What are disposable syringes made of? Types of disposable syringes used in Russia
On the this moment in Russia, 70% of the sold syringes are imported. There will always be a demand for syringes, and if a domestic manufacturer appears in the region, then syringes will most likely be purchased from him, and not from imported suppliers.
For the manufacture of syringes with an injection needle, a lot of expensive equipment will be needed, and total amount the required investments for starting a business from scratch will be about 1 billion rubles. Some companies started by opening the production of disposable needleless syringes, which saved money. When the business began to make a profit, they started issuing complete set. Also, many buy imported needles for a complete set. It takes about 11-12 months to set up a syringe manufacturing business (purchase equipment, train staff, etc.).
Syringe: types and structure
In medicine, a syringe is widely used: it is used for various injections, for blood sampling, and suction of pathological contents from cavities. A modern disposable syringe can be two-component (cylinder, piston) and three-component (cylinder, piston, rubber tip lubricated with liquid for better sliding along the cylinder).
Syringes come in sizes:
- small volume (0.3, 0.5 and 1 ml). Used in endocrinology (insulin syringes), phthisiology (tuberculin syringes), neonatology, for vaccination and allergological intradermal tests.
- standard volume (2, 3, 5, 10 and 20 ml). Used for subcutaneous, intramuscular and intravenous injections.
- large volume(30, 50, 60 and 100 ml). They are used for suctioning liquids, introducing substances and washing.
The syringe has a different location of the tip on the cylinder:
- coaxial (concentric). Location in the center of the cylinder. For a syringe with a volume of 1-11 ml.
- eccentric. Side location. For a syringe with a volume of 22 ml.
There are three types of needle attachment:
- Luer - the needle is put on the cylinder.
- Luer-Lok - the needle is screwed into the cylinder.
- non-removable needle integrated into the cylinder body (usually needles with a volume of up to 1 ml).
Production technology
Production room includes several departments: cylinder and piston production line, warehouses where raw materials are stored and received.
The cylinders and pistons of the syringe are made from polymer raw materials (polyethylene, polypropylene) by casting on special machines equipped with molds. The raw materials are poured into the bunker, the machine melts the mass, and then forms the necessary parts of the syringe. After casting and cooling, the scale is applied to the cylinders by offset printing or silk screen printing. Tips are put on the pistons, after which they are connected to the cylinders. The finished syringe is sterilized and packed in blisters.
Equipment and raw materials
The production line for the production of syringes includes the following set of equipment:
- injection molding machine (injection molding machine) - from 150 thousand rubles for a used one, from 1 to 2 million rubles for a new one;
- molds (200 thousand rubles - 500 thousand rubles);
- cooling machine - from 50 to 250 thousand rubles;
- pneumatic or vacuum forming machine for packaging - from 60-90 thousand rubles;
- offset printing machine - about 300 thousand rubles;
- syringe assembly machine (up to 24,000 syringes / hour) - from 1 million rubles;
- sterilizer - about 1 million rubles;
Total: about 4 million rubles.
Required raw materials:
- polypropylene (30-75 rubles / kg). The production of 3 million syringes per month will take about 6-7 tons of raw materials, the costs will be about 400 thousand rubles;
- rubber / silicone for the cuff from the piston (from 240 rubles / kg);
- ink for printing (3-4 tons per month);
Premises and staff
The production premises, together with warehouses, should have an area of 2-5 thousand square meters. m. (depending on the volume of production), ceiling height - at least 6 meters, spans - 12 m. Naturally, communications must be carried out in the building and electricity must be connected. Location - no more than 500 meters from the nearest housing. Number of personnel on the production line:
- raw material preparation area (raw material transportation to the casting area, reception) - 2 operators, 2-3 workers;
- casting section (automatic line) - 1-2 masters;
- area for applying the scale - 1-2 operators;
- packaging area (automated) - 1-2 operators;
- sterilization area - 1-2 operators;
- quality control - 1 specialist;
- warehousing - 5-10 workers;
Total: at least 15-20 people.
Requirements
The product must be tested in Rospotrebnadzor and receive a certificate of conformity. The required syringe characteristics and test methods are described in GOST R ISO 7886-4-2009.
Investments
Initial investment (when renting premises) will amount to about 7-8 million rubles. Monthly expenses are about 3 million, income - 3.5 - 6 million rubles. The cost of a syringe without a needle is 50 kopecks -2 rubles / piece.
Cherukhina Christina
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Injection (translated from Latin - “injection”) - parenteral administration of medicinal substances (getting medicines into the body, bypassing the digestive tract). A syringe and an injection needle are required to perform the injection.
Syringe - an instrument in the form of a hollow graduated cylinder with a piston for pumping or sucking fluids, introduced into the tissues and cavities of the body.
