Medical Injections

Hi All.

I'm doing a bit of research on injections. I know there are a number of different sites around the body such as subcutaneous, intramuscular, IV, epidural (aka butt, hip, leg, top of the arm, stomach and crook of the elbow) but I can't find a list that tells me which area would be used for an injection containing sedatives.

Can anyone let me know??

Thanks x

 

It depends if the injection is intramuscular or intravenous and if the patient is fighting you or cooperating. Which drug are you wanting to inject for what condition and how fast does it need to work?

 

What is Sedation?

It's link from some dentist or other. I don't know much about this stuff either, but it's a start:

 

That a good source @Okon if the patient is cooperating, going in for a procedure for example.

 

Thanks guys.

Patient is not fighting but not happy. Extremely depressed and agitated. Dehydrated, not eaten or slept for 48 hours and is therefore weak but verbal.

Sedation needs to be done quickly but only for an hour as she's pregnant at the time so long term sedation would be dangerous.

The name of the drug is not mentioned but the injection site is so I'm not too worried about the choice of drug at the moment. I know there are different levels of sedation so I'm going for moderate.

They basically need to put her to sleep for an hour so that when she wakes up, she's calm enough to begin pulling herself back together.

 

That is a good start as it does state that the drugs have to go into a vein which rules out hip, butt, stomach and points us in the direction of crook of arm or back of hand.

I'm planning on putting a cannula in the back of her hand (the character's hand ) to administer fluids so I guess I could use the cannula as way in for the sedatives although, I would rather go for a hypodermic injection for the sedatives just because I need something quick as she's in such a state to begin with.

Hmmm

 

Safe sedation in pregnancy is a critical consideration. It's not something normally done without a very good reason. And you have to consider the infant if birth is imminent or might be. You don't want the infant born while sedated.

A small dose of benzodiazepine, aka: valium, would be a likely choice and that would be IV, it's harmful to the tissues if you miss the vein. And it sounds like oral would take too long for your needs but honestly, in most situations they would give a pill.

Morphine is another option, again IV. It's commonly used in early labor, can be reversed in the infant with Narcan, and isn't known to be harmful during pregnancy.

You might want to do a Google search on this for specifics. Drugs in pregnancy are limited.

For an IV push of valium or morphine, it's best if you have an IV line in place and running. You can put either in an established heparin lock but after the valium you need to be sure the line is patent and irrigated well after the injection. Valium precipitates easily when mixed with other drugs so you wouldn't want to risk any residual being left in the heparin lock.

Using the syringe to inject the drugs directly into the vein without an IV line or heparin lock is rarely done except in the movies.

A direct injection without a line would almost certainly be in the antecubital area, the inner side of the elbow. The IV line can be in the arm anywhere from the back of the hand to the antecubital area and sometimes elsewhere.

 

Does it have to be a shot? She won't take a pill orally?

 

Thanks for that @GingerCoffee lots for me to think about.

She's a few weeks away from giving birth so there's no danger there at the moment. From a drama point of view, her partner can't cope with watching her go through anything medical. He doesn't just have a fear of needles when he himself is having injections, he fears them when he sees them.

There's no way she'll take oral medication at the moment. She's on the verge of a breakdown following a big upheaval.

I can change the jab to include the sedation in the iv drugs if that's the way to go but from a drama point of view, I can see how a jab would work better.

Thanks for giving me something to think about x

 

There are probably drugs one would use IM. The other two were just ones I was more familiar with. If it were in the muscle usually the gluteus muscle (butt) is used because it's a larger muscle. One uses the deltoid for smaller, non-irritating meds like vaccinations.

 

So that's why A&E jabbed me in the butt cheek when I had a problem with my back!

I can see I'm going to have to give some serious thought to which way I go with this.

From a dramatic point of view, I should go with the upper arm (IM) or crook of the elbow (vein) which would warrant a Band-Aid application for the vein one.

From a real life point of view, she would be rolled over and jabbed in the bare ass cheek - not good is she's about to have a breakdown and is 9 week away from giving birth.

From a realistic point of view, a cannula would be inserted, the sedation would be pumped in, then flushed, then she would be hooked up to a fluids drip for re-hydration.

I've already done the part where the fluids come into the story, it's just the tiny bit before that.

Does anyone else find that these tiny little bits give them the biggest problems when writing?

 

I spent quite a bit of time researching interstellar travel details even though it was only mentioned in a paragraph of backstory in my WIP.