Intravenous and Intramuscular Injections Protocols

INTRAVENOUS AND INTRAMUSCULAR INJECTION PROTOCOLS 

IV INJECTION PROTOCOL

Prior to injecting:

  • Use a sterile needle and syringe
  • When drawing up medication
    • Triple check the correct drug is being used
    • Triple check the correct amount has been drawn up with the right dose
    • Make sure you have the correct patient
    • Make sure you have the correct route of administration
    • ***Nothing white goes IV***
    • Make sure you are administering the medication at the correct time.
  • Check injection site is clean and dry
  • Make sure needle is an appropriate size for the vein being injected
  • Horse must be properly restrained
  • Ensure good lighting and safe footing

To Inject:

  • Detach needle from syringe
  • Raise vein several times to ensure the vein is prominent and visible
  • Insert the needle through the skin at a 45 degree angle toward the neck in the jugular grove
  • Make sure bevel is pointing outwards
  • Once through the skin and blood is coming out flatten the angle and insert the needle all the way up to the hub
  • Once in place connect the syringe to the needle while trying to keep the hub as still as possible.
  • Once connected, draw back blood to ensure the needle is still in vein, and if still in the correct place, slowly inject drawing back several times throughout the injection.
  • ****If horse moves draw back again to ensure the needle is still within the vein****
  • Remove needle and syringe in one movement and ensure you do not touch the injection site (to prevent infection) .
  • If site continues to bleed clean area with clean/sterile swabs and apply pressure.

 

Risks and side effects 

  • Perivascular swelling (outside the vein), abscess, skin to slough off (swelling around the vein)
  • Vein thrombophlebitis (inflammation of the vein causing a blood clot with infection) caused by poor technique, multiple injections without proper preparation or horse with systemic illness. Characterized by swelling, heat and pain.
  • Intra-arterial injection (medication is injected into the artery instead of the vein) characterized by hysteria of the animal, collapse, seizure or death depending on drug. (High suspicion if blood comes out with high pressure when needle is placed into the site or removed from the vessel after injecting)
  • Haematoma forming at injection site (haemorrhage around the vein or under the skin).

 

IM INJECTION PROTOCOL

Prior to injecting:

  • Use a sterile needle and syringe
  • When drawing up medication
    • Triple check the correct drug is being used
    • Triple check the correct amount has been drawn up with the right dose
    • Make sure you have the correct patient
    • Make sure you have the correct route of administration
    • Make sure you are administering the medication at the correct time.
  • Check injection site is clean and dry
  • Make sure needle is an appropriate size for the muscle being injected
  • Horse must be properly restrained
  • Ensure good lighting and safe footing

 

To inject:

  • Detach needle from syringe (to help ensure you are not in a blood vessel when injecting).
  • Know the anatomical landmarks of the area to be injected (either neck- trapezius muscle, chest-pectoral muscle, rump- gluteal muscle).
  • Depending on the site being used for injection, either thump the site once or twice with a knuckle while holding the needle efore introducing the needle (pectoral or rump area) or pinch the skin and slide the needle in next to the pinch. The needle should be introduced perpendicular to the skin.
  • Once the needle has been inserted and the hub has been checked ensuring blood is not present, attach the syringe.
  • Once syringe is attached to the needle draw back again to ensure that the needle is not within a blood vessel.
  • ***If blood is drawn into the syringe the needle needs to be removed and replaced into another position with a new sterile needle***
  • In no blood then inject the medication, drawing back throughout the process to ensure that the needle is still clear of any blood vessels.
  • Remove the needle and syringe in one swift movement and ensure the injection site is not touched to limit any bacterial contamination.
  • If continues to bleed clean with clean/sterile swabs and apply pressure.

 

Risks and side effects of intramuscular injections

  • Injury to handlers (accidental self-injection or being hurt by the patient).
  • Injury to patient (self-inflicted trauma during or after restraint)
  • Injecting into structures other than the muscle e.g. blood vessels or damaging the nuchal ligament or spinal column in the neck or injecting into the vein.
  • Pain, stiffness or an abscess at the injecting site (VERY important to rotate the injecting site when the patient is receiving multiple injections ie “Right at night”).
  • Penicillin reaction- when injected into a blood vessel procaine will cause an extreme central nervous system reaction. Frantic and uncontrollable behavior is shown by the patient which usually lasts a few minutes.