The injection needle is intended for the introduction of drug solutions, blood sampling from a vein or artery, blood transfusion. It is used together with a syringe, as well as with a system for transfusing fluids or blood.
Single-use syringes and needles must be disposed of after a single use. Single use of an injection syringe and needle is regulated by written instructions and a special symbol international organization standardization (ISO) denoting inadmissibility reuse.
The volume (capacity) of syringes is determined by their purpose and varies according to GOST from 1 to 50 ml. Syringes with a volume of 0.3; 0.5 and 1.0 ml are used for accurate administration of drugs (tuberculin, insulin, standard allergen extracts) in small volumes - from 0.01 ml.
Components of a reusable syringe:
Cylinder (glass);
Needle cone (metal);
A piston that has a retainer and a handle (made of metal).
Components of a single-use syringe:
Cylinder with finger rest;
Needle cone;
Piston with handle (all parts are made of polymeric materials).
The injection needle is a narrow metal tube made of certain grades of steel, one end of which is cut and pointed - needle shear , and the other is tightly attached to the short muff (cannula) for connection to a syringe or elastic tube. Reusable injection needles are made entirely of metal. For single-use injection needles, the sleeve (cannula) is plastic.
The main parameters of the needle: length, diameter, sharpening angle. Needles come in various lengths (from 16 to 90 mm) and diameters (from 0.4 to 2 mm). The cutting angle of the injection needles ranges from 15 to 45 degrees.
TYPES OF NEEDLES AND SYRINGES USED FOR INJECTIONS
There are two main types of syringes and injection needles for them. A syringe is the simplest pump designed for injection and suction. Historically, Record type syringes (assembled from metal parts and a glass cylinder) and Luer type syringes (previously made entirely of glass, now made of plastic) are produced. Syringes made of glass and metal are designed for repeated use; they are sterilized. Plastic syringes are manufactured and sterilized in the factory, are used once and are not re-sterilized. Syringes of the "Record" type and the "Luer" type differ in the shape of the cannula - a sub-needle cone. The consequence of this is that the needle for the Record syringe does not fit the Luer type syringe and vice versa. Disposable syringes are packaged in sterile packaging with an injection needle.
Syringes are manufactured in various capacities - 1, 2, 5, 10 and 20 ml. Twenty-milliliter syringes are designed for intravenous infusion. One-milliliter syringes are used to administer insulin or tuberculin and have special graduations. Injection needles are also available different size, differing both in the length of the hollow metal tube, and in its diameter and the angle of the cut of the needle. Mostly disposable plastic syringes are used.
Rice. 21. Needles for injections, infusions, transfusions: but- injection needle (1 - needle tube, 2 - needle head, 3 - mandrel, 4 - dagger sharpening, 5 - spear sharpening, b - needle cut angle); b- a needle with an emphasis for intradermal injections; in- a needle with a safety bead; G- a needle with side holes for air release;
d- a nozzle to an injection needle for accession to systems of blood transfusion, etc.; e- transitional cannula for injection needles; well- Dufo needle for blood transfusion; h- Needle for taking blood.
· Needles for intradermal injections: 0410, 0415, No. 25-27 (0.9-1 cm) needle cut 5 0 .
· Needles for hypodermic injections: 0420, 0425, 0430, No. 25-27 (0.9-1.6 cm), 0620 - needle cut 30.
Needles for intramuscular injections: 0640, 0860, 0840, 1060, No. 23-25 (1.6-2.5 cm - for small muscles), No. 18-25 for adults - 2.5-3.8 cm.
· Needles for intravenous injections: 0440, 0840, 0860, needle cut 45 0 .
· Needles for blood transfusion and blood sampling: 0860, 0840.
· Insulin needles: 0410, 0415, 0420, 0430, 0440 (depending on the method of administration).
The first two digits indicate the diameter of the inner lumen of the needle in mm, increased by 10 times, the next two digits indicate the length of the needle in mm.
Needles for single use syringes have colored cannulas.
Rice. 22. Single use needles
Hypodermic needles - blue color;
Needles for intramuscular injection - green;
· Needles for intravenous administration – Pink colour;
· Needles for intradermal injection - beige.
Types of syringes
According to their purpose, the following types of syringes are distinguished:
I. Single and multiple use.
II. By volume: 1 ml, 2 ml, 3 ml, 5 ml, 10 ml, 20 ml, 30 ml.
III. By appointment:
for the administration of insulin;
for the administration of heparin;
tuberculin;
· for washing of cavities, feeding - Janet's syringe;
injectable.
Fig.23. Syringe device disposable
In the recent past, syringes were only reusable. They were subjected to compulsory sterilization. However, things have now changed. Manufacturers offer disposable syringes that have a wide range of applications, are reliable and convenient.
Invention history
Disposable syringes owe their appearance to the New Zealand veterinarian and pharmacist Colin Murdoch. During his life he received more than forty-five patents. However, Murdoch's most significant invention was the disposable medical syringe. As conceived by the veterinarian, the invention involved the acceleration and simplification of the procedure for vaccinating animals. To do this, the medicine had to be sealed in advance in the syringe.
Somewhat later, he came up with the brilliant idea that by using disposable products in medical practice, the risk of infection transmission could be minimized. The production of disposable syringes on an industrial scale was established in 1961.
Idea for business
Currently, only single-use syringes are used for medical purposes. They are essential for diabetic patients. With their help, vaccinations are carried out, intramuscular, subcutaneous, and intravenous injections are made.
However, seventy percent of this instrument, which is in demand in medical practice, is manufactured outside of our country. Consequently, the cost of these products is much higher than that for which it would be possible to sell similar products of domestic production.
It is no secret that there is and will always be a demand for disposable syringes, because no one has yet replaced injections with anything. That is why the production of disposable syringes is promising business idea. This business can bring in a good income.
The structure of syringes
In medical practice, injections, blood sampling, and suction of pathological contents from the cavities are performed using a special tool. It is a disposable syringe. At the same time, two-component syringes are distinguished by structure, consisting of a piston and a cylinder; three component tools integral part which (except piston and cylinder) is also lubricated special fluid rubber tip designed to glide more smoothly over the cylinder.
Disposable syringes may differ in the location of the tip. In some medical instruments, it is concentric, or coaxial. This means its location in the central upper part of the cylinder. Typically, this structure is typical for syringes having a volume of from one to eleven milliliters. Injection instruments with a lateral tip (eccentric) are produced. Usually these are large volume syringes (from twenty-two milliliters).
In disposable syringes, there may be different types needle attachments. There is a luer when the needle is simply put on top of the cylinder; luer-lock - the needle is screwed into the cylinder; and the non-removable type, where the needle is integrated into the cylinder body.
Dimensions
Disposable syringes differ in their volumes. This allows them to be used for various purposes.
Sizes of disposable syringes
Small volume - 0.3 and 0.5, as well as 1 milliliter. Such syringes are used in endocrinology (for insulin injections), in phthisiology (tuberculin syringes), as well as in neonatology (for taking intradermal allergy tests, as well as for vaccination).
Standard volume - 2, 3, 5 and 10, as well as 20 milliliters. As a rule, such syringes serve as a medical instrument for intramuscular, subcutaneous, and intravenous injections.
Large volume - 30, 50, 60 and 100 milliliters. Such syringes are necessary for fluid suction procedures, as well as for washing cavities and introducing substances.
Choice of direction of activity
The production of disposable syringes equipped with an injection needle will require the purchase of a large number expensive equipment. Let's say you're starting your own business from scratch. With this layout, it will take about a billion rubles to open a syringe production plant. This is an impressive amount.
Some syringe manufacturers opened lines to create this medical instrument without a needle. This allowed to reduce the amount of initial investments. Only after the business was established, they began to release a complete set. Some entrepreneurs go the other way. They buy imported needles for a complete set.
How will you do it? It all depends on financial possibilities. It is possible to organize the production of disposable syringes in eleven to twelve months. During this period, it will be necessary to purchase equipment, train personnel, etc.
Technological process
The production of disposable syringes will require special room. First of all, there must be a line dedicated to the manufacture of the piston and cylinder. At the production site, it is also necessary to fence off warehouses for receiving and storing raw materials.
For the manufacture of pistons and cylinders, polypropylene or polyethylene will be required. Parts of disposable syringes are obtained by casting. To implement this process, you will need special machines equipped with molds.
The manufacturing technology of disposable syringes is simple. First of all, raw materials are filled into a special bunker. After that, the machine melts the mass and forms the necessary parts of the product. After cooling, using the method of silk-screen printing or offset printing, a measuring scale is applied to the cylinders. At the next stage, tips are put on the pistons and connected to the cylinders. The syringe is ready. It is sterilized and packaged in blisters.
Necessary equipment
Syringe production lines must be composed of a specific set of machines. Among them are the following.
Injection molding machine. This is a machine designed for casting, the cost of which is one hundred and fifty thousand (when buying previously used equipment), or one or two million rubles (new equipment).
Molds, for the purchase of which you will need from two hundred to five hundred thousand rubles.
A machine designed for cooling (50-250 thousand rubles).
Vacuum forming or blow molding machine for packaging finished products(60-90 thousand rubles).
