Subcutaneous (SubQ) Medication Administration: Drawing Medicine out of a Vial (Nursing)

00:04 Hi, let's take a look at drawing up a subcutaneous medication injection.

00:09 So, first of all, I want you to note that I am not wearing gloves.

00:13 Now, you may have a question about this But we are actually not providing direct patient care at this point.

00:20 So, therefore, needing gloves is not necessarily a requirement.

00:24 Also, if you do wanna wear gloves, that is totally okay.

00:28 It's gonna depend also on the type of medication that you are drawing up.

00:32 So, just keep that in mind as well. Also, when we draw up medications, we are typically drawing up the medications in the medication room.

00:41 So, therefore, we are not close with the patient or not in the view of the patient.

00:45 So, that also helps as well.

00:47 Alright, so, first of all, let's take a look at our equipment.

00:50 We've got a very common subcutaneous medication injection needle.

00:55 This, if you remember from previous is an orange cap which this typically means that we are giving an insulin injection.

01:03 When you see an orange cap, this is something to think of insulin.

01:07 The great thing, it's a great safety device.

01:10 It's a great safety notification for us anytime you see an orange cap, think of an insulin needle and that should be the only thing we draw up with this.

01:19 Alright, so, we've got our needle.

01:21 Also, we've got alcohol prep pads and also, I've got my vials of medication.

01:27 So, one thing I want you to note before we draw up, so, we've got two vials here.

01:32 One of these as you can tell is our insulin.

01:35 Now, however, this one does not have a top on it like this one here with the blue.

01:41 So, anytime you go give insulin on your unit, it's very common that this is a multi-use vial.

01:48 So, just know that the cap like this may be missing when you go to get your insulin.

01:53 Or if you're opening up a new vial, you may have one that looks like this that has some sort of cap like this and before use, you simply just pop it off.

02:05 I'm just gonna take my thumb here, push it, and it very easily pops off for you.

02:12 So, again, these are multi-use vials.

02:14 So, even if I pop off the cap or the cap is missing, we always want to clean the vial off first before we puncture it.

02:23 So, I'm gonna do that now. I'm just gonna take an alcohol pad and we're gonna use this one for today.

02:32 So, remember, even if the cap was on, I would still clean the vial.

02:36 There could be dirt, there could be debris. We wanna clean this off before we put our needle in.

02:41 So, I just take my alcohol and rub this vigorously, clean off this top and let that dry.

02:50 So, now, I'm gonna take my needle, open this up, okay.

02:57 So, here's something to think about in regards to drawing up medication.

03:01 First thing is first. We wanna pull back on our plunger and then, we wanna pull back air.

03:09 That's right. I said air. Reason being is once I puncture or pull this back, I put the air in the vial.

03:16 This is gonna help us draw our medication up better.

03:19 So, I'll show you what I mean. So, let's uncap the needle.

03:23 I've got my air pulled back and notice when I do this, I'm gonna try to steady my hand and be very conscious of not accidentally sticking myself and sticking the vial.

03:37 I like to rest my hand like this just so I'm very careful.

03:41 So, I put the needle all the way in the vial.

03:43 Then, you see me push the air into the vial. Now, there's some debate about this.

03:49 Sometimes, your nursing instructor may tell you, you need to put the exact amount of air of the exact amount of medication that you're gonna draw up.

03:58 Really, the purpose of this is just to make sure that that medication pulls back smoothly.

04:04 It helps provide that pressure for that to fill the syringe when I turn this over to draw up my med.

04:11 So, that's really up to you. So, now, I'm gonna take this hand and flip this over.

04:16 So, I'm gonna pull up five units and units because I'm using an insulin syringe and insulin is typically in units.

04:23 So, now, I'm gonna take this and notice that I have to kind of use both hands.

04:28 There's a little bit of dexterity here.

04:30 So, I'm gonna take the plunger and slowly pull back this insulin amount and you can see it fill, fill, fill, fill up the top. So, this is a great tip for you.

04:42 What I typically like to tell students when they're learning this skill is if you pull back more medication as you note while I'm still in the vial than you need, this will help eliminate air bubbles that you're gonna pull up in your syringe.

04:56 Alright, so, I've pulled all the way down at least passed the 10 but I only need five units here for my medication order.

05:03 So, you will see me slowly push this plunger back up all the way to that five.

05:13 So, now, I have the medicine that I need. So, I'm gonna push this back down.

05:17 I've got my needle. Now, you notice my needle is exposed.

05:23 Here's what we do not want you to do is take this cap and recapping in the air.

05:29 As you can imagine I could stick myself, I could miss.

05:33 This is what we absolutely do not want and it's really prevalent that nurses get needle sticks in the hospital. So, we need to be really careful about this.

05:43 So, the appropriate way to recap your needle if you're in the medication administration room preparing your med is to use the one-handed scoop method.

05:52 So, note that I'm going to take my hand. I'm going to place the needle inside the cap.

05:58 It's really important that I don't put the needle on the table because this is sterile.

06:03 So, now, you see me place the needle in the cap.

06:06 I scoop the cap up and also, this is a very fragile needle and you never know, this could also puncture the cap.

06:16 So, I recommend taking your hand on the sides of the cap, not on top and pushing this down to securely until you hear the click.