If the muscle injection site is selected in the deltoid muscle of the upper arm, what are the precautions?

With the development of medicine, the change of disease spectrum and the emergence of a large number of new generation antibiotics, intravenous administration has been widely used in clinical work, but intramuscular injection still has its irreplaceable advantages. If we don't pay enough attention to it, it will also cause many bad consequences, especially in special circumstances. My nursing experience for many years is summarized as follows.

1 First, strictly observe the following injection principles.

(1) Seriously implement the check system and do a good job of "three checks and seven pairs"; (2) Strictly abide by aseptic operation procedures to prevent infection; (3) Select the appropriate syringe, needle and correct injection site; (4) Correct injection method: master the painless injection of "two quick and one slow" and observe the drug reaction after injection.

2 Matters needing attention in intramuscular injection under special circumstances

2. 1 intramuscular injection of children's gluteal muscles is underdeveloped, and improper posture is easy to hurt blood vessels and nerves. The position is that the fingertip and the middle fingertip are placed in the triangle formed by the anterior superior iliac spine and the lower edge of iliac crest respectively. When injecting, insert the needle vertically for a short distance, and push the liquid medicine faster to prevent the child from breaking the needle.

2.2 cachexia patients, due to the extreme consumption of subcutaneous fat and thin muscle layer, pick up the skin at the puncture site with their left hand during injection and inject drugs slowly to prevent the accumulation of liquid medicine.

2.3 Patients with hematological diseases, such as hemophilia and aplastic anemia, have disorder of coagulation mechanism and prolonged coagulation time due to lack of coagulation factors. Generally, injections should be avoided as much as possible. When necessary, the puncture site should be pressed for a long time after intramuscular injection, and it should not be rubbed.

2.4 Edema patients are common in patients with severe heart, liver and renal insufficiency. Due to the accumulation of too much fluid between tissues, the skin is swollen and shiny. When injecting, eat with your left hand, tighten the skin with your middle finger staggered downwards, quickly insert the needle, and then press the eye of the needle hard after injection to prevent exudation.

2.5 Obese people and obese people injected with highly irritating drugs have a thick subcutaneous fat layer, and the liquid medicine injected into the fat layer is not easy to absorb, which affects the therapeutic effect. In order to reduce local irritation, both of them should be injected into the deep muscle, usually with No.7 needle, and the liquid medicine should be reinjected without drawing blood.

2.6 There are scars at the injection site. Dermatologists should try to avoid scars and skin diseases during injection. Because the liquid medicine in the scar is not easy to be absorbed, the mold in the skin disease is easy to be brought into deep tissue and cause infection.

2.7 "Fear of needles" psychological person should straighten up before injection, do a good job of explanation, distract attention during injection, and slowly push medicine to relieve pain and prevent needle halo. In clinical nursing work, if we can pay attention to the above points, I believe it will reduce adverse reactions and help patients recover.