Offset printing machine (approximately three hundred thousand rubles).
A machine that assembles disposable syringes with a capacity of up to 24,000 units per hour (from one million rubles).
Sterilizer (about one million rubles).
Thus, equipment for the production of syringes will cost approximately four million rubles.
Purchase of raw materials
The production of disposable syringes will require the purchase of the following materials:
Polypropylene (from 30 to 75 rubles per kilogram). In order to produce three million syringes per month, six to seven tons of this raw material will be required. In this case, the costs will amount to about four hundred thousand rubles.
Silicone or rubber for piston cuffs (from two hundred and forty rubles per kilogram).
Paints for printing (three-four tons per month).
Selection of premises and required staff
The production area intended for the production of disposable syringes must be at least two to five thousand square meters. A certain ceiling height must be observed. It must be at least six meters. You will also need to observe the width of the spans (at least 12 meters). The building must be equipped with a network engineering communications and located no further than five hundred meters from residential buildings.
It is necessary to put two operators and three workers on the site where the preparation of raw materials is carried out. Behind technological process The automatic casting line must be supervised by two masters. One or two operators will need to be taken to the area where the scale will be applied. One staff unit should be located in the packaging, sterilization and quality control area. In stock finished products it will take five to ten workers.
Required documents
The goods produced by you must be tested in Rospotrebnadzor, where a certificate of conformity will be issued for it. Required characteristics syringes, as well as methods for their testing are described in GOST R ISO 7886-4-2009.
^ Scheme of the structure of a disposable syringe
A disposable syringe consists, like a glass one, of a cylinder and a piston rod (collapsible or non-collapsible). The cylinder has a Luer-type cone tip (Record syringes can be produced on request, they are practically not produced), a finger rest and a graduated scale. The rod-piston assembly consists of a rod with a stop, a piston with a seal and a reference line.
Depending on the structure of the piston rod, the design of disposable syringes
Subdivided into 2-component (Fig.) and 3-component (Fig.). In 2-component syringes, the rod and piston are a single whole, in 3-component syringes the rod and piston are separated. The main functional difference between these designs is the characteristics of lightness and smoothness of the piston. Disposable syringes can also be coaxial and eccentric (Fig. 18), which is determined by the position of the cone tip.
Rice. 18. Disposable syringes coaxial (1) and eccentric (2)
Fig.19. Syringes disposable eccentric.
The capacity of syringes is determined by their purpose and ranges (GOST) from 1 to 50 ml. In practice, the range of volumes of disposable syringes ranges from 0.3 to 60 ml. Syringes with a volume of 0.3; 0.5 and 1.0 ml are used for accurate administration of drugs (tuberculin, insulin, standard allergen extracts) in small volumes - from 0.01 ml.
P 
The industry produced sterilizing cases for storing and sterilizing syringes. They were sometimes called syringe stacks. were very widespread in various field conditions. Today they have been replaced by disposable syringes, but you can still meet them in your practice.
Fig.20. Cases-sterilizers for storage and sterilization of glass syringes.
^ Medical needles
Stabbing or piercing-cutting instruments in the form of a thin rod or tube with a pointed end. In addition, they produce special ligature needles .
Depending on the purpose, medical needles are divided into:
injection,
puncture biopsy,
surgical.
Injection needles are designed for the introduction of drug solutions, blood sampling from a vein or artery, blood transfusion. They are used together with syringes, as well as systems for transfusion of liquids or blood. The injection needle is a narrow metal tube made of certain grades of steel, one end of which is cut and pointed, and the other is tightly attached to a short metal sleeve for connection to a syringe or elastic tube ( inner diameter head holes for syringes "Record" - 2.75 mm, for Luer type syringes - 4 mm). Sterile disposable injection needles are becoming more and more common. Their use dramatically reduces the risk of infectious complications, they are convenient and do not require preliminary sterilization. The main significant parameters of the needle are length, outer diameter, sharpening angle and puncture force. The needles have different lengths (from 16 to 90 mm) and diameters (from 0.4 to 2 mm):
for intradermal injection, a needle 16 mm long and 0.4 mm in diameter is used,
for subcutaneous injection, a needle 25 mm long and 0.6 mm in diameter is used,
for intravenous injection, a needle 40 mm long and 0.8 mm in diameter is used,
for intramuscular injection a needle 60 mm long, 0.8-1 mm in diameter is used.
Rice. 21. Needles for injections, infusions, transfusions: a - injection needle (1 - needle tube, 2 - needle head, 3 - mandrel, 4 - dagger sharpening, 5 - spear sharpening, - needle cut angle); b - a needle with an emphasis for intradermal injections; in - a needle with a safety bead; g - needle with side holes for air release; e - attachment to the injection needle for connection to blood transfusion systems, etc.; e - transitional cannula for injection needles; g - Dufo needle for blood transfusion; h - a needle for taking blood.
