1 of 17

PROPER MEDICATION ADMINISTRATION LAB

Jennifer Volberding PhD, LAT, ATC, NREMT

Professor

Department Chair Athletic Training

Athletic Training Program Director

Oklahoma State University Center for Health Sciences

​

2 of 17

CONFLICT OF INTEREST

  • No Disclosures

3 of 17

LEARNING OBJECTIVE

  • Apply appropriate medication administration techniques for common medications

4 of 17

SIX RIGHTS OF PATIENT MEDICATION ADMINISTRATION

  1. Right patient
  2. Right medication
  3. Right dose
  4. Right route
  5. Right time
  6. Right documentation

​

5 of 17

DRAWING MEDICATION OUT OF VIAL

  • Get Ready
    • Gather supplies: medicine vial, alcohol pad, sharps container
  • Check Your Medication
    • Check label
    • Check date
    • If vial is a powder mix, mix
    • If multi-use write date of opening
    • Look at medicine: change in color, small pieces floating, cloudiness, etc
  • Ge the Vial Ready
    • Take cap off
    • Wipe the rubber top with an alcohol pad

​

6 of 17

DRAWING MEDICATION OUT OF VIAL

  1. Hold ampule upright between thumb and fingers
  2. Shake downward or gently tap the top until all medication is below the neck of the ampule
  3. Place ampule upside down
  4. Take syringe (do not prefill with air) and insert needle into the ampule
  5. Draw medication, keeping the needle tip below fluid level
  6. Draw slightly more medication than needed, keeping the needle tip below fluid level in ampule
  7. Remove needle from ampule; hold syringe upright
  8. Tap or flick the syringe to dislodge air bubbles and allow them to collect at top of syringe
  9. Depress the plunger until the top edge of black disk is located on proper dosage level for administration
  10. Dispose of needle used to draw medication and attach needle for medication administration

7 of 17

STEPS FOR ADMINISTERING SUBCUTANEOUS INJECTIONS

  1. AT first uses proper PPE
  2. AT checks patient six rights for medication
  3. AT properly prepares and draws medication
  4. AT selects proper needle for administration––a 25 to 27ga needle with a length of 1/2 to 5/8 inches in length––and attaches to the syringe.
  5. AT cleans the site following established aseptic techniques
  6. AT proceeds to pinch an approximately 1-inch fold of skin between thumb and forefinger
  7. AT positions needle at 45° angle to the skin, inserts it into the pinched skin, and injects medication
  8. AT withdraws the syringe, engaging the needle’s safety cap, and disposes in sharps container
  9. AT reassesses patient to determine whether intervention is having desired effect

​

8 of 17

STEPS FOR IM INJECTIONS

  1. Selection of the right medication
  2. Selection of proper site based on dose to be given
  3. Properly draw up the medication and prepare the injection site
  4. Selection of proper gauge and length of needle
  5. Stabilize skin over selected site
  6. Place needle at a 90° angle to the skin
  7. Insert needle, then draw back on the syringe slightly, checking for blood
    • If no blood, then administer medication
    • If blood is aspirated into syringe, do not inject; remove and start over
  8. Place adhesive bandage over site
  9. Reassess patient for effects of medication

​

9 of 17

GLUCAGON ADMINISTRATION

  • Either prefilled syringe or powder to be mixed.
    • Powder will be in bottle with syringe filled with sterile water to mix with.
    • Push water into bottle and shake before pulling medication out.
  • After administration always turn the patient on their side as they will vomit. Be prepared to utilize suction.
  • Only inject once. After 15 minutes, EMS personnel or the ED may provide a section injection.

10 of 17

NALOXONE ADMINISTRATION

  • Insert tip into one nostril until your fingers on either side of the nozzle are against the bottom of the person’s nose
  • Press plunger firmly to give full dose
  • Dosages can be given every 2 to 3 minutes until the patient responds or advanced medical care is available

11 of 17

EPIPEN ADMINISTRATION

1

Check expiration

2

Look at the orientation of the pen

3

Remove blue cover

4

Place orange tip against middle of the outer thigh at a right angle

5

Push the auto-injector until it clicks

6

Hold firmly for 3 seconds

12 of 17

NITROGLYCERIN ADMINISTRATION

  • 1 tablet placed under the tongue or between the cheek and gum at the first sign of angina attack
  • 1 tablet may be used every 5 minutes as needed, up to 3 dosage
  • As a preventative measure, 1 tablet can be taken 5-10 minutes before activity
  • Do not crush, chew, or swallow the tablets

13 of 17

14 of 17

METER DOSE INHALER (MDI)

  1. Identify proper medication
  2. Check date
  3. Determine if spacer is needed
  4. Shake the MDI
  5. Tilt head back and breathe all the way out
  6. Patient places mouthpiece in mouth and seals lips around it
  7. Patient takes a deep breath, simultaneously depressing the canister, and continues inhaling for 3-5 seconds
  8. Patient holds breath for approximately 5 seconds before exhaling
  9. Breathe out slowly

​

15 of 17

16 of 17

NEBULIZER

  • Wash hands
  • Connect the hose to the air compressor
  • Fill medication cup and close cup tightly
  • Always hold mouthpiece straight up and down
  • Attach the other end of the hose to the mouthpiece and medication cup
  • Turn on nebulizer machine
  • Place the mouthpiece in your mouth keeping your lips firmly around the mouthpiece so all medication is delivered. Facemasks are recommended in children
  • Breathe through your mouth until all the medication is used (typically 5-20 minutes)

17 of 17