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33 The student must be able to do: 1. To handle hands in a hygienic way. 2. To prepare everything necessary for the injection. 3. To assemble the syringe and take the medicine from the ampule or vial. 4. Perform subcutaneous and intramuscular injections using the simulator (phantoms of the upper limb and gluteal region). Content of training material Parenteral (Greek. para – near, entern – intestine) method of the drug administered means injection. Injection refers to invasive interventions (from neo-Latin invasivus; from invado – «come inside»), it is a medical procedure with the penetration through the outer barriers of the body (skin, mucous membranes). The following parenteral ways of administration of drugs are used: in tissue (skin, subcutaneous tissue, muscles, bones), in vessels (veins, arteries, lymph vessels), in the cavity (abdominal, pleural, cardiac, joint), in the subarachnoid space (under the meninx), in the spinal canal, in any painful focus. The advantages of the parenteral method of drug administration are: 1. the speed of action of the drug, so the injection are used in the provision of emergency assistance; 2. greater accuracy of dosage, since the effect of gastric juice and digestive tract enzymes on medicines is excluded; 3. the barrier role of the liver is excluded; 4. vomiting, swallowing difficulty, the unconscious state of the patient do not obstacle to the introduction of the drug. Standard syringe volume for subcutaneous and intramuscular injections from 2 to 22mm; for intramuscular injection a needle length of 40, 60 mm and cross section of 0.8–1.0 mm is used, for intravenously – one with a length of 40 mm and a cross section of 0.8 mm, for subcutaneous – the needle with length of 20 mm and a cross section of 0.4–0.6 mm. Treatment of hands in a hygienic manner. The aim : to provide the infectious safety of the patient and medical staff, prophylactic of intra-hospital infection. It is held 1. before performing any invasive manipulations; 2. before working with particularly susceptible patients and newborns; 3. before and after manipulations with wounds and catheters;