The cutting angle of injection needles ranges from 15 to 45° depending on the execution task:
15-18° for injection needles,
30° at needles for inserting catheters into a vein, for spinal puncture,
30 and 45° for short-bevel needles for the introduction of radiopaque substances
The needles have a spear-shaped or dagger sharpening. The outer diameter of the needle ranges from 0.4 to 2 mm, length - from 16 to 150 mm. The number of the needle corresponds to its dimensions (for example, No. 0840 means that the diameter of the needle is 0.8 mm, the length is 40 mm). 
Fig.22. A - disposable needles with
Different designs of cannula with case.
IN - various options needle sharpening,
Produced by industry.
The IV needle is cut at a 45° angle, while the hypodermic needle has a sharper cut. The needles must be very sharp, without burrs. (fig.21). The point of the needle is sharpened in 3 planes (spear-shaped sharpening), which ensures that the piercing effect prevails over the cutting one when puncturing tissues. The protective cap protects the needle from external damage and ensures safety when handling it. On the packaging, the type of cut of the needle is indicated by a special symbol ©. In this case, the needle is average length cut and is intended for intradermal administration of drugs.
The characteristics of the injection needle are important. The ease of tissue penetration (penetrating force), the accuracy of hitting certain anatomical structures, the stability of the position of the needle in the vessels, the degree of tissue trauma, and hence the pain of the injection depend on them. The listed characteristics of the needle in certain cases, along with the cost, determine the choice of the entire kit (syringe + needle).
The following requirements apply to a good injection needle:
minimum force for puncture,
longitudinal resistance to bending (elasticity),
strength, stability of connections with a syringe,
minimum roughness of the outer surface and sharpening area.
Puncture force
The force required for a puncture is determined by various factors, including design and production. This indicator depends on the shape and quality of the tip and cut of the needle, as well as on its diameter and special surface coating. A poor-quality cut can capture microfragments of the skin. With an increase in the diameter of the needle from 0.5 mm (insulin syringe needle - orange cannula) to 0.8 mm (standard needle - green cannula), the puncture force increases by 1.5 times. The best glide of the needle at the moment of puncture is achieved by applying a silicone coating to the surface of the needle, which is used by most manufacturers, including large domestic ones.
^ Packing needles
Needle packaging should provide:
maintaining the sterility of the contents when stored in dry, clean, properly ventilated areas;
minimal risk of contamination of the contents at the time of its opening;
adequate protection of the contents under normal storage and transport conditions;
creation of conditions under which the opened package cannot be re-closed without much effort, and the fact of opening is obvious.
When choosing injection devices, preference should be given to syringes in a two-part package, since when the paper part of the package is torn, packaging paper fibers are found on the parts of the syringe and needle. If the package consists of two parts, it is necessary to follow the opening method indicated on it.
^ Safe manipulations (injections)
Improving injection devices, first of all, they have in mind ensuring their safety for both the patient and the nurse. According to the World Health Organization, the world produces about 12 billion injections. Different kinds injections are an invasive procedure that is recognized as the most common in the world.
According to the American Nurses Association, between 600,000 and 1 million cases of medical needle injuries have been reported in the United States, which is the cause of at least 1,000 new cases of HIV infection, as well as viral hepatitis "B" or "C" . The risk of infection is:
with HIV infection 1 case per 300 contaminated needle injuries (1:300),
with viral hepatitis "C" -1:30.
with viral hepatitis "B" - 1:3
Reuse of injection equipment, according to various estimates, leads to infection:
from 8 to 16 million people with hepatitis B virus,
from 2.3 to 4.7 million - hepatitis C virus,
from 80 to 160 thousand people leads to HIV infection.
IN 
1987, WHO, through the Expanded Immunization Program, launched a call for the introduction of technologies to prevent the reuse of disposable syringes. As a result, original mechanisms appeared that made it possible to block and partially destroy a disposable syringe after its use. One of the most popular self-locking disposable syringe designs is the V-clip. (Fig. 22). After a set of the drug and its complete introduction, the clip blocks the piston rod in the position of maximum displacement, which makes it impossible to reuse such a syringe. Self-locking syringes are widely used in mass immunization. Today, disposable syringes supplied by UNICEF are produced in a self-locking version.
Fig.22. Self-locking syringe.
There is another common way to prevent the reuse of a disposable syringe - this is its self-destruction when the contents are expelled from it, which is provided by cutting edges or blades built into the piston rod that damage the syringe barrel. As a result, a disposable syringe no longer performs its functions, and therefore is not suitable for further use.
