Draw Up Medication with Blunt Fill Needle (Nursing)

00:04 Welcome to looking at, preparing, and intramuscular injection.

00:09 So, first of all, you may notice, "Hey, she's not wearing any gloves." And that's okay.

00:13 So, a couple of reasons why this is okay is typically when we prepare medications, we are usually in the medication administration room or medications room on your unit.

00:24 Now, some nurses may feel like they feel more comfortable wearing gloves preparing meds and that is okay, too.

00:31 So, the reason why they may do this is some medications, we wanna make sure we don't get on our skin that we absorb.

00:39 So, this is really a preference thing for you.

00:42 Alright, so, now, let's take a look at what we have in front of us.

00:46 So, I've got my medication here for us. I've got an alcohol pad to clean.

00:51 I've also got the type of needle that I want to choose in regards to giving a medication intramuscular injection for my patient.

01:02 So, let's take a look at the type of needle that I have here.

01:05 This is really where we have to put a little critical thinking in for our patients.

01:10 So, we first have to decide, what gauge is appropriate or the diameter of the needle.

01:16 So, we typically call this a gauge.

01:19 So, with an intramuscular injection, it could be anywhere from about 23 to 25 gauge size of needle.

01:27 So, we need to decide this for our patient.

01:29 What's going to also matter is the viscosity or the thickness of the medication we give.

01:35 So, this is something we need to consider.

01:37 Also, next, we need to think about the length of the needle.

01:41 This could be anywhere from 5/8 for someone quite a bit smaller or maybe even one inch.

01:48 One inch is pretty standard in length but if you have someone with maybe a really wide or really big deltoid that you're gonna give the injection in, you may need even a one and a half inch. So, you wanna assess your patient.

02:02 Alright, so, now, I'm gonna start with my needle and really think through our choices in regards to picking what needle you would like to use.

02:10 So, we've got our needle first.

02:12 Then, now, I've got a small syringe here and this can range from one to three mL's depending on how much medication you're gonna give.

02:20 Then, notice here what's a little bit different is I have a blunt fill needle.

02:24 So, one thing I want you to really keep in mind anytime you're gonna go into the intramuscular location on a patient, you do not want to poke this rubber stopper with the same needle that you're gonna poke your patient with.

02:41 So, it's really important to switch. Alright, so, let's take a closer look at that.

02:46 So, I've got my medication vial here and I've already popped the top.

02:50 Even if it's a brand new vial, I wanna make sure to clean the top of this thoroughly with an alcohol pad.

02:57 There could be microbes, just dirt, or debris, so, we don't wanna inject this in our patient, so, we wanna clean this off.

03:11 Okay, so, now, I'm gonna take my syringe and open that.

03:16 Notice that I'm careful not to touch with my hands the ends of this as well.

03:25 So, I'm gonna take my blunt fill needle because this is what I'm going to poke the rubber stopper and when I open up my injection supplies, notice I peel back and I'm really conscious not to touch anything on the table or touch anything with my hands.

03:41 So, I'm gonna take this and I'm going to go end-to-end to keep this clean and screw this on.

03:49 Alright, so, now, I can get rid of that. Okay, so, now, I have my blunt tip needle.

03:54 Now, remember, this is the one we are not going to inject our patient with.

03:58 It is not kind. This is the one we're gonna puncture the rubber stopper, and so, we're going to use this to draw up our medication.

04:06 Alright, so, first thing's first is I'm gonna take my plunger and pull back slightly on at least the amount of medication that I need and you can even pull back a little bit more air.

04:17 This is going to help us fill the syringe much more smoothly when you're drawing up your medication and eliminate some of those air bubbles.

04:27 Alright, so, I'm pulling back here and I'm uncapping my blunt fill.

04:33 Okay, so, as you can see, you don't wanna inject anybody with this.

04:37 So, I'm gonna take this so I can steady myself and also, steady my medications.

04:42 Now, this is the little part that it's a little tricky.

04:45 You wanna make sure you don't poke yourself.

04:47 So, I like to kind of rest my hand down so I can make sure to hit the vial and not myself.

04:53 So, now, I'm puncturing the rubber stopper and you can see, it's a pretty good puncture and then, I'm gonna take my plunger and push down and inject the air.

05:03 Alright, so, this is where it gets a little bit tricky.

05:06 We're gonna flip this over, so, this is where it's -- this is where it's a little bit hard to handle for some students.

05:14 You wanna keep a hold of your needle.

05:16 You also wanna keep a hold of your medication.

05:19 So, one really important thing when drawing up medication that can definitely help you eliminate air is make sure the top of your needle is below the level of the liquid of fluid.

05:31 So, what I mean by that is make sure your needle when you're drawing up medication is in the actual liquid and not in the air in the vial.

05:41 Alright, so, now, I'm gonna pull back my 0.5 or 1/2 mL.

05:45 I can pull back on my plunger slowly, make sure this is nice and filled.

05:55 And you can see it's doing it a little bit slowly.

05:59 It could because this has been punctured before and that's okay.

06:02 So, we're just gonna keep continually pulling back and I need to make sure I'm below the level of my liquid.

06:14 And now, if I pull passed what I need, see how much air I have in there, you can come back, push the plunger and then push it to where the desired amount is.

06:26 That way, you can eliminate all those air bubbles.

06:29 The other thing you may see a nurse do is take their finger if there's a little bit of air bubble in there and tap and hit those air bubbles out just to make sure those aren't in the injection.

06:40 So, now, I have my desired amount. Okay, so, now, I'm gonna take this out.

06:45 I'm gonna pull this out here. Now, this is really important.

06:49 We need to recap this. So, when I do this, I wanna use a one-handed technique.

06:55 A big, big no-no for students is to try to recap in the air.

07:00 As you can already see if I miss, if I get in a hurry, I could stab myself and miss the cap.

07:06 So, this is what we do not wanna do.

07:08 Needle sticks are a really big problem for nursing and this is something we wanna eliminate.

07:13 Alright, so, I'm gonna put this on the table.

07:15 I'm gonna take my hand and one-handed scoop the cap.

07:19 Alright, so, notice that I make sure my needle is inside the cap.

07:26 I'm gonna guide this along and you can see it's on here and I'm gonna take the sides just to be careful not to touch the needle and make sure that clicks down for us.

07:37 So, now, that's securely on here. So, you can see how long this is.

07:41 We don't -- we do not want to inject our patient with this.

07:44 So, now, I'm gonna switch needles.

07:49 Now, I've got here the needle that I wanna inject my patient with.

07:55 Notice that I don't touch this part because this is sterile and now, I can just change out the needles that I need to go inject my patient.

08:06 So, now, I can take this out of the package because I have a sheath on here. It's ready to go.

08:12 I've got my safety device and now I'm ready to go administer my medication.