Equipment:
1. Medication
   
2. 3cc syringe
   
3. Needle
   
4. Alcohol swab

Instructions:
1. Remove the syringe from the package.
   
   
2. Open the ampule of water. Hold the glass ampