Injection Site ReactionInduced ByDesferal

12 years old female giving chelation therapy through 2.5g/day. desferal into

10ml. syringe for 8 hours at night. Since 9 years already. Her only

problem is why her skin around her nivel has something that formed a

mass, redness and itching ?

Objective

• What is Injection Site reaction.• Mechanism.• Symptoms and sign.• Management.

What is Injection Site ??

• Inflammation In or damage to tissue surrounding where a drug was injected.

Mechanism1. local allergic reaction (Histamine

release).

2. extravasation

Symptoms and sign

1. Redness 2. Pain 3. Itching4. Swelling

Management

• Before injection :

• Technique

• After injection:

• Nursing implication

Technique1. Wash your hands with soap and water for 3 minutes!

2. Emla cream or a patch.

Technique3. Lay out all supplies on a clean table or flat surface.

4. Draw the water for injection into a syringe

5. Clean the rubber stopper of the desferal vial with alcohol.

Technique

6. Shack the vial vigorously to dissolve the drug.

7. Draw the dissolved drug into the syringe.8. Attached one end of the extension tube

to the syringe, connect the other end to the butterfly-type needle.

Technique9. Place the syringe in the infusion pump.

10. Insert the butterfly-type needle under the skin.

11. The infusion needle should not be inserted too close to the dermis.

Nursing implication1. Emla cream local application.2. Apply warm towel.3. Use 1-2 hydrocortisone ointment.4. Using a more diluted solution.5. Slowly SC infusion. 6. Injection should not be given in dose higher in

recommended.7. Rotation of the subcutaneous injection site.

To reduce pain • Emla cream local application.• Apply ice pack.• Using a more diluted solution.• Slowly SC infusion.

To prevent reactions• Follow aseptic tech.• Use more diluted solution.• Slowly SC infusion. • Injection should not be given in dose higher than recommended.• Rotation of the subcutaneous injection site.

To treat reactions • Apply warm towel or pack.• Exclude and observe for sepsis.• Use local antihistamines.• Use 1-2 hydrocortisone ointment.

Following repeated local reactions• revise injection technique dose and dilution. • Use 1-2 hydrocortisone ointment before insertion.• Use longer needles. • Apply warm towel after removal.

Guideline to Minimize Injection Site Reactions Induced by Desferal

Thank you