Intramuscular injections complications during administration. Complications of injections

The nurse must clearly understand what may be complications after and how to avoid them. If complications arise, the nurse must know the algorithm of medical care for the patient.

So, they might be next.

Needle breakage

Not often, but it does happen. Cause - strong muscle contraction due to fear of the procedure, unexpected start of injection, improper psychological preparation of the patient.

Help: keeping calm, reassure the patient, assure him that everything will be fine. With the !-th and 2nd fingers of the left hand, press down the tissue on both sides of the broken needle, squeezing it out in this way. Take tweezers with your right hand, carefully grab the tip of the fragment and remove it. The action is repeated several times. If attempts are unsuccessful, urgently call a doctor through an intermediary, remaining with the patient and reassuring him. In the future, follow all the doctor’s instructions.

Damage to the periosteum

Can occur when giving an intramuscular injection with a needle that is too long in a thin patient. Help: referral to a surgeon and implementation of his instructions. Prevention: correlate the length of the needle with the size of the patient’s subcutaneous fat layer at the site of the intended injection.

Traumatization of nerve trunks

Such complications after intramuscular injections may occur when the needle is inserted not into the upper-outer quadrant of the buttock, but, for example, into the lower-outer quadrant. Nerve trunks can also be damaged when the drug acts directly on the nerve tissue. This happens if the drug is injected near the location of the nerve.

Help: referral to a doctor and explanation to the doctor of all the circumstances surrounding the injection.

Infiltrates

Causes: rapid administration of the drug, low temperature of the administered drug, insufficient needle length, injections into areas located next to a recently made injection or with an old infiltrate.

Help : applying a semi-alcohol compress or the same with the addition of a 25% solution of magnesium sulfate, informing the attending physician.

Abscesses

Very common complications after intramuscular injections.

Causes: non-compliance with the rules of asepsis and antisepsis, injections into infiltrates, intramuscular injections using a short needle.

Help: urgent referral to a surgeon.

Hematomas

Causes: needle damage to blood vessels.

Help: referral to a doctor and fulfillment of his prescriptions.

Emboli

Oil and suspension embolisms occur when a needle enters the lumen of a blood vessel with subsequent administration of a drug. If there is insufficient air displacement from the syringe, there is a risk of an air embolism if the entire contents of the syringe are injected into the blood vessel where the needle entered.

Help: placing the patient in a lying position on his side with the head end raised, immediately calling a doctor through an intermediary.

Prevention: complete displacement of air from the lumen of the syringe, “pulling back” the piston when the needle is inserted with the intention of introducing oil or suspension solutions.

Thrombophlebitis and necrosis

Such complications after intramuscular injections rare, but they do happen. Thrombophlebitis occurs when blood vessels are damaged, often multiple times, followed by necrotization of soft tissues.

Help: If the patient complains of severe pain and the presence of hematomas, immediately consult a surgeon.

Infection with HIV, parenteral hepatitis

Causes: gross violation of the rules of asepsis and antisepsis when administering intramuscular injections, including hand washing, pre-sterilization cleaning and sterilization of instruments.

Prevention: strict adherence to all existing regulations and sanitary standards when carrying out invasive manipulations.

Allergic reactions

When administering any drug, the patient may experience an allergic reaction ranging from urticaria to . The treatment room should be equipped with an anti-shock first aid kit and instruments to assist in respiratory arrest.

Knowing the possible complications after IM injections, the nurse should make every possible effort to prevent them. And if any complication arises, be ready to take the necessary actions on your part.

Most Frequent complications after intramuscular injections– these are compactions, hematomas and pain symptoms.

The causes of such complications may be:

• the needle is too short,
• dull needle
• incomplete insertion of the needle into the tissue,
• multiple injections in one specific location,
• vascular injury,
• nerve ending injury,
• violation of antiseptic treatment of the injection site,
• ingress of conditionally pathogenic microflora from the skin surface,
• ingress of infectious agents from the surface of the needle,
• slow immune reactions.

Consolidation after injection(in medical terminology - infiltrate) is formed as a result of the drug solution entering not into the muscle tissue, where it is quickly absorbed, but into the layer of subcutaneous fatty tissue, where there are practically no conditions for absorption (the fatty layer is poor in blood supply). Prolonged presence of the drug in the subcutaneous fat layer can cause inflammatory processes, which will result in tissue abscess formation.

