Tips for Minimizing Pain - Pharmacology

Receiving medication via injection is a painful process for the patient. However, you can minimize the discomfort by following these tips:

  • Encourage the patient to relax. The more they tense their muscle, the more the injection hurts.
  • Replace the needle with a new needle after you withdraw medication from a vial or if the medication is irritating.
  • Position the patient on his or her side with knees flexed if you are using the ventrogluteal site. Position the patient flat on the abdomen with toes turned inward if you are using the dorsogluteal site. Use the same technique if the patient prefers to stand.
  • Don’t inject into sensitive or hardened tissues.
  • Compress tissues at the injection site.
  • You can prevent the antiseptic (e.g., alcohol wipe) from clinging to the needle during the injection by waiting for the antiseptic to dry before injecting the medication.
  • Dart the needle to reduce puncture pain.
  • Inject the medication slowly.
  • Withdraw the needle quickly and straight.
  • Use the Z-Track technique.
  • Ask the patient to cough on the count of three. Inject the medication when the patient coughs.

  • INTRAVENOUS

Intravenous injections are used to provide rapid onset for a medication because the medication is directly injected into the circulatory system (IV push [IVP]). IVs can be placed in the cephalic or cubital vein of the arm or the dorsal vein of the hand. However, cubital veins should be avoided except in emergency situation because cubital veins are used for withdrawing blood specimens for laboratory testing. Start an IV at the hand and then work toward the cubital vein. IV injections use a 21- to 23-gauge needle that are 1 to 1.5 inches in length. Use the larger bore for viscous (thicker) drugs. IV lines are inserted with a butterfly needle or with an angiocatheter that ranges from 14 gauge for whole blood or fractions of blood to 23 gauge for rapid infusion. Medication may be administered directly into the vein with a syringe, into an intermittent catheter inserted into the patient’s vein, or injected into intravenous fluids such as 5% Dextrose in Water (D5W) and delivered as an intravenous drip called a piggy back.

Here’s how to administer medication IV:

  • Check the prescriber’s medication order.
  • Wash hands and then put on clean gloves.
  • Properly identify the patient.
  • Cleanse the area of the site in a circular motion using alcohol or betadine as per the agency guidelines.
  • Apply a tourniquet above the site.
  • Insert the butterfly or catheter into the vein until blood returns through the butterfly or catheter.
  • Remove the tourniquet.
  • Stabilize the needle or catheter.
  • Dress the site according to your healthcare agency’s policy.
  • Monitor the flow rate of the IV fluid, distal pulses, skin color (redness [infection]), skin temperature, insertion site for infiltration (swelling), and side effects of the medication since the action of the medication occurs rapidly.
  • Follow policy agency policy regarding adding medications to the fluid in the bottle or bag, piggy back technique, and intravenous push.

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