The document discusses proper medication administration procedures for paramedics. It outlines the 10 rights of drug administration and various routes of administration including intravenous, enteral, parenteral, percutaneous, and others. Precautions are discussed for obtaining medications, administering injections via different routes, and documenting care.

1. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
IV therapy and Medication
Administration
Catherine Cabrera
Clinical Supervisor

2. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
10 Rights of Drug Administration
Right patient
Right drug
Right dose
Right time
Right route
Right to refuse
Right to assessment
Right to evaluation
Right to health education
Right documentation

3. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Knowing all drug administration
protocols is essential.

4. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
PPE

5. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Treat all blood and body fluids as
potentially infectious.

6. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Needle Handling Precautions
Dispose sharps in a sharps container.
“Fish Hook” when recapping.

7. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Medication Administration
and Documentation
Record all information concerning the
patient and medication
Example:
0800H Cefuroxime 250mg via IV push
given ANST.

8. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
PERCUTANEOUS DRUG administration
is drugs applied to and absorbed through
the skin or mucous membranes.

9. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Transdermal
Absorbed through the skin at a slow,
steady rate
Example:
Topical Ointment
Spray
Intradermal

10. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Place the pill or direct spray between the underside of the tongue and the
floor of the oral cavity.
Sublingual Medication
Administration

11. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Place the medication between the patient’s cheek and gum.
Buccal Medication Administration

12. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Use a medication dropper to place the
prescribed dosage on the conjunctival sac.
Eye Drop Administration

13. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Nasal Medication Administration

14. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Manually open the ear canal and administer the appropriate dose.
Aural Medication Administration

15. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Pulmonary Drug Administration
Medications are administered into the
pulmonary system via inhalation or
injection.

16. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Metered dose inhaler

17. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Endotracheal Tube
Several medications can be
administered through an endotracheal
tube

18. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Enteral Drug Administration
The delivery of any medication that is
absorbed through the gastrointestinal
tract

19. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Gastrointestinal tract

20. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
1. Oral Drug Administration
Any medication taken by mouth and
swallowed into the GI tract.
Be sure the patient has an adequate
level of consciousness to prevent
aspiration.

21. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
2. Gastric Tube Administration
Gastric tubes provide access directly to
the GI system.

22. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Confirm proper tube placement.

23. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Withdraw the plunger while observing for the
presence of gastric fluid or contents.

24. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Instill the medication into the gastric tube.

25. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Gently inject the saline.

26. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Clamp off the distal tube.

27. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Rectal Administration
The rectum’s extreme vascularity
promotes rapid drug absorption.
Medications do not travel through the
liver, and are not subject to hepatic
alteration.

28. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Parenteral Drug Administration
Drug administration outside of the
gastrointestinal tract.

29. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Syringes and Needles
Syringe Hypodermic needle

30. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Ampules
Vials
Ampules and Vials

31. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Information on Drug Labels
Name of medication
Expiration date
Total dose and concentration

32. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Obtaining Medication from a
Glass Ampule

33. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Hold the ampule upright and tap its
top to dislodge any trapped solution.

34. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Place gauze around the thin neck…

35. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
…and snap it off with your thumb.

36. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Draw up the medication.

37. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Obtaining Medication
from a Vial

38. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Confirm the vial label.

39. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Prepare the syringe
and hypodermic needle.

40. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Cleanse the vial’s rubber top.

41. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Insert the hypodermic needle into
the rubber top and inject the air
from the syringe into the vial.

42. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Nonconstituted drugs come in separate
vials. Confirm the labels.

43. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Remove all solution from the
vial containing the mixing solution.

44. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Cleanse the top of the vial containing the
powdered drug and inject the solution.

45. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Agitate or shake the vial
to ensure complete mixture.

46. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Prepare a new syringe
and hypodermic needle.

47. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Withdraw the appropriate
volume of medication.

48. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Parenteral Routes
Intradermal injection
Subcutaneous injection
Intramuscular injection
Intravenous access
Intraosseous infusion

49. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Intradermal
Injection

50. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Assemble and prepare
the needed equipment.

51. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Check the medication.

52. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Draw up the medication.

53. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Prepare the administration site.

54. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Pull the patient’s skin taut.

55. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Insert the needle, bevel up at
a 10-degree to 15-degree angle.

56. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Remove the needle and cover the puncture
site with an adhesive bandage.

57. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Monitor the patient.

58. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Subcutaneous Injection
45º

59. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Subcutaneous Injection Sites

60. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Prepare the equipment.
© Scott Metcalfe

61. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Check the medication.
© Scott Metcalfe

62. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Draw up the medication.
© Scott Metcalfe

63. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Prep the site.
© Scott Metcalfe

64. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Insert the needle at a 45-degree angle.
© Scott Metcalfe

65. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Remove the needle and
cover the puncture site.
© Scott Metcalfe

66. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Monitor the patient.
© Scott Metcalfe

67. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Intramuscular Injection Sites
Deltoid
Dorsal gluteal
Vastus lateralis
Rectus femoris

68. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Intramuscular Injection
90º

69. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Intramuscular Injection Sites

70. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Prepare the equipment.
© Scott Metcalfe

71. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Check the medication.
© Scott Metcalfe

72. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Draw up the medication.
© Scott Metcalfe

73. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Prepare the site.
© Scott Metcalfe

74. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Insert the needle at a 90-degree angle.
© Scott Metcalfe

75. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Remove the needle and
cover the puncture site.
© Scott Metcalfe

76. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Monitor the patient.
© Scott Metcalfe

77. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Summary
10 Rights
Medication Administration Routes
Medication Package
Anatomy and Physiology related to
Medication Administration

78. Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Questions?