For treatment of lumps after injections(but not at the moment when signs of a developing abscess are noticed), it is necessary to carry out warming procedures (dry heat, not baths): alcohol compresses on the site of compaction, a heating pad, iodine nets. Warming procedures cause expansion of the vascular bloodstream, which increases blood circulation and lymph flow. If there are signs of tissue abscessation, heating is not carried out, and under no circumstances should the injection sites be steamed; this creates conditions under which the skin becomes looser, which allows the purulent-inflammatory process to easily spread to neighboring areas. Redness of the tissues, swelling and nagging, twitching pain indicate the beginning of the process of tissue abscessation and require contact with a surgeon.

A hematoma or bruise is formed when a blood vessel is damaged and requires the use of lipophilic, anticoagulant and absorbable ointments (Heparin, Troxevasin). These types of drugs are not used immediately after the injection, but the next day, since a prerequisite for their use is that there is no violation of the integrity of the tissues (a puncture is also a violation of the integrity of the tissues), otherwise bleeding from the injection site is possible.

The pain symptom of damaged nerve fibers can be relieved using a cold heating pad. Cold will reduce the sensitivity of nerve endings, and will also lead to a narrowing of blood vessels and prevent the formation of a hematoma. But you should not get carried away with cool compresses, as they do not promote the resorption of the medicine and the resulting infiltrate, which can increase the risk of the formation of interstitial compactions.

What are post-injection complications? The role of the nurse in the prevention of complications after injections. What results from non-compliance with asepsis rules.

Types of injections

Post-injection complications (PIC), as the name suggests, are complications that occur after an injection (injection). What is it injection? Wikipedia tells us that an injection is a way of introducing various solutions (for example, medicines) into the body using a syringe and a hollow needles. Depending on where exactly this solution needs to be delivered, there are several types of injections:

• subcutaneous;
• intramuscular;
• vniturivennaya;
• intraosseous;
• intradermal;
• intra-arterial;

The role of the nurse in the prevention of post-injection complications

According to a recent survey, most patients, especially the older generation, prefer injections or droppers as one of the ways to introduce drugs into the body. That is, people do not know or underestimate the risk of post-injection complications.

The role of the nurse is not only to correctly perform the injection itself, in compliance with all aseptic rules, but also to provide the necessary advice on the prevention of PIO. Many nurses simply neglect this. Upon completion of the procedure, it is necessary to make an appropriate entry in the journal.

Complications, which can occur after injections (injections) are divided into 3 groups according to the factor of their occurrence:

Failure to comply with asepsis rules

Asepsis- preventing various microorganisms from entering an open wound.
Post-injection infiltrate- occurs, as a rule, after subcutaneous and intramuscular injections. The reason for the development may be

an incorrectly placed injection can cause many problems

serve incorrect choice of length needles or low quality of its execution. And if in treatment rooms, where they are most often performed injections, nurses are trained in the rules for choosing the length of the needle, it is quite difficult to answer for the quality of the injection itself (we all know that some people have a “light” hand, while others have the opposite). There are many companies producing disposable injection needles, but only a few do it conscientiously.

Also, the cause of post-injection infiltration may be incorrect determination of the site for injection, administration of the medicine to the sites of previous injections, or too rapid administration of the medicine.
Violation of sterility during injection is the No. 1 reason for the development of post-injection infiltrate.

Abscess– formation of an inflamed cavity with purulent contents inside the soft tissues. The reason for the occurrence of a post-injection abscess is the same as for infiltrates, only with the obligatory addition of infection.

The occurrence and development of an abscess

Most often, the injection is given into the gluteal muscles. Accordingly, to reduce the chance of an abscess, a number of factors should be taken into account:

• Do not inject twice into the same point, be sure to change sides. Each injection is already a kind of microtrauma for the muscle. Multiple injections into one point can cause a post-injection abscess, even with full compliance with the rules of asepsis.
• The amount of the drug recommended for one injection, if repeated at the same point, can lead to tissue necrosis.
• The patient’s weak immunity and disturbances in the blood supply to tissues can also lead to an abscess.

Phlegmon- acute diffuse purulent inflammation of the cellular spaces; unlike an abscess, it has no clear boundaries. There are several types: subcutaneous, subfascial, intermuscular, retroperitoneal, perirenal (paranephritis), perirectal (paraproctitis), mediastinal tissue, phlegmon of the foot, hand, etc.

The cause of the occurrence is the entry of pathogenic bacteria into the fiber through damaged skin or from nearby foci of infection (boils, dental caries, suppurating lymph nodes, etc.); sometimes they are carried in the bloodstream (hematogenously) from distant foci.

