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206 Tasks for the Veterinary Assistant

pinch of skin up to form a “tent,” and wipe the injection
site (Figure 11.35), which is the “door of the tent,” with
the wetted cotton ball. This serves two purposes: it cleans
the area and it can be used to part the hair so you can
SQ injection IM visualize the skin. Put the cotton ball down and properly
area
site grasp the syringe in your dominant hand and with the
bevel up quickly insert the needle up to the hub through
the “door” of the tent. This is usually between your
thumb and index finger on your non‐dominant hand.
Aspirate, which is a quick pull back on the syringe
plunger, no more than a tenth of a milliliter, and if no
blood or air is seen in the syringe, depress the plunger to
deliver the medication. This can be done quickly and
FIGURE 11.34 Subcutaneous (SQ) and intramuscular (IM) injection with no wiggling! The more you move an inserted needle
sites.
the more it hurts. Withdraw the needle and give your
patient a pat and a treat for being good.
Dispose of the entire syringe and needle in the sharps
container. Throw away the needle cap, syringe pack-
aging, and the cotton ball. Put the medications back in
the pharmacy if it is a multi‐draw bottle. Mark the
patient’s file with the medication amount given, the loca-
tion of the injection, the date, time, and your initials.
There is a needle‐free, transdermal system of vaccine
administration available. It uses a CO cartridge that
2
forcefully propels the vaccine across the skin into the
subcutaneous tissues. This provides a more consistent
administration of vaccine and is less painful to the
FIGURE 11.35 SQ injection technique. patient. Follow the manufacturer’s instructions for set‐
up and use of the system.
Subcutaneous Injections
Subcutaneous Fluid Administration
If restraining for a SQ injection, a sitting, standing, or
sternal recumbency position works equally well. This Subcutaneous fluids are frequently given to patients;
tends to be a relatively less painful injection so distrac- the restraint and locations are the same, but the equip-
tion techniques and a light hold are usually all you will ment is different. Gather a 20 or 18 gauge needle or
need. This is unless the material being given stings. Then butterfly catheter, an IV drip set, the IV bag of fluids or
you will want to snug the patient close to your body with a syringe large enough to accommodate the amount of
an arm around the neck. fluids needed. Mark the bag with the desired amounts
divided into the amounts each SQ site can accommo-
date (Figure 11.36). This will differ depending on the
TIP BOX 11.3 size of the animal. Cats and small dogs can handle
15–25 mL per SQ site. Medium‐sized and slender large
Practice manipulating the syringe with one hand until
you can pull and depress the plunger without excessive dogs can handle about 45–50 mL and the giant breeds
movement of the needle within a pillow, orange, or can handle about 50–75 mL per site. This is a range and
stuffed toy. This will vastly decrease the pain your the only way to really determine the amount per site is
patient feels when receiving an injection. to feel the skin as the fluid runs in. A soft bump will
start to rise under the skin, before it becomes tight
feeling move to another site, even if not at the amounts
If you are giving the injection you will need to provided above.
gather a syringe and needle, a cotton ball wetted with Once the bag is marked aseptically attach the IV drip
warm water or alcohol, and the medication or vaccine set to the IV bag and remove all bubbles from the drip
to be given. set (see Chapter 12). Attach a needle or butterfly cath-
To give a SQ injection properly, assemble and fill the eter to the end of the drip set and then slip it under the
syringe to the prescribed amount of medication or skin in the same way as described for a SQ injection.
vaccine. Find the area with the loosest skin, gently lift a Instead of pushing the plunger on a syringe, the IV drip