In the United States, in 2000, the Federal Needle Safety and Accidental Injury Prevention Act was signed by the President and has the force of law. In this document, medical needles are categorized as potentially dangerous objects, identifying risk factors and providing access to safe tools.
Currently, safe syringes are produced, which are standard injection devices equipped with special protective screens, which, after use, close the needle, protecting the nurse from subsequent contact with the tip. The syringe is then discarded.
But all the advantages of safe injection instruments created and produced by the industry lose their significance if they are further processed, which involves washing, detaching the needle, rinsing the instruments after soaking, etc. Thus, safety is ensured not so much by the design of the tool, but by a whole range of preventive measures.
^ List of some special purpose syringes
Anel's syringe (historical D. Anel) - a collapsible syringe for washing the nasolacrimal duct, having a ring at the end of the piston rod and three cannulas - straight, slightly curved and strongly curved. Currently, the industry is not produced.
Brown's syringe (C.R. Braun, 1822-1891, Austrian gynecologist) - a syringe with a capacity of 2 or 5 ml with a metal tip 15 cm long, slightly curved at the end, used for intrauterine infusions.
Guyon's syringe (J.C.F. Guyon) - a syringe with a piston moving in the cylinder with the help of a screw, with each half-turn of which one drop of the contents is released. Designed for instillation in the back of the urethra and bladder.
Syringe jane (J. Janet) is designed for washing, characterized by a significant capacity (100-200 ml). At the end of the stem and on the ring around the glass cylinder, there are soldered rings for ease of operation.
Luer syringe (Luer) - an injection syringe made entirely of glass and having a larger tip cone diameter (4 mm) than metal syringes (2.75 mm).
Continuous syringe designed for massive infusions, having a lateral cannula with check valve through which the injected liquid enters the syringe barrel.
Syringe Polikarpov (S.N. Polikarpov, Soviet surgeon) continuous action with a hollow piston having a valve that opens during suction and closes during discharge. It is mainly used for local anesthesia.
Syringe machine equipped mechanical device, providing a given depth of tissue puncture with a needle and the introduction of a given volume of liquid.
Syringe tube (syn. siretta) - a disposable device for the administration of drugs subcutaneously or intramuscularly, consisting of an elastic container filled with an injected liquid and connected to a sterile injection needle, hermetically sealed with a mandrin cap.
Injections
Injections- parenteral administration of medicinal substances (the entry of drugs into the body, bypassing the digestive tract). (give a scheme for injections of various ones, we had it!)
The main advantages of this method of drug entry into the body are the speed of their action and the possible accuracy of dosage. The negative side is the possibility of developing various complications, since these manipulations require, albeit minimally, damage to the integument (skin, mucous membranes, etc.). Depending on the type of injection, one or another type of complication or their combinations may develop.
Injections are most often carried out in adapted rooms - the treatment room of a hospital or clinic, but it is possible to perform in a ward or at home, when a health worker visits the patient. In emergency situations, they are also performed at the scene. It all depends on the situation and need. For example, if a patient suffering from insulin dependence diabetes do not administer insulin in a timely manner, it is impossible to exclude the development of coma and even death.
For injections, syringes (see section syringes) and needles (see section needles) are used. The syringe must be airtight, i.e., do not allow air and liquid to pass between the cylinder and the piston. The piston should move freely in the cylinder, tightly adhering to its walls.
Before you fill the syringe with medicine, you must carefully read its name to make sure it is appropriate for the intended purpose. (diagram of action and photo) There is a procedure for preparing and performing various manipulations. For each manipulation we try to show step by step actions, which should facilitate familiarization with various manipulations and their implementation in practice.
^ Algorithm for performing manipulation a set of medicinal solution from an ampoule
Target
Perform an injection.
Indications
Injection methods of administering medicinal solutions.
Equipment
Disposable syringe.
Disposable sterile rubber gloves.
Sterile tray.
Sterile tweezers.
Medicines in ampoules.
List of appointments of the procedural sister.
Container with 0.25% aqueous solution of gibitan.
Files.
Bix with sterile dressing material;
Bottle with 70° alcohol.
Container for used needles.
Container for used material.
Prepare everything necessary equipment and prepare yourself for the procedure.
Wash your hands.
Take the ampoule and carefully read the name of the medicinal solution, dose, expiration date.
Check the label information with your doctor's prescription.
It is necessary to move the drug from the narrow part of the ampoule to the wide one. To do this, take the ampoule with one hand by the bottom, and with the fingers of the other, make light blows on the narrow end of the ampoule.
File the ampoule in the center of the narrow part of the ampoule. The narrow part of the ampoule is filed with a special nail file.
