Injection safety

Needles and syringes are used for prevention as with vaccines, diagnosis to administer contrast material, radioactive isotopes, and blood tests, and treatment with antibiotics, chemotherapy, insulin, sedatives, pain medicines, and fluids.



The WHO estimates that worldwide more than 16 billion injections are given each year, making injections one of the most common medical procedures.



Injection safety is an important component of care with infection control practices that must be carried out.



If safe injection practices are not followed the transmission of blood-borne pathogens and other types of infection can result.



There are four types of needle insertion:


subcutaneous, intravenous, and intradermal injection, intratissue.



Injection refers to the act of putting a liquid, especially a drug, into a person’s body using a needle  and a syringe.



Injection is a technique for delivering drugs by parenteral administration, referring to an administration route other than through the digestive tract.



Parenteral injection includes subcutaneous, intramuscular, intravenous, intraperitoneal, intraosseous, intracardiac, intraarticular, and intracavernous injection.



Injection  administrations usually  as a bolus, but can possibly be used for continuous drug administration as well.



Depot injections are long-lasting.



The use of an indwelling catheter is generally preferred instead of injection in case of more long-term or recurrent drug administration.



95% of injections are administered in curative care, 3% are for immunization, and the rest for other purposes, such as blood transfusions.



The injection process includes a small puncture wound to the body, accompanied by varying degrees of pain depending on injection type and location, medication type, needle gauge, the skill of the individual administering the injection and the sensitivity of the individual being injected, fear of needles.



The injection process is a common phobia and proper antiseptic measures should be used.



Intravenous injections (IV injections) involve needle insertion directly into the vein and the substance is directly introduced into the bloodstream.



This route is the fastest way to get the desired effects since the medication moves immediately into blood circulation and to the rest of the body.



The intravenous injection route is the most common and often associated with illicit drug use because of the rapid effects.



Intramuscular injection delivers a substance deep into a muscle, where it is 


quickly absorbed by blood vessels. 



Common muscle injection sites include:  the deltoid, vastus lateralis, and ventrogluteal muscles.



Most inactivated vaccines are given by IM injection.



With subcutaneous injection (sc) , medication is delivered to the tissues between the skin and the muscle.



With sc injection absorption of the medication is slower than that of intramuscular injection. 



The usual site of administration is fat tissues behind the arm. 



Common sc injections include: 


EpiPen®, Insulin vaccines including the MMR vaccine (measles, mumps, rubella), varicella vaccine (chickenpox), and zoster vaccine (shingles) are given subcutaneously.



Intradermal injection, refers to medication delivered directly into the dermis, the layer just below the epidermis of the skin. 



Intradermal injection medication absorption takes the longest from this route compared to intravenous, intramuscular, and subcutaneous injections. 



Intradermal injection  are often used for sensitivity tests: tuberculin and allergy tests, and local anesthesia tests. 



Intradermal injections are usually placed in the forearm and lower back.



A depot injection may be subcutaneous, intradermal, or intramuscular.



A depot injection deposits a drug in a localized mass, from which it is gradually absorbed by surrounding tissue. 



It allows for the active compound to be released in a consistent way over a long period. 



Depot injections are usually either solid or oil-based, may be available as certain decanoate salts or esters. 



Depot injection advantages include: increased medication compliance,  and more consistent serum concentrations. 



Depot injection disadvantage is that the drug is not immediately reversible due to its slow release.



The pain of an injection may be lessened:prior application of ice or topical anesthetic; simultaneous pinching of the skin;coughing during an injection; distraction.



Sterile needles should be used each time.



Needles should not be shared.



Aseptic technique should always be practiced when administering injections. 



Aseptic practices and procedures include: barriers such as gloves, gowns and masks for health care providers, sterile instruments, and equipment, contact guidelines to avoid touching non-sterile surfaces with sterile items, and environmental controls.



Needles should be disposed of in sharps containers, to reduce the risk of accidental needle sticks and exposure to other people.



Unsafe injection practices can lead to transmission of Hepatitis B and C, HIV, and bloodstream infections.



Reusing of needles puts people at risk for diseases: HIV, Hepatitis B, and Hepatitis C.



Risks for poor collection and disposal of dirty injection equipment exposes healthcare workers and the community to the risk of needle stick injuries. 



Healthcare professionals should use safety syringes or alternative methods of administering medicines whenever possible.



Unsafe injections cause an estimated 1.3 million early deaths each year.



There is a rising prevalence of supervised injection sites, providing clean needles, safe space with clinicians and life saving support if needed. 



Such safe injection sites are associated with lower overdose mortality, ambulance calls, and HIV infections.






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