Heparin can be administered subcutaneously or intravenously delivered by direct

Heparin can be administered subcutaneously or

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Heparin can be administered subcutaneously or intravenously, delivered by direct IV injection or a continuous IV drip. Safety: Heparin should never be given IM. A continuous IV drip will require constant monitoring of the infusion rate. The abdomen is the preferred site for a subcut injection. Safety: Administer heparin slowly into the subcutaneous tissue and leave the needle in place for about 10 seconds before withdrawing it. The goal of heparin therapy is to lengthen both the PT and APTT to 1 ½ to 2 ½ times the normal range. The normal ranges and the therapeutic ranges desired for patients on anticoagulant therapy with heparin are as follows: PT Normal range: 60 to 70 seconds Therapeutic range: 90 to 175 seconds APTT Normal range: 30 to 40 seconds Therapeutic range: 45 to 100 seconds Intramuscular Injections An IM injection is an injection directly into the largest portion of a muscle, called the body of the muscle. It is used for certain types of medications, particularly those that are rapid and long lasting, such as vaccines, and medication solutions that are irritating to the subcutaneous tissue. IM injections are administered in the larger muscles of the leg and hip, and smaller volume injections are administered in the deltoid of the upper arm.
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The maximum volume to inject intramuscularly is based on the site and the patient’s muscle development: 2 to 3 mL for injecting a large ventrogluteal site (gluteus medius and gluteus minimus muscles) or a very large vastus lateralis muscle of the leg in an adult 1 to 2 mL for a ventrogluteal (gluteus minimus and medius muscles), vastus lateralis, or rectus femoris site in trim, average-size adults; older children with adequate muscle development; older adults; and thin patients 0.5 to 1 mL for small muscles in infants and small children 0.5 to 1 mL for the deltoid muscle in small children and up, through older adults Some nurses prefer to use an air-lock for the purpose of reducing irritation of the tissue along the path the needle made through the skin, subcutaneous layer, and muscle. The air-lock technique is quite simple. After drawing up the exact volume of medication, continue to aspirate 0.1 to 0.2 mL of air into the syringe. Z-TRACK. The Z-track method of IM injection prevents irritating and dark-colored medications, such as iron dextran, from leaking out of the injection site into sensitive tissues or subcutaneous tissues that may stain. It also helps to reduce the inflammation and discomfort that can be caused by the medication irritating the subcutaneous tissue. The technique achieves this by closing the needle track in the tissue, preventing seepage of medication.
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  • Fall '19
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