Treat the place of the file with a cotton ball moistened with alcohol. Using a cotton ball, you need to break off the end of the ampoule in the opposite direction from the file, and throw it into the container for the used material.
Take the syringe in your right hand so that the divisions are visible. Grab the opened ampoule between the 2nd and 3rd fingers of the left hand so that the opened part is facing the inside of the palm. Insert the needle into the ampoule.
Move your right hand to the plunger and draw up the required amount of the drug solution, tilting it as necessary, while making sure that the needle section is constantly immersed in the solution.
Without changing the position of the hands, give the syringe a strictly vertical position. Press the piston with your right hand and force the air out of the syringe into the ampoule (if it is empty).
Next, you need to remove the ampoule from the needle and place it in a container for the used material.
Taking the injection needle with tweezers, put it on the cone of the syringe. Be sure to re-expel the air from the needle. By pressing on the plunger of the syringe and gradually expel the air from the syringe (until drops appear from the lumen of the needle). If we introduce an oily liquid, the ampoule should be preheated by lowering it into warm water. A single-use needle must be capped.
You are all set to perform the manipulation. Put a syringe, sterile cotton balls moistened with alcohol in a sterile tray.
^ Algorithm for performing the manipulation of diluting the powder in a vial
Target
Perform an injection.
Indications
Injection methods of administering medicinal solutions.
Equipment for manipulation
vial with medicinal powder;
solvent (0.25% novocaine solution, 0.9% sodium chloride solution, water for injection);
sterile syringe with needles;
cotton balls moistened with 70% alcohol solution,
tray,
gloves,
tweezers;
Bix with sterile wipes.
Wash your hands and put on sterile gloves.
Read carefully the inscription on the bottle (name, dose, expiration date).
Using non-sterile tweezers, open the aluminum cap in the center of the antibiotic vial.
Rub a cotton ball soaked in alcohol on the rubber stopper of the vial.
Draw up the amount of solvent required for this drug into a disposable syringe. If solvent ampoules are supplied with the powder vial, one of them should be used.
Take the syringe in your right hand. Puncture the rubber stopper of the powder bottle with a needle and inject the solvent.
Remove the vial, together with the needle in it, from the cone of the syringe and, shaking the vial, achieve complete dissolution of the powder.
Put the needle with the vial on the cone of the syringe.
Lift the vial upside down and draw the required dose of the drug into the syringe (this may be the entire contents of the vial or part of it).
Remove the vial with the needle from the syringe cone.
Put on and secure the injection needle on the cone of the syringe.
Raise the syringe to a strictly vertical position. Release 1-2 drops of the solution through the needle.
Put a syringe, cotton balls moistened with alcohol in a sterile tray, cover the tray with a sterile napkin.
Each injection requires two needles, one for drawing the solution into the syringe, the other for the injection itself. It is desirable that the first needle be with a wide lumen. The change of needles ensures sterility. This requirement is met by pre-treatment with alcohol or iodine of the neck of the ampoule or the rubber stopper of the vial containing the medicine. (diagram of action and photo)
Before the injection, the patient's skin is prepared: with a sterile swab dipped in alcohol, they wipe a rather large area of the skin where the injection should be made. Proper preparation syringe, needle, hands of a nurse and the patient's skin has a very great importance. The main thing at the same time is the observance of all the rules of asepsis. Delivery of a syringe ready for injection to the patient's room is carried out in a sterile tray, at the bottom of which there are sterile gauze wipes. (diagram of action and photo)
IN 
^
NUTRISKINAL INJECTIONS
Intradermal injections are used both for diagnostic purposes and for local anesthesia.
Intradermal administration of drugs is usually carried out on inner surface forearm. The skin at the injection site is treated
antiseptic. A thin needle with a small lumen and a length of not more than 2-3 cm is injected into the thickness of the skin to an insignificant depth so that the tip enters only under the stratum corneum. Directing the needle parallel to the surface of the skin, advance it to a depth of 0.5 cm and inject 1-2 drops of liquid, which causes a whitish tubercle in the form of a lemon peel to form in the skin. photo from disk video 1) Gradually advancing the needle and squeezing out a few drops of liquid from the syringe, the required amount is injected under the skin. Rice. twenty
Indications
Antibiotic sensitivity test.
Mantoux test.
Katsuoni test.
Burne test.
Local anesthesia ("lemon peel").
Equipment
Sterile balls.
Antiseptic.
1 ml syringe with intradermal needle (15 mm) or insulin syringe.
Required drug.
Sterile gloves.
The middle third of the anterior (inner, palmar) surface of the forearm ( rice. twenty).
Patient position
Sitting, lying, standing.
