Anesthesia Instruments

Dr. Abdelrahman Alalawneh

Dra.alaawneh@hotmail.com
 SYRINGES

INJECTION

Table of IV ACCESS

contents:
CANNULAE

IV GIVING SET
Syringes

• A syringe is a simple pump consisting of a

plunger that fits tightly in a tube to assist
pushing liquids or solids into an object either
through a needle, tubing, or a nozzle.

• The most common use of a syringe is to administer injections into the body
Syringe Parts
 Syringes are
available in various
sizes
Needle Parts
Syringe Types
INJECTION

• Definition:
• Injection is a method of putting liquid into the body with a Hollow Needle and
a Syringe which is pierced through the skin to a sufficient depth for the
material to be forced into the body.
Types of injection:
• Each injection route differs based on the types of tissues the
medication enters:
• Intra Dermal: ID
• Sub Cutaneous : SC
• Intramuscular : IM
• Intra Venous : IV
Types of Injection
How to choices the root of
administration :
• According to :
• The volume of medication.
• The characteristics of the medication.
• The onset of action.
• The site of action.
Minimizing
Patient
Discomfort
(practical
notes)
Intra Dermal Injection
• Has longest absorption time of all parentral routes
• Are used for diagnostic purposes, because the body reaction is easily
visible
• Needle size is 25 to 27 gauge.
• Needle length is 0.5 inch.
• Needle is inserted at angle 15 degree.
• Volume of Injection Dose is less than 0.5 ml.
• A small bleb will form as you inject; if it does not form, it is likely the
medication is in subcutaneous tissue, and the results will be invalid.
Intra Dermal Injection
Indications of Intra Dermal Injection
• Diagnostic :
• Identify Skin Allergy to Drugs
• Tuberculin Skin Test

• Therapeutic :
• Administration of Local Anesthesia prior to Surgery
Subcutaneous Injection
• Medication is placed in loose connective tissue under the dermis.
• Absorption is slower than with IM injections.
• Needle size is 23 to 25 gauge.
• Needle length is 3/8 to 5/8 inch.
• Pinch up the skin and inject at 45 degree.
• Aspirate and message , except for Heparin & Insulin.
• Air-lock is not required.
Sites of SC
Intramuscular Injection
• Medication is absorbed in the Muscle
• Faster absorption than subcutaneous route
• Needle size is 18 to 22 gauge.
• Needle length is 1 to 1.5 inch.
• Air-lock of 0.2 ml is needed.
• Maximum dose is 3-5 ml.
• Aspirate and message for all medications.
• Hold the skin , and inject at 90 degree.
Sites of intramuscular injections:
Comparison between IM sites:
 Assess the muscle before giving the
injection.

Properly identify the site by palpating

bony landmarks.

Steps for IM Be aware of potential complications

with each site.

injection: The site needs to be free of tenderness.

(practical notes)
Minimize discomfort.

Insertion angle is 90 degrees.

Intra Venous Injection
• Medication is circulated in the blood.

• Needle size is 16 to 20 gauge

• Inject at 45 degree
Intra Venous Injection
Complications of IV Injection
• Phlebitis:
• inflammation of the vein
• Infiltration:
• leakage of medication into extravascular tissue
• Extravasation:
• infusion of medication into the tissue
Other Injection Types
• Intra Thecal (into the spinal canal) is most commonly used for spinal anesthesia
and chemotherapy

• Intra Arterial (into an artery), e.g. vasodilator drugs in the treatment of

vasospasm and thrombolytic drugs for treatment of embolism.
• Intra Cardiac(into the heart), e.g. adrenaline in cardiopulmonary resuscitation
• Intra Osseous (into the bone) intravenous access because the bone marrow
drains directly into the venous system. This route is used for drugs and fluids in
emergency medicine and pediatrics when intravenous access is difficult.
• Intra Peritoneal(into the peritoneum) e.g. Peritoneal dialysis is predominantly
used in animal testing for the administration of systemic drugs and fluids due to
the ease of administration compared with other parenteral methods
IV ACCESS
Indications of IV Access
• Administration of Medication.
• Administration of Fluids.
• Administration of Medications.
• Administration of Blood and Blood Products.
• Radiological Imaging using IV Contrast.
Contraindications of IV Access
• Sites close to Infection
• Veins of fractured Limbs
• A Limb that has an A-V Fistula
• Edema
• A Limb affected by CVA
• Side of Mastectomy
Complications of IV Access
• Hemorrhage or Hematoma.
• Infection:
• Should be removed or replaced after 72 hours if possible.
• Puncturing of Artery.
• Phlebitis or Thrombophlebitis.
• Infiltration or Extravasation.
Vein Selection
• Site :
• Dorsum of Hand
• Forearm
• Antecubital Fossa

• Properties :
• Patent & Palpable
• Straight & Distal
• Not at the Bifurcation
Veins to be Avoided
• Area of Joint Flexion
• Mobile or Fragile or Sclerosed Vein
• Major Veins near Arteries
• Veins in Lower Extremity
• Area of Surgery
• Previously Cannulated Veins
Location of veins in Arm and Forearm
How to do it: (practical notes)
Intravenous cannulae

• Overview
• Intravenous cannulae are available in a wide variety of shapes and sizes.

• Uses
• They are inserted into a peripheral vein and can be used to deliver fluid
therapy or IV drugs to the patient.
• Rare emergency treatment of a tension pneumothorax.
Standard Gauge sizing:
• Cannulas are sized according to standard wire gauge (SWG).
• measuring the cross-sectional area.
• It refers to the number of wires of the same size as the cannula that
could pass through a hole of a standard size in parallel.
• The bigger the wires, the fewer could fi t through the hole, and
therefore larger cannulae have a smaller gauge number.
IV cannulae
Parts
Specifications
Flow Rate through Canulae:
• The maximum flow rate through a cannula depends most on the
fourth power of its radius (from the Hagen–Poiseuille equation).
• The maximum flow rate through a cannula is important because it
dictates the speed at which fluid can be given.

• Using distilled water at a temperature of 22°C and under a pressure of

10 kPa, the flow through a 110-cm tubing with an internal diameter
of 4 mm.
Intravenous
giving sets
• These are designed to
administer intravenous
fluids, blood and blood
products
Infusion set Parts:
Adult Giving Set
• A clear plastic tube of about 175 cm in length and 4 mm in internal
diameter.
• One end is designed for insertion into the fluid bag, whereas the other end
is attached to an intravascular cannula with a Luer lock connection.
• Blood giving sets have a filter with a mesh of 150–200 μm and a fluid
chamber.
• Giving sets with finer mesh filter of about 40 μm are available .

• A flow controller determines the drip rate :

• 20 drops of clear fluid is 1 mL
• 15 drops of blood is 1 mL
Components of Pediatric set:
• In order to attain accuracy, a Chamber of (30–200 mL) in 1 mL divisions is
used to measure the volume of fluid to be infused.
• The Chamber has a filter, air inlet and an injection site on its top.
• At the bottom, there is a flap/ball valve to prevent air entry when the
chamber is empty.
• There are two flow controllers: one is between the fluid bag and the
chamber and is used to fill it; the second is between the chamber and the
patient and controls the drip rate.
• An injection site should be close to the patient to reduce the dead space.
• Drop size is 60 drops per 1 mL of clear fluid. A burette with a drop size
similar to the adult’s version (15 drops per mL) is used for blood
transfusion.