Flush the tubing, check the site for infiltration, and adjust the flow of fluid to the
desired rate.

Scan 12-6 (12 of 12)
Obtaining IV Access
12. Use a commercial dressing to protect the site and secure the tubing in place with tape.

• Unsuccessful IV attempts and discontinuing
IV therapy
– An unsuccessful attempt may occur because
 Vein moves away from needle
 Needle punctures both sides of vein
 Catheter meets resistance from valve
 Angle of insertion is wrong

• Unsuccessful IV attempts and discontinuing
IV therapy (continued)
– To discontinue IV therapy
 If IV discontinued after tubing connected, close roller clamp
or clamp on saline lock to prevent leakage of contaminated
fluid when catheter removed
 Remove IV needle/catheter combination and dispose of
it safely
 Apply bandage to insertion site

• Changing an IV bag
– Change bag when a few milliliters of fluid is left
in the bag
– Close roller clamp to prevent further fluid from
entering tubing
– Spike new bag and make sure drip chamber is
one-third to one-half full
– Readjust flow rate

• Complications of IV therapy
– Infection
– Infiltration
– Air or catheter embolism
– Bruising or hematoma
– Thrombosis
– Phlebitis
– Pyrogenic reaction
– Fluid overload

Think About It
• Heart failure patients, elderly, and pediatric
patients are at risk of fluid overload.
• Calculate infusion rate accurately.
• Monitor rate of IV infusion carefully.
• Check for signs of fluid overload in re-
assessment.
– shortness of breath and crackles (rales) = significant
fluid load

Pediatric Intraosseous Access (1 of 3)
• IV access in pediatric patients can be difficult
• IO is an alternative
• Proximal tibia
• EZ IO (Vidacare) device
• Bone injection gun or BIG (WaisMed) device
• Manual access

Figure 12-17
EZ IO device. Needles of different sizes are available for some devices. Shown here are a
bariatric needle (yellow), a standard adult needle (blue), and a pediatric needle (red).

Figure 12-18
A manual intraosseous needle.

• Contraindications
– Fracture of the extremity
– Previous IO attempt in same bone
– Osteogenesis imperfecta
– Osteoporosis
– Infection over insertion site

• Complications of IO attempts and IO access
– Incorrect placement
– Obstruction of needle
– Fracture
– Infection
– Compartment syndrome
– Fat embolus

Scan 12-7 (1 of 10)
Pediatric Intraosseous Access Using the EZ IO Device
1. Assemble all needed equipment. Set up an IV line and prefill the extension tubing
provided with the saline. Leave the syringe attached to the tubing.

Scan 12-7 (2 of 10)
2. Find the proper insertion site, two fingerbreadths below the tibial tuberosity along the
anteriomedial surface.

Scan 12-7 (3 of 10)
3. Ensure the correct needle length for the size of the patient.

Scan 12-7 (4 of 10)
4. Prepare the site with a povidone iodine swab.

Scan 12-7 (5 of 10)
5. Place the needle on the driver.

Scan 12-7 (6 of 10)
6. Hold the driver at a 90-degree angle to the leg and drill the needle into the bone.

Scan 12-7 (7 of 10)
7. Remove the stylet (guide) from the needle.

Scan 12-7 (8 of 10)
8. Attach the tubing prefilled with normal saline and flush the needle. Observe for free flow
of fluid and absence of infiltration into the soft tissues.

Scan 12-7 (9 of 10)
9. Insert the IV bag into a pressure infusion device, inflate the infusion bag following local
protocol, attach the IV tubing to the extension tubing, and adjust the flow rate.

Scan 12-7 (10 of 10)
10. Secure the needle and tubing and attach the information band to the extremity.

Chapter Summary (1 of 2)
• Administering medications comes with
tremendous responsibility for patient safety
• Follow safety principles using the Six Rights
of Medication Administration
• Use aseptic technique to reduce the potential
for complications
• Know your equipment and how to troubleshoot it

Chapter Summary (2 of 2)
• Carefully calculate and verify drug dosages
• Select proper route of administration
• Administer medications at right time and rate
• Document details of medication administration

Alexander ch12 lecture

More Related Content

What's hot (20)

Similar to Alexander ch12 lecture (20)

More from corynava00 (20)

Recently uploaded (20)

Alexander ch12 lecture