As we talk about the methods of giving medication by different routes, it's
important to remember that you always need to follow the written instructions
from the child's health care provider. These instructions will tell you the
five rights: the child's name, the medication, dose, route, and time so you
know what to give and went to give it. But you may also need to look at the
information that comes with the medication either written on the package
or on the pharmacy printout for how to give the medication. Knowing how to give
medication is just as critical as knowing what to give because each
medication has specific instructions you'll need to follow. This training will
provide you with key principles to keep in mind as you give medication.
Topical medication comes in many forms including creams, lotions, gels,
ointmints, or aerosols. Putting on topical medication is usually not complicated
but follow these principles to make sure you give the medication safely.
You should wear gloves if the skin on your hands or the child's skin where the
medication is to be applied is cut, scabbed, or broken; if your skin should
not come in contact with the medication; If you feel more comfortable wearing
them; or if you will come in contact with body fluids such as saliva or naval
secretions. When applying creams, gels, or ointment, squeeze the medication into
your hand and then use your other hand to apply the medication. Don't put the
tube directly on the child's skin and squeeze. This helps keep the medication
container clean and makes sure you don't put too much on the child's skin. Apply
the medication evenly over the child's skin. If you need to apply more
medication, change gloves and squeeze the medication into the clean glove. Topical
medication can also come as an aerosol spray. The directions for use on the
bottle to tell you how far away from the child you should hold the spray.
You may also need to apply medicated patches to the skin. Medicated patches
are applied to the child's skin so the child's body can absorb the medication
slowly. The medicated patch may be left on the child for different lengths of
time so be sure you know if you are responsible for removing it. Even though
medicated patches are applied to the skin there are different principles for
putting them on. Using a waterproof pen, write the date and time directly on the
patch to communicate with others when it was applied. This helps if anyone other
than you is removing it. Choose the area where you will put the new patch. The
place you choose must be free from any cuts or broken skin. You should alternate
sites unless otherwise instructed. Clean the child's skin with soap and water and
pat the skin dry. Wear gloves if needed. All medicated patches may be applied
differently so be sure to follow the written instructions. Be sure these
instructions include what to do if the child removes the patch or if it falls
off. Even if the parents or other staff applied the patch, you may be responsible
for removing it, so follow these guidelines. To avoid coming in contact
with the medication put on gloves to remove the old patch. Unless otherwise
instructed, wash off the residual medication. It's good practice to roll
the patch up in the dirty gloves and throw it away so it's not accessible.
The most common way children get medication is by mouth, such as tablets,
liquids, melts, or medication that is rubbed on the gums. But no matter what
oral medication you give here are a few principles to follow to be sure you are
giving it safely. If you need to get tablets, capsules, or melts out of a
bottle, avoid touching them with your bare hands by pouring the number you
need into the container cap and then into a small cup. If you pour too many
out, return the extra ones to the bottle without touching them.
Even though the medication bottle is not sterile, this helps to keep the
medication as free as possible from germs. Always protect yourself and the
child when giving medication by wearing gloves. Whether or not you need gloves
depends on how the medication is prepared and if you may be exposed to
any body fluids while giving it. Never crush or split a tablet or capsule
unless you have instructions to do so. You can change the effectiveness of the
medication and may possibly harm the child if the medication has a protective
coating. If the instructions tell you to crush or sprinkle the medication, add the
medication to a small amount of food. This way you can be sure the child will
finish and get the entire dose. Be sure to check the package instructions to see
if there are certain types of food you should not mix the medication with. If a
child needs to swallow the medication, look in the child's mouth and under the
tongue to make sure the child took it.
Many medications given by mouth are also available as a liquid. Liquid medication
is often given to children because the dose can be easily adjusted based on the
child's age and weight and because the child has an easier time taking it.
Giving liquid medication by mouth will require you to pay careful attention to
how you are measuring the correct dose. When measuring liquid medication always
use the tool that comes with the medication or the one provided by the
parent. If the tool is separate from the medication container, make sure it is
labeled with the child's first and last names.
Remember, the measurement on the administration tool must exactly match
the measurement on the child's written medication consent form. Do not convert a
dose from one form of measurement to another. There is too much of a chance to
make a mistake. If the instructions tell you to give one teaspoon and the tool
only has measurements in CCs or milliliters, you will need a new tool
with teaspoons on it before you can give the medication. If you want to mark the
correct dose on the tool with a pen, be sure to mark next to the measurement
line instead of on top of it.
In addition to following the package instructions, keep these guidelines in
mind when measuring any liquid medication. Pour the liquid out of the
bottle from the side opposite the pharmacy label to avoid dripping any
medication on it. To make sure you have the right amount of medication, use the
lowest point of the liquids curvature, not the edges when measuring. If you pour
too much liquid into the medicine cup or spoon, pour the excess into a second
clean disposable cup. You can now use the second cup to add or subtract liquid
until you've reached the correct dose. Unless otherwise instructed, you can
return this leftover medication to the original container. If you're using a
medicine cup, put the cup on a flat surface
after you have poured the medication and check it at eye level. If you're using a
dosing spoon, check the medication dose at eye level and wipe any excess
medication that may be on the outside or in the lip of the dosing spoon to make
sure you are giving the correct dose. Even a little bit on the outside can
dramatically change the dose. After giving the medication, put a little water
into the cup or spoon to collect any residual medication that may be left
over. Have the child drink this.
If the parent gives you an oral medication syringe, check to see if it
has a cap. If so, be sure to remove it and throw it away so it does not become a
choking hazard. Before you start, make sure the plunger is pushed all the way
down into the syringe. If the bottle has an adapter, put the
syringe in the adapter and pull the syringe plunger until you get the
correct dose. Carefully turn the bottle upright before removing the syringe in
order to avoid spilling medication. If the bottle does not come with an adapter
pour a small amount of medication into a clean disposable cup. Place the tip of
the syringe into the liquid and pull up on the plunger to draw the medication.
The top of the plunger must be level with a line on the syringe that marks
the right dose. You need to make sure the syringe tip is filled with the
medication you need to give in order for the dose to be correct. There should not
be any air bubbles in the syringe. If you need to remove air bubbles, turn the
syringe so the tip is pointing towards the ceiling, then tap the syringe to move
the air bubbles to the top. Push the plunger to remove the air bubbles.
After removing the bubbles, recheck the syringe at eye level to make sure the
dose is correct and wipe off any medication on the outside of the syringe.
Give the medication by placing the tool in the child's mouth between the rear
gum and cheek. Do not squirt more medication then the child can swallow at
one time. After giving medication by mouth, be sure to clean any
administration tools you use to prevent buildup of medication. This will help
avoid giving a wrong dose and prevent possible infections. You can wash
medicine cups, dosing spoons, oral syringes, and pill crushers with
dishwashing soap in water, but never put an oral medication syringe in the
dishwasher because the rubber can break down or the measurement markings can
become worn and unable to read. Your trainer will
provide you with time to practice applying topical medications and giving
medication by mouth.