Hepatitis B and C, HIV– the most unpleasant and long-lasting consequences that can be obtained during injections in violation of the rules asepsis. Fortunately, modern options for using disposable syringes minimize the risk of infection through injections.

More detailed information about the types of infiltrates and methods of their treatment can be found in the article ““.

Wrong choice of injection site

Choosing the right injection site

Damage to nerve endings– occurs more often with intramuscular injections, if the injection site is chosen higher than acceptable, closer to the lower back. Let us remind you that for the optimal intramuscular injection you should choose the upper outer quadrant of the buttock. Irritation of the nerve trunk by a needle or injected medication can lead to severe lumbodynia(severe pain in the lumbar region) and sciatica and even to neuritis And paralysis.

Damage to the periosteum- can occur when a needle that is too long is chosen for an intramuscular injection into the thigh.

Vascular damage a needle or medicine that irritates the walls of the vessel.

Incorrect injection technique

Needle breakage– occurs due to a violation of the intramuscular injection technique (performing the injection while standing and/or without warning), which leads to a sharp spasm of the gluteal muscles. Poor quality needles can be either a concomitant or a separate factor. Lack of experience with intramuscular injections should also be taken into account.

Oil or air embolism- in both cases it occurs due to the entry of an oily medicinal solution or air from a syringe into a vein. The prevention of such a dangerous complication is to check whether the needle has entered the vessel (pull the plunger slightly and make sure that there is no blood in the syringe).

Blood clots– this complication occurs when the same vein is used for a long time to administer the drug.

Tissue necrosis after injection. Essentially, necrosis is the process of cell death. Agree, a very unpleasant phenomenon. It is formed due to various damage to the cells of the body, if caution is not observed during vein puncture and the administration of irritating drugs in addition to the veins (subcutaneously, intramuscularly). Be sure to check the presence of a needle in the vein when injecting chloride (10% calcium chloride solution).

Hematoma occurs due to a through puncture of the vein, due to which blood flows into the surrounding tissues. You can eliminate the hematoma with a warm compress.

Administering the medication too quickly may cause dizziness and disturbances in heart rhythm.

Allergic reactions(urticaria, Quincke's edema up to anaphylactic shock) arise as a result of an unclear allergic history in the patient. They usually appear 30 minutes after administration of the drug, but can appear earlier and immediately after the injection. The basic rules for preventing this complication are: finding out the allergy history before the injection, especially before the first one, and monitoring the patient for the first 30 minutes after injections, if the drug was administered for the first time in life.

In addition to these three factors, post-injection complications are classified according to the timing of their appearance:

• immediate– occur on the first day after the injection (allergic reaction);
• short-term– period of appearance from several days to a week (infiltration);
• deferred– may appear even after a few months (hepatitis, HIV).

As a rule, injections are performed in a hospital. institutions, and this is mainly done by nurses; accordingly, to prevent post-injection complications, the nurse must follow a number of rules:

1. Be careful when preparing the medicine for injection. Each patient should receive only the medicine prescribed by the doctor.
2. Follow the rules of asepsis and antiseptics.
3. Follow the rules for administering medications.
4. Follow the injection technique.
5. Light massage of the injection area promotes better absorption of the medicine.
6. Avoid administering the medicine to the same point.

Almost 80% of cases of PIO occur due to injections given outside medical institutions and by unqualified performers. In particular, injections at home.

An injection into the buttock is a fairly common medical procedure that each of us has to go through from time to time. It is better, of course, to carry out the procedure in a special medical institution, where there are qualified personnel who can give the most painful injections almost imperceptibly.

However, patients often prefer to save their own time and perform injections. Before starting self-medication, we recommend that you clarify what will happen if the injection is given incorrectly.

For most patients, such treatment passes without consequences, however, if the injection is performed incorrectly, a large number of procedures are prescribed, or, due to individual characteristics, the nerve is located close to the skin. In this case, the procedure can cause very painful sensations: it becomes difficult to sit, the leg goes numb, unpleasant sensations reverberate in the lower back, and other complications appear. We suggest you figure out why this happens, what to do in such a situation and how to relieve the pain.

You can alleviate your condition, reduce discomfort, if the injection site hurts a lot, if you understand the cause of these sensations. Most often there are two of them:

• failure to comply with hygiene rules;
• the appearance of cones. They are an extremely unpleasant and painful type of lump that appears as a result of the slow resorption of the medicine. They occur mainly when many injections are taken. How long the lump lasts depends on the measures you take.

