Preparation and Administration of Medications

General Principles

The Centers for Disease Control and Prevention (CDC) emphasizes using sterile devices and maintaining sterility when preparing parenteral medications, and single-use devices should be used for one patient only and disposed of appropriately 1
Sterile water is generally considered a neutral diluent and compatible with many medications, although specific compatibility data for certain medications in sterile water is limited 1

The CDC recommends cleaning the vial access diaphragm with 70% alcohol before inserting the needle, and using a sterile device to access medication vials and avoid contaminating the access diaphragm 1
When administering medications with sterile water, a single-dose preparation should be used for a single patient only, and the mixture should not be stored for extended periods as stability data is limited 1

Aseptic technique should be used throughout the preparation of parenteral medications to maintain sterility, although specific guidelines for medication-water compatibility in syringes are limited 1
Handle collected samples as biohazard specimens and transport them in sturdy, leakproof containers labeled with appropriate identification, as recommended by the CDC 1
Clean and disinfect contaminated specimen containers or place them in impervious bags labeled with the biohazard symbol, as suggested by the CDC 1
Dispose of single-use devices after use with one patient to prevent cross-contamination, as recommended by the American Society for Clinical Pathology 1

Instruct patients to avoid eating, drinking, smoking, or using oral products for at least 10 minutes prior to collection, and to rinse their mouths with water if they have recently consumed food or beverages, as recommended by the World Health Organization (WHO) 1
Explain the procedure to patients and have them place the absorbent pad between the lower cheek and gum, keeping the device in place until the indicator shows sufficient sample collection (typically 2-5 minutes), as recommended by the National Institute for Occupational Safety and Health (NIOSH) 1

Prepare medication using aseptic technique, select and clean the injection site, and administer medication while maintaining sterility, as recommended by the CDC 2, 1
Verify medication labels, expiration dates, and dosages before administration, as recommended by the CDC 2, 1
Select injection sites based on medication type (IM, subcutaneous, or intradermal) and choose areas free from veins, lesions, and scars, as recommended by the CDC 2
Clean injection sites with antiseptic swabs using a circular motion from center outward, allowing the site to dry thoroughly before administering the injection, as recommended by the CDC 2
Hold needles at the recommended angle for the specific injection type: 90° for intramuscular, 45-90° for subcutaneous, and 10-15° for intradermal injections, as recommended by the CDC 2
Insert needles with a smooth, controlled motion, as recommended by the CDC 2
Remove needles without pressing the area, and blot the site lightly with gauze if blood or fluid is present, then discard used needles and syringes in puncture-resistant containers without recapping, as recommended by the CDC 2, 1

Document the date and time of injection, location of trigger points treated, solution used, patient's response, and any complications, as recommended by the CDC 2
Be aware of potential complications, including local pain or bruising, vasovagal syncope, pneumothorax, and infection, and contraindications such as bleeding disorders, anticoagulation therapy, and local infection, as recommended by the CDC 2
Never reuse syringes or needles to prevent transmission of bloodborne pathogens, as recommended by the CDC 1

Ensure the indicator on the collection device shows adequate sample volume to prevent insufficient sample collection, and maintain proper hand hygiene and use aseptic technique throughout the procedure to prevent contamination of the sample, as recommended by the College of American Pathologists 1
Enforce the waiting period before collection to prevent invalid results due to recent oral consumption, and double-check all documentation to prevent chain of custody errors, as recommended by the American Medical Association (AMA) 1
Follow guidelines from reputable sources, such as the Mayo Clinic, for specific injection techniques, including inserting the needle directly into the trigger point and injecting the solution slowly 3