Administering injectable medication

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You may have had a discussion about managing the symptoms that you or the person you are caring for are experiencing and how occasional one-off injections may relieve these. The information in this leaflet is intended to help you with your decision about giving these injections yourself and is an addition to the support and training you will receive if this is something you feel you can undertake.

You may decide that this is something that you do not feel confident enough to do and if that is the case that is absolutely fine, your nurses will work with you to find alternative solutions.

The nurse will insert a line into the layer of tissue just under the skin (subcutaneous tissue). This will stay in place so that medications can be administered. To save repeated injections being given, this line is referred to as the stat line
You will be taught what the medications are, what they are for, how much to give and when to give it as well as any likely side effects
You will be taught to draw up the medication into a syringe and how to administer through the line
You will be taught how to flush the line after administering the medication to ensure the whole amount is received
You will be shown how to record any drug that you have administered
Very occasionally, people prick themselves with the needle when they are preparing the medication. If this happens you need to make it bleed, wash it and cover it, and let your community nurse know so that she can provide you with additional advice
People can experience symptoms throughout the course of their illness, even in the last few hours of life. It may be that an injection you give to ease these symptoms may come close to the end of life of your relative or friend. This is not unusual, and you must not worry that this injection has in any way hastened their death.

Giving medication

As people become more poorly, they often lose the ability to swallow oral medications. In these instances, pain relief and symptom management can be controlled by injecting medicines under the skin. These symptoms can occur at any time of the day and night and when they occur, your community nursing team would usually be contacted and a nurse would come to administer the medication required, although it is possible that you or your loved one can be taught how to give these injections. You will receive support from your community nursing team throughout this time and they will discuss any concerns with you.

Medication information

Below are the most common symptoms people may experience and some examples of the drugs that are given to relieve these symptoms and provide comfort. These can be given as an injection as and when required, or may be used alongside a syringe driver. A syringe driver is a small electrical pump that delivers medication continuously over a period of 24 hours which the community nursing team will manage. Your community nursing team will discuss this in more detail and further information will be provided.

An individualised care plan will be developed to enable the management of the symptoms that you or the person you are caring for is experiencing. A prescription will be written by a Doctor or Specialist Nurse which provides the dose to be given. There will often be a range of doses provided so that the amount can be adjusted as required.

All medications may impact people individually and it is not uncommon when medications are first administered for someone to feel more drowsy or sleepy. If you are feeling concerned, please speak to your community nursing team.

What do you need to know?

Pain and breathlessness

Pain management is focused on controlling pain by administering the right drug, in the right dose, at the right time. Morphine is an opioid painkiller, it is used for moderate to severe pain. Opioids are strong drugs which are similar to the natural pain killing substances made by your body called endorphins. Opioids block pain messages from travelling along the nerves to the brain. Smaller doses of morphine have been used to treat breathlessness for many years as it can help to reduce rapid breathing to a normal rate.

For people who cannot tolerate morphine, the doctor or specialist nurse will prescribe an alternative medication. Oxycodone is an example of an alternative opioid that can be used for moderate or severe pain and breathlessness.

Nausea and vomiting

Nausea and vomiting can be caused by a number of factors. Talk to your nurse to find out if there are any other causes that can be alleviated. The prescribing practitioner will determine the cause before treatment with a medication is started.

Secretions

Some people experience a different breathing pattern which may be noisy or sound rattly. There may also be excessive secretions which are hard to relieve and changing position may help with this. Please discuss with the nurse for advice. The most common medications you may see to help with secretions are:

Glycopyrronium
Hyoscine Hydrobromide

Agitation

Towards the end-of-life people may appear restless, anxious or agitated. Relaxing medications such as midazolam may be used to help manage this. Your community nurses are available to support and advise you whenever you need it, so please contact the team if you have any questions.

First Community provides front-line NHS community healthcare services in east Surrey and parts of West Sussex.

We provide first-rate care, through our first-rate people, offering first-rate value. For more information visit: www.firstcommunityhealthcare.co.uk

If you would like this information in another format, for example large print or easy read, or if you need help communicating with us, please contact:

First Community (Head Office)

Call: 01737 775450 Email: fchc.enquiries@nhs.net Text: 07814 639034

Address: First Community Health and Care, Caterham Dene Hospital, Church Road, Caterham, Surrey, CR3 5RA.