It is important to know! If both buttocks are punctured, it is better to give intramuscular injections in the thigh or shoulder than to continue to injure the butt.

It is recommended to wipe the injection sites daily with a cotton swab soaked in medical alcohol, and at the first signs of lumps, use absorbable ointment. It is better to find out what to smear with your doctor; most often in such cases, “Alor”, “Delobene”, etc. are prescribed.

When a lump forms, massage and iodine mesh will help get rid of it. And at night it is recommended to apply all kinds of compresses. For example, a magnesium or alcohol compress, or apply a leaf of fresh cabbage (not cut). To prevent the formation of abscesses, Solcoseryl cream is used.

If the gluteal muscle at the injection site turns red, the patient’s temperature rises, but there is no lump, most likely a purulent process has begun in the body. This phenomenon indicates that an infection has entered the injured area. Eucabol (an antibacterial agent) and the already mentioned Solcoseryl jelly help relieve inflammation.

It is important to know! All of the symptoms mentioned above, plus severe pain and a feeling like someone is cutting you, may indicate the onset of an abscess.

Is it possible to swim after an injection in the buttock?

The question of whether it is possible to wash after an injection so as not to increase the likelihood of infection worries many patients. It all depends on the type of intramuscular drug being injected. These kinds of restrictions should be clarified with your doctor, he will tell you whether you should swim after this medicine, limit yourself to taking a shower, or completely refrain from import procedures.

Consequences of self-injection in the buttock

If you overcome the psychological barrier, giving yourself an injection yourself is not difficult. You just need to wipe the injection site with medical alcohol or peroxide, confidently insert the needle at an angle of 45⁰, and slowly inject the drug. However, if at least one of these actions is done incorrectly, complications can be very dangerous.

Negative consequences that occur if an intramuscular injection into the buttock hits a nerve:

• , pulls his leg;
• tingling, numbness;
• heat;
• edema;
• seals;
• bruises and other marks;
• abscess.

If the injection is given properly, then the negative consequences of an injection into the buttock inside appear extremely rarely, although they should not be completely excluded. If you suspect that you have performed a medical procedure incorrectly, be sure to contact your doctor so that an unsuccessful injection does not affect your health.

Let's find out why the consequences of injections are dangerous.

Cones

A lump or lump at the injection site is a dense, painful swelling. It usually occurs after intramuscular injections, if the injected drug is not absorbed. You are probably wondering why such phenomena are dangerous? If appropriate measures are not taken and the lump remains 1-2 months after the end of treatment, an abscess and damage to the sciatic nerve may develop.

Reasons why seals appear:

• high-speed drug administration;
• short or poor quality needle;
• excessive muscle tension by the patient;
• injection in the middle of the buttock;
• an excessive amount of medication was administered;
• injection with air into the buttock;
• infection;
• allergy.

You will recognize that a lump has appeared by the following signs:

• in case of infection: swelling, temperature, redness, pain in the lower back, buttock, pus is released;
• in case of nerve injury: numbness, the injection site loses sensitivity, pain “shoots” into the lower extremities;
• if air gets into the buttock during an injection (air infiltration): formation of a lump or lump.

It is important to know! Immediately after the injection, be sure to wipe the injured area with a cotton swab and alcohol, this will reduce the risk of infection.

Folk remedies that will tell you what to do if a lump forms and how to remove its consequences:

• An iodine mesh applied for 3 days will help to dissolve the seal;
• placing half a fresh potato on the compaction ball;
• compress of chewed rye bread with sugar;
• applying gauze made of alcohol or magnesium will help soften and remove old formations;
• an ordinary fresh cabbage leaf helps to remove even old bumps if it is stuck with an adhesive plaster overnight;
• It is recommended to apply aloe juice if there is a large lump;
• kefir compress.

A qualified doctor will tell you how to treat such formations. Usually prescribed:

• Vishnevsky ointment is an effective antiseptic and anti-inflammatory agent, applied for 3-4 hours. Not used when spawned;
• heparin ointment. Has anti-inflammatory and analgesic effect;
• troxevasin – relieves swelling and inflammation;
• demexide solution - helps to dissolve and remove blood clots, reduce inflammation.

