NEVER recap needles after giving an injection. When possible, IM injections should be avoided in muscles that are emaciated or atrophied because these muscles absorb medication poorly.5, Aspiration before injection and slow injection of the medication are not supported by research for vaccine administration.2 The vastus lateralis and deltoid muscle are the only two sites recommended for vaccine administration because these sites do not contain large vessels that are within reach of the needle.2 For all other medications, there is no evidence to either support or abandon the practice of aspiration before administration. Want to create or adapt OER like this? Abbreviations: DEN4CYD = dengue vaccine; DT = diphtheria and tetanus toxoids; DTaP = diphtheria and tetanus toxoids and acellular pertussis; HepA = hepatitis A; HepB = hepatitis B; Hib = Haemophilus influenzae type b; HPV = human papillomavirus; IIV = inactivated influenza vaccine; IM = intramuscular; IPV = inactivated poliovirus; LAIV = live, attenuated influenza vaccine; MenACWY = quadrivalent meningococcal conjugate vaccine; MenB = serogroup B meningococcal vaccine; MenCY = bivalent meningococcal conjugate vaccine component; MMR = measles, mumps, and rubella; MMRV = measles, mumps, rubella, and varicella; MPSV4 = quadrivalent meningococcal polysaccharide vaccine; PCV13 = pneumococcal conjugate vaccine; PPSV23= pneumococcal polysaccharide vaccine; RV1 = live, attenuated monovalent rotavirus vaccine; RV5 = live, reassortment pentavalent rotavirus vaccine; RZV = recombinant adjuvanted zoster vaccine; Subcut = subcutaneous; Td = tetanus and diphtheria toxoids; Tdap = tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis. 9. Consider the type of medication and the age, condition, and size of the patient when selecting an IM site. A new generation of jet injectors with disposable cartridges and syringes has been developed since the 1990s. Collaboration with the practitioner helps determines which methods will help best reduce pain before injection. Response to vaccines recommended by the subcutaneous route is unlikely to be affected if the vaccines are administered by the intramuscular rather than subcutaneous route. Allow the skin to dry completely. IM .. Haemophilus influenzae type b (Hib) 0.5 mL IM Hepatitis A (HepA) 18 yrs: 0.5 mL IM 19 yrs: 1.0 mL Hepatitis B Prepare medication from an ampule or a vial as per hospital policy. (2022). U.S. Food and Drug Administration (FDA). 2022-2023 Targeted medication safety best practices for hospitals. 19. The total daily dose is 750 mg every four hours, or 3,000 mg per day. Data source: CDC, 2013, 2015; Perry et al., 2014. deltoid are 1.0 ml each for an adult. Compare the medication label with the MAR one final time at the patients bedside.

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