What to look for before injecting.

1. Expiry dates
- Check the expiry dates of every product.

2. Product
- Make sure that the vial or ampoule contains the right drug in the right strength.

3. Sterility
- During the whole preparation procedure, material should be kept sterile.
- Wash your hands before starting to prepare the injection.
- Disinfect the skin over the injection site.

4. Bubbles
- Make sure that there are no air bubbles left in the syringe.

5. Sterility again
- Once the protective cover of the needle is removed extra care is needed.
- Do not touch anything with the unprotected needle.
- Once the injection has been given take care not to prick yourself or somebody else.

6. Waste
- Make sure that contaminated waste is disposed of safely.

7. Materials needed
- Vial with required liquid or solution, syringe of the appropriate size, needle of right size (im, sc, or iv) on syringe, disinfectant, gauze.

8. Step by step for vials

1. Wash your hands.
2. Disinfect the top of the vial.
3. Use a syringe with a volume of twice the required amount of liquid or solution and add the needle.
4. Suck up as much air as the amount of solution needed to aspirate.
5. Insert needle into (top of) vial and turn upside down.
6. Pump air into vial (creating pressure).
7. Aspirate the required amount of solution and 0.1 ml extra. Make sure the tip of the needle is below the fluid surface.
8. Pull the needle out of the vial.
9. Remove possible air from the syringe.
10. Clean up; dispose of waste safely; wash your hands.

9. Materials needed
Syringe of appropriate size, needle of required size, ampoule with required drug or solution, gauze.

10. Step by step for ampoules

1. Wash your hands.
2. Put the needle on the syringe.
3. Remove the liquid from the neck of the ampoule by flicking it or swinging it fast in a downward spiraling movement.
4. File around the neck of the ampoule.
5. Protect your fingers with gauze if ampoule is made of glass.
6. Carefully break off the top of the ampoule (for a plastic ampoule twist the top).
7. Aspirate the fluid from the ampoule.
8. Remove any air from the syringe.
9. Clean up; dispose of working needle safely; wash your hands.

11. Materials needed
Syringe with the drug to be administered (without air), needle (Gauss 22, long and medium thickness; on syringe), liquid disinfectant, cotton wool, adhesive tape.

12. Injecting - step by step

1. Wash your hands.
2. Reassure yourself / patient's for procedure.
3. Uncover the area to be injected (lateral upper quadrant major gluteal muscle, lateral side of upper leg, deltoid muscle). 4. Disinfect the skin.
5. Relax the muscle.
6. Insert the needle swiftly at an angle of 90 degrees (watch depth!).
7. Aspirate briefly; if blood appears, withdraw needle. Replace it with a new one, if possible, and start again from point 4.
8. Inject slowly (less painful).
9. Withdraw needle swiftly.
10. Press sterile cotton wool onto the opening. Fix with adhesive tape.
11. Check yourself / patient's reaction and give additional reassurance, if necessary.
12. Clean up; dispose of waste safely; wash your hands.

It might sound complicated but in reality it is really simple.

THREE ACCEPTABLE SITES FOR INTRAMUSCULAR INJECTIONS ARE SHOWN BELOW

A) BUTTOCK

B) LATERAL SURFACE OF THIGH

C) DELTOID REGION