skin and joint injections Flashcards
(22 cards)
risk of infection depends on what factors
pathogen type route/type of exposure amount exposed to amount of infected blood exposed post exposure Tx specific immune response
When do majority of needle stick injuries occur
during use and immediately after use or before disposal
What are 2 common problems when giving someone an injection
fainting
allergic reaction
major contraindications to injections
known hypersensitivity to drug, skin is inflamed, irritated or infected
if the patient is pregnant or breast feeding
stopper is latex and patient is allergic to latex
is informed consent required for all injections
yes
What is included in pre-procedure patient education
indications, potential risks, complications and side effects, alternatives and potential outcomes
what are the 3 types of cutaneous injections
intradermal
subcut
intramuscular
what are most intradermal injections
diagnostic purposes like TB
1 cc with 27 gauge 1/2” needle
how are subcutaneous injections given
45-90 degree for slow sustained absorption
1-3 cc with 23-25 gauge 1/2- 5/8” needle
How are intramuscular injections given
well perfused m at 90
rapid systemic action
vaccines like HepA/B MMR DPT
3 cc 21-25 gauge 1-1.5”
What is the most common complication of giving injections
vasovagal syncope
what are the absolute contraindications for joint injections
local cellulitis septic arthritis acute fracture bacteremia joint prosthesis achilles or patella tendinopathies
what is a fast acting local anesthetic
lidocaine
what is the longer acting local anesthetic
bupivacaine (marcaine)
what anesthetic do we use for nerve blocks
bupivacaine
what is a short acting corticosteroid
hydrocortisone
what articular conditions are treated with steroids
RA, OA, Gout, Ankylosing Spondylitis, Reite’s syndrome, Psoriasis
what mechanisms are corticosteroids believed to help articulations
increase viscosity of synovial fluid
alterations in neutrophil chemotaxis and function
stabilization of cellular lysosomal membranes
alterations in synovial permeability
changes in synovial fluid leukocyte count and variability
what are some of the bad adverse consequences of corticosteroids in joints
may accelerate normal aging and cause prearticular calcification
tendon rupture
what position is the patient in for a joint injection
supine
65% of dorsal wrist ganglion arising from what joint
scapholunate
what forms the triangle for injection or aspiration of the elbow
lateral olecrenon, head of radius and the lateral epicondyle
