IPH - Hour 3 - Routes or Administration

Types of Parenteral Injections

Injection routes are defined by the target absorption tissue. Intradermal medications enter and are absorbed in the epidermis layer. Subcutaneous injections deliver medications that are absorbed in the subcutaneous fat layer. Intramuscularly injected medications are delivered deep into and absorbed in the muscle tissue. Intravenous medications enter directly into the circulatory system by way of a vein penetration.

Injections Given by Nurses

IV

The intravenous route has the most rapid onset of action. The effects of the medication are seen almost instantly. Intravenous medication can be delivered over a period of several minutes, such as an IV bolus , or over several hours with an intermittent IV drip.

IM

The intramuscular route is sometimes more beneficial than the oral route, especially when the patient is nauseous or vomiting. Muscles are vascular, and care should be taken to avoid large veins, else the medication may be introduced intravenously. When choosing a site in the buttocks or thigh, it is especially important to avoid the sciatic nerve.

subQ

Insulin is an example of a medication that is given by the subcutaneous route. The subcutaneous needle is shorter and thinner (guage) than the intramuscular needle.

ID

Intradermal medications are placed just under the skin. The most common intradermal injection is the Mantoux test which tests for past exposure to Tuberculosis. Properly injected, ID medications leave a visible bubble.

Injections Given by Physicians and Other Specially Trained Health Care Providers

Intracardial medications are injected directly into the heart.

Intralesional medications are injected into a lesion.

Intraarterial medications are injected directly into an artery.

Intraarticular medications are injected into a joint.

Even when an injection is given by another health care professional, the assigned nurse is still responsible for assessing the patient's response and reactions to that medication.