Algorithm for performing intradermal injection
Specify whether the patient has previously met with this procedure:
if so, on what occasion and how did he endure it?
if not, it is necessary to explain to the patient the essence of the procedure.
Obtain patient consent for the procedure.
Wash your hands.
Place the patient in a comfortable position (supine or sitting) in which the intended injection site is easily accessible. Ask the patient to remove her clothing. photo from disk
By inspection and palpation, determine the immediate site of the upcoming injection.
Put on a mask.
Put on gloves (if they are already on, treat them with a cotton ball moistened with alcohol).
Treat the injection site with an antiseptic. Usually use two or three balls with alcohol or other antiseptic. (Petrospirt) Smears must be done in one direction. Wait until the alcohol dries.
Take a filled syringe with a needle directed upward at an angle of 0-5 °, almost parallel to the skin, so that the needle cut is hidden in the thickness of the epidermis. (diagram of action and photo)
Administer the drug intradermally. A blister should form at the injection site. (a photo)
Remove the needle without pressing the injection site with a ball moistened with alcohol. Explain to the patient that no water should enter the injection site for 1-3 days (if one of the diagnostic tests was performed).
Ask the patient how they feel. Make sure he feels okay.
^ Complications and their elimination
With intradermal administration of various drugs, the most common complication is infection of the injection site or the introduction of drugs that are not designed for their intradermal administration. In both cases, an inflammatory process develops in the tissue, requiring special medical procedures.
The first actions upon detection of a complication that has arisen - infection:
Treat if infected given place antiseptic, apply a "half-alcohol" compress.
With the development of necrosis of the skin area, treat with an antiseptic (brilliant green or potassium permanganate solution). Apply a sterile bandage. If necrosis has developed as a result of the administration of a chemical (for example, a solution was introduced that is intended only for intravenous administration due to its high concentration, which caused tissue necrosis), then it is necessary to quickly prick this place either with distilled water taken from a sterile ampoule or with saline or a solution of novocaine (0.25%) to reduce the concentration of the previously administered solution.
It is necessary to consult a doctor, as surgery may be necessary.
^ SUBCUTANEOUS INJECTIONS
Due to the fact that the subcutaneous fat layer is well supplied with blood vessels, subcutaneous injections are used for faster action of the drug.
Under the skin, you can enter from a small amount of liquid up to 2 liters.
Indications
The introduction of medicines.
Local anesthesia (infiltration).
Any skin lesions at the intended injection site.
Previous allergic reaction to a drug
Equipment
Antiseptic.
Sterile balls.
Syringe 2-5 ml.
Required drug.
Subcutaneous injections are made with a needle of the smallest diameter to a depth of 15 mm and up to 2 ml of drugs are injected, which are quickly absorbed in loose subcutaneous tissue and do not have a harmful effect on it.
^ The most convenient sites for subcutaneous injection are:
The outer surface of the shoulder; - subscapular region;
Anterior surface of the thigh; - anterolateral surface of the abdominal wall.
In these places, the skin is easily captured in a fold (take a photo) and there is no danger of damage to blood vessels, nerves and periosteum.
in places with edematous subcutaneous fat;
in seals from poorly absorbed previous injections.
Wash the hands.
Put on gloves.
Treat the injection site sequentially with two balls with alcohol, disinfectant solution or with soap and water: first a large area, then directly the site of the upcoming injection.
Place a ball of alcohol under the 5th finger of the left hand.
Take the syringe in your right hand (with the 2nd finger right hand hold the cannula of the needle, with the 5th finger - the plunger of the syringe, with 3-4 fingers hold the cylinder from below, and with the 1st finger - from above) (make a photo series).
With your left hand, gather the skin into a triangular fold, base down.
Insert the needle at an angle of 45 ° into the base of the skin fold to a depth of 1-2 cm (2/3 of the length of the needle), hold index finger needle cannula.
Postpone left hand on the piston and enter medicine(without shifting the syringe from one hand to the other).
Remove the needle by holding it by the cannula.
Press the injection site with a ball of alcohol.
Make a light massage of the injection site without removing the ball from the skin.
-
Cap a disposable needle, discard the needle and syringe into a needle disposal container (Figure 21), or
Immerse the syringe and needle (reusable) in a container with a disinfectant solution. (Petrospirt, give a list of drugs).
^ Complications and their elimination
When it enters a vessel. Press the injection site with a ball for 5-10 minutes. Rice. 21
Infection is possible in violation of asepsis. Treat the injection site with an antiseptic. Apply a "half-alcohol" compress.
With the formation of phlegmon at the injection site ( rice. 22) surgical treatment is indicated.
Rice. 22 Formation of purulent infiltrate after injection in (A) the area of the shoulder, (B) on the anterior abdominal wall.
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