From Big Medical Encyclopedia

INJECTION (Latin injectio throw-in; synonym injection) — a way of parenteral administration in an organism of drugs or diagnostic means (usually in the form of solutions or suspensions up to 20 ml) by their forcing under pressure on various Wednesdays of an organism by means of the syringe with a needle or other injektor.

Injections are made vnutrikozhno, subcutaneously, intramusculary, intravenously, and according to special indications — in an artery, in bodies (e.g., vnutriserdechno, vnutrimatochno), vnutrikostno, to the spinal canal and other environments of an organism.

The same as injection (see) and other ways of parenteral administration of drugs, And. are applied only when reception of necessary medicine is inside impossible or inexpedient. Indications for the choice of an injection way are: 1) need for bystry achievement of the maximum effect of medicine during the carrying out emergency treatment or in the course of resuscitation; 2) lack of a dosage form for intake; 3) disturbance of vsasyvatelny function of a digestive tract; 4) the need for dominance of a certain local action of medicine over the general resorptive (intraorganic And., local anesthesia, etc.); 5) special diagnostic testings (intradermal And. allergens, intravascular And. contrast agents at an angiography, etc.).

Equipment I. assumes knowledge and skills relating not only to the procedure, but also to rules of an asepsis, sterilization of instruments and materials for And., knowledge of properties of a number of drugs. And. in bodies, intra arterial, intra bone, to the spinal canal are rather difficult and are made by only specially trained medical personnel (see. Angiography , Angiocardiography , Miyelografiya , Puncture etc.). Equipment intravenous And. it is connected with mastering venipuncture (see) and venosektion (see).

Fig. 1. Areas of a human body where injections can be made. Areas where it is not necessary to do subcutaneous and intramuscular injections are darkened.

At the choice of body parts for hypodermic and intramuscular And. consider that in a number of zones I. drugs (except necessary local anesthesia) for various reasons are not made (fig. 1).

For production hypodermic And. the site of skin is wiped with the cotton wool moistened in alcohol then he is captured pleated and delay fingers of one hand, and other hand pierce the delayed skin with the needle which is put on the syringe with medicine. Piston pressure of the syringe make injection.

Fig. 2. The place of intramuscular injection in a buttock (an outside upper quadrant).

For intramuscular And. choose the body part with the developed muscles which is in a distance from an arrangement of large vessels and nerves — most often an upper outside quadrant of a buttock (fig. 2).

Skin over the place of an injection after its processing by alcohol is fixed fingers; pierce with the needle which is put on the syringe skin (perpendicularly to its surface), hypodermic cellulose and muscular a fascia. After that the podsasyvayushchy movement of the piston of the syringe check an extravasated arrangement of a needle (blood in the syringe is not sucked in) and then the forcing movement of the piston make injection.

The place of a puncture of skin after any kind And. process solution of iodine or for 2 — 3 min. cover with the cotton wool moistened in alcohol.

Complications at the correct carrying out And. are observed seldom and are connected generally with individual intolerance of the entered means or special reaction of the patient to pain and the procedure I. (e.g., sometimes, especially at intravenous And., faints are observed). The majority of the found complications is connected with non-compliance with rules of prescription of medicines and disturbance of the equipment I. For these reasons there can be following groups of complications: 1) acute anaphylaxis (see) and other types of allergic reactions to drugs at underestimation allergol. the anamnesis or non-compliance with rules of desensitization (see. Bezredki methods ) at introduction of vaccines and other proteinaceous drugs; 2) manifestations of collateral, excess direct or undesirable effect of the medicine at its overdose, underestimation of contraindications to it or at wrong And. one medicine instead of another; 3) the complications caused by hit of the administered drug on adjacent Wednesdays at disturbance of the equipment I. (e.g., a necrosis of fabrics at hit under skin of the calcium chloride entered intravenously, an embolism of branches of a pulmonary artery by particles of the oil solutions which got into a vein at their intramuscular or hypodermic And., etc.); 4) local inflammatory and general infectious processes because of non-compliance with rules of an asepsis.

For prevention of the complications connected with And., any kinds And. appoint only but to strict indications taking into account allergol. and pharmakol, anamnesis and assessment of all possible contraindications. The name, concentration and a dose of the entered medicine just before its fence in the syringe attentively are read on the label of a bottle or an ampoule and verified with appointment. All types And. make strictly with observance asepsises (see) that together with perfect sharpening of an edge of a needle is an important condition of prevention of pyoinflammatory complications. The possibility of transfer of causative agents of some infectious diseases, especially a virus of infectious hepatitis, is eliminated only with careful cleaning and sterilization of medical needles and syringes (see. Sterilization ), and for some categories of patients — allocation of an individual sterilizer, needles and syringes or use of syringes disposable (see. Injektor needleless , Unit-dose syringe , Syringes ).

Bibliography: Sparrows A. A., Nekrasov I. L. and Bandakov L. F. A needleless way of administration of biological drugs in an organism, M., 1972, bibliogr.: Chelidze L. N. and Dzhasha L. M. Needleless Injektor in stomatology, Tbilisi, 197 7. TT of TZh

N. I. Ivanov.