Technically Speaking |
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Monthly Column by Deborah Wexler, MD |
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Technically Speaking is a monthly column written by IAC’s Executive Director Deborah Wexler, MD. The column is featured in The Children's Hospital of Philadelphia Vaccine Education Center’s (VEC's) monthly e-newsletter for healthcare professionals. Technically Speaking columns cover practical topics in immunization delivery such as needle length, vaccine administration, cold chain, and immunization schedules. |
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Check out a recent issue of Vaccine Update for Healthcare Providers. The VEC e-newsletter keeps providers up to date on vaccine-related issues and includes reviews of recently published journal articles, media recaps, announcements about new resources, and a regularly updated calendar of events. |
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TECHNICALLY SPEAKING |
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Let's Get It Right! How to Avoid Shoulder Injury with Deltoid Intramuscular Injections |
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Published
October 2018 |
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During influenza vaccination season, and at all times
of the year, it is critically important that clinic staff who
administer vaccines avoid injury to patients’ shoulders by being
knowledgeable about how to properly administer intramuscular
injections in the deltoid muscle. At the October 2017 Advisory
Committee on Immunization Practices meeting, a presentation titled
"Reports of Shoulder Dysfunction Following Inactivated Influenza
Vaccine in the Vaccine Adverse Event Reporting System (VAERS),
20102016", included the following background information about shoulder
injury related to vaccine administration (SIRVA):
- Definition: SIRVA is caused by injury to the musculoskeletal
structures of the shoulder (e.g., tendons, ligaments, bursae,
etc.)
- It manifests itself as shoulder pain and limited range of
motion occurring after a patient receives a vaccine intended for
intramuscular administration.
- These symptoms are thought to occur as a result of unintended
injection of vaccine antigen or trauma from the needle going into
and around the underlying bursa of the shoulder, resulting in an
inflammatory reaction.
SIRVA may result in patients having chronic shoulder pain and
limited range of motion, and require ongoing medical
intervention. To avoid SIRVA, make sure clinic staff who
administer vaccines recognize the anatomic landmarks for
identifying the deltoid muscle and use proper intramuscular
administration technique. Helpful resources to assist with
staff education IAC resources
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How to administer intramuscular and subcutaneous vaccine
injections to adults This one-page educational tool includes diagrams and descriptions of boney landmarks and
provides practical, easy-to-understand instructions for
administering injections.
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How to administer intramuscular and subcutaneous vaccine
injections Covers
infants, children, teens and adults.
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Administering vaccines: Dose, route, site, and needle size.
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Administering vaccines to adults: Dose, route, site, and needle
size.
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Skills checklist for vaccine administration.
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Administering vaccines: Handouts webpage
With many additional free, downloadable, ready-to-print materials (all CDC-reviewed).
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DVD – Immunization techniques: Best practices for infants,
children and adults Updated in
2010 by the California Department of Public Health, this
25-minute DVD helps ensure that staff administer vaccines
correctly.
CDC resources
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