Bruise

If the needle gets into a vessel when injecting into the buttock, it is injured and a bruise forms.
Why, after treatment, blood accumulates in the tissues at the injection site, and painful bruises remain (reasons for this phenomenon):

• incorrect insertion of the needle, as a result of which the walls of blood vessels are punctured;
• poor quality syringe;
• poor blood clotting in the patient;
• individual characteristics (close location of blood vessels to the surface);
• surface input;
• using an insulin syringe.

It is best for your doctor to tell you what to do and how to treat the bruise. Special drugs (troxevasin, heparin ointment, traumeel and others) help to get rid of this phenomenon. There are also folk recipes that tell how to remove painful formations (the same cabbage leaf, honey or rye compress). However, they can only be used if a bruise just appears, but the following symptoms are not observed:

• throbbing pain;
• big boss;
• heat;
• edema.

Abscess

This phenomenon is one of the most dangerous post-injection complications. What an abscess looks like can be seen in the photo below. It is an inflammatory, purulent formation, the treatment of which is an extremely responsible and important step.

How to determine that you have an abscess (complication symptoms):

• increased sweating;
• weakness;
• body temperature up to 40⁰ C;
• loss of appetite;
• painful redness and swelling at the injection site.

Because of the danger of such a phenomenon, rather than treating an abscess after an injection, it is better to check with a qualified physician, whom you should contact after detecting symptoms. Self-medication in this case is not acceptable.

Seal

A slight hardening that forms at the injection site is quite common. As a rule, no special treatment is required if it appears. It is recommended to simply inject into the other buttock until the lump goes away.

The tips below will tell you how to remove hardening after injections:

• iodine mesh is the most popular way to cure compaction;
• vodka compress on skin previously lubricated with cream;
• cabbage leaf and others.

In addition to folk remedies, traditional medicine will also tell you how to treat such problems. The doctor explains what to do and how the lumps dissolve; usually in this case, ointments for inflammation and swelling that have antiseptic and analgesic properties are prescribed.

Numbness of the buttock

When the buttock and thigh go numb after an injection, many do not take this phenomenon seriously. However, if the feeling appears and does not go away for a long time, you should sound the alarm, asking your doctor what to do and how to treat this phenomenon. After all, a numb thigh or numb leg may indicate an abscess or nerve injury.

Inflammation

A most dangerous symptom indicating the onset of suppuration; when it appears, mandatory treatment is required. Only a doctor can tell you what to do in this case, after conducting an appropriate examination and taking the necessary tests. Based on them, the physician determines how to treat the patient.

Purulent inflammation symptoms:

• red spot on the skin;
• the injection site becomes hot, body temperature rises significantly;
• painful sensations when pressing;
• External and internal fistulas are formed (in advanced cases).
• How to relieve inflammation:
• stop administering the injectable medication until the complication is treated;
• physiotherapeutic procedures;
• dynamics control;
• use of specialized medications.

Infiltrate

Infiltration is a hardening formed at the injection site due to improper injection, violation of hygiene rules, or for other reasons. Treatment in this case occurs as with the appearance of cones (seals).

Why does blood bleed after an injection in the buttock?

If after performing the injection blood starts to flow (sometimes it flows quite strongly, like a stream). Why is this happening? Most likely, a needle inserted under the skin made a hole in the vessel.

This phenomenon may be an accident or caused by the individual characteristics of the body (close proximity of blood vessels to the skin). When injecting the corners, it is recommended to pull the syringe corkscrew slightly towards you; if blood is drawn in, you should not continue the injection.

Allergic reaction to an injection in the buttock

If the patient is allergic, administering an allergen drug to him can have the most dire consequences, including anaphylactic shock.

You should immediately seek qualified help if:

• a burning sensation appeared after an injection in the buttock;
• the injection site in the buttock itches;
• Itching appeared on the buttocks after injections.

Preliminary preparation for performing the manipulation:

– wash your hands thoroughly twice with soap and running water, dry with a clean individual towel or sterile disposable napkin, treat with a 70% ethyl alcohol solution, wear sterile rubber gloves;

– release the disposable syringe and needle from the packaging;

– draw into a syringe the dose of the drug indicated in the prescription sheet from a bottle or ampoule;

– place the syringe with the collected medication on a sterile tray;

– place 3 sterile cotton balls soaked in a 70% ethyl alcohol solution on this tray;

– when administering the medicine to the buttock area, ask the patient to lie on his side or stomach. In this case, the muscles completely relax. If the patient has tensed his muscles, he should be asked to calmly breathe deeply and relax them;

– when injecting the medicine into the thigh, ask the patient to lie on his back. The injection site is the anterior outer surface of the thigh;

– when injecting the medicine into the subscapularis area (deltoid muscle), ask the patient to sit on a chair, straighten his back, press his left or right side to the chair; the puku on the injection side should be lowered and pulled back slightly; in this case, the corresponding scapula extends from the posterior surface of the chest, forming a small depression.

The main stages of the manipulation:

1. Mark the injection site: the buttock area is conditionally divided into 4 quadrants (draw a vertical line through the gluteal hump, and a horizontal line through the greater trochanter of the femur). The injection is carried out in the upper outer quadrant of the buttock, where there are no large vessels and nerve trunks.

2. Palpate the selected area: the injection cannot be performed in areas of swelling or compaction (infiltrates) that remain from previous injections.

3. Wipe the injection site twice with sterile cotton balls soaked in a 70% ethyl alcohol solution;

4. Take a syringe filled with medicine with a needle with your right hand so that the V finger supports the needle coupling, the II finger is placed on the piston, and the remaining fingers hold the syringe cylinder (Fig. 7.10).

5. Using the index finger and thumb of the left hand, stretch and fix the skin with the subcutaneous layer in the appropriate area.

6. Perpendicular to the surface of the skin, quickly insert the needle to a depth of 4-5 cm, piercing the skin, subcutaneous layer, fascia, and gluteus maximus muscle. It is necessary to ensure that the needle is not completely inserted and that a part of the needle at least 0.5 cm long remains above the skin.

7. Take your left hand from your buttock.

8. After inserting the needle, pull the syringe plunger towards you with your left hand and check whether the needle has entered the lumen of the blood vessel (blood should not appear in the syringe).

9. Press piston II with the finger of your right hand (or, without changing the position of your hands, with the first finger of your left hand), slowly inject the drug into the muscle.

10. With your left hand, apply a sterile cotton ball soaked in a 70% ethyl alcohol solution to the injection site; and quickly pull out the needle. Using this cotton ball, lightly massage the injection site of the medicine so that it is better distributed in the muscle.

11. Dip the used cotton ball into a 5% chloramine solution in a container marked “For used cotton balls” for 1 hour.

12. Disinfect the syringe and needle after use.

Rice. 7.10. Performing an intramuscular injection.

Possible complications of intradermal, subcutaneous, intramuscular injections, their prevention

The technique of any injection must be strictly performed by the nurse, because most of the complications (with the exception of allergic reactions) occur due to the fault of the nurse who did not adhere to all the necessary requirements.

Fainting (sudden short-term loss of consciousness, predetermined by acute cerebral ischemia).

Prevention: To prevent this complication, you should remember the rule: you cannot perform the injection when the patient is standing. The patient should be asked to sit in a chair or lie down in bed.

Tactics in case of fainting: put the patient with his head slightly lowered and his legs raised (to increase the flow of blood to the brain), free him from tight clothes, sprinkle his face with cold water, let him sniff a solution of ammonia (ammonia) on a piece of cotton wool. In more severe cases, administer cordiamine and caffeine.

Allergic reaction (increased sensitivity of the body to the administration of a particular drug). This may be an immediate reaction (eg, anaphylactic shock, angioedema) or a delayed reaction (eg, dermatitis, eczema).

Prevention: Before prescribing the drug, carefully collect an allergy history; before the first injection, perform a test to determine the individual sensitivity of the body to the drug; make the first injection at the rate of 1/3 of the prescribed dose into the limb and observe the patient for 20 minutes.

3. Infection of the patient with acute viral hepatitis, AIDS, syphilis, malaria and other infectious diseases (Addition 3, order No. 120, 408).

Prevention: clear knowledge of the orders of the Ministry of Health of Ukraine (No. 120, 408) on the prevention of these diseases and strict adherence to them in their work. Remember! For gross errors, a medical worker may be held criminally liable.

4. Infiltration(seal at the injection site ).

Prevention: strict adherence to the rules of asepsis and antisepsis at the stages of preparation and during the injection process; mandatory palpation of the injection site (the injection cannot be performed in areas of swelling or compaction that remain from previous injections); heating oil solutions; simultaneous administration of the permissible volume of a medicinal substance (subcutaneous no more than 5 ml, intramuscular no more than 10 ml).

Tactics if infiltration occurs: make a semi-alcoholic warming compress, apply an iodine mesh to the skin, use a heating pad, apply physiotherapeutic methods of treatment (UV radiation, UHF field).