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Chapter 11 Clinical Techniques 205

FIGURE 11.33 Proper technique to hold a syringe.

Injections
FIGURE 11.32 Vaccine bottles set/powder and dilutant.
Beware, there is controversy as to whether an assistant
should administer injections. If one adheres strictly to
be at least 1 mL of fluid withdrawn. Remove the needle many state practice acts, the answer in most states is
and syringe and insert it into the vial with the powder, “yes,” the assistant can administer injections under the
and slowly inject all the fluid. Leave the needle in the direct supervision of a veterinarian. If one adheres to
vial, and gently roll the vial in your palm hanging onto the recommendations of the NAVTA, the answer is
the syringe barrel. When the powder is fully dissolved, “no.” The administration of an injection is always
invert the vial and withdraw all the fluid. Take the needle limited to credentialed veterinary technicians. In
out of the vial and slowly push the barrel up to get rid of truth, the answer is determined by each veterinary
the air. If there is a “bridge of liquid” in the barrel, tap practice. If the veterinarian expects the assistant to be
the barrel with your fingernail to loosen it. If you don’t, able to give an injection and it is not prohibited by the
it will come out of the needle before you get the rest of state’s veterinary practice act, then the assistant needs
the air out of the syringe. The vaccine amount should be to learn how.
1 mL total in the syringe. Label the syringe with the The proper way to hold a syringe for all injections and
patient’s name and vaccine type; they are similarly col- blood draws is between your index finger and thumb at
ored and are easy to get mixed up. It is important to the end of the barrel as close to the “wings” as you can
keep them separate because they are given in different get. Your hand should be “on top” of the barrel
locations on the patient’s body. (Figure 11.33). This allows you to use your three remain-
Vaccines are considered biologicals and therefore ing fingers to aspirate and inject without letting go of the
must be kept refrigerated. If a vaccine is mixed up and syringe. If you hold it in the middle of the barrel or close
then not used it has a “shelf‐life” of 1 hour after which to the tip you will always have to let go in order to repo-
time it must be discarded. If there is some question as sition your fingers for the injection. When you let go of
to whether the patient is well enough for a vaccina- the syringe it can fall out and it wiggles, causing more
tion, then just set the bottles out with an unassembled pain. If you hold the barrel with your fingers underneath
needle and syringe. If they are not used, they can the graduations then they are often in the way when try-
easily be placed back into inventory. Never mix differ- ing to get an IV injection or blood draw.
ent vaccines together, for example a rabies vaccine The three most common routes used for injections
with a distemper vaccine in the same syringe. They can are subcutaneous (SQ or SubQ), intramuscular (IM),
react, creating a toxin that could harm the patient or and intravenous (IV). Subcutaneous is used most fre-
inactivate the vaccine, so the patient isn’t protected quently for vaccinations. An appropriate location for
from the diseases. SQ injections on a dog or cat is anywhere there is loose
Some medications will also come in a powder that enough skin to lift up so the needle can be inserted
needs to be reconstituted with sterile water or saline. underneath. Some veterinarians will prefer the SQ
Read the label carefully to determine which one to use injection to be given anywhere off the midline, which
and how much to mix with the powder. Do not mix the is along the back or back of the neck. This is so if the
medication with the wrong diluent as it can cause a reac- vaccination causes an abscess it can be drained easily.
tion that results in crystals forming and rendering the Figure 11.34 shows the sites available for SQ and IM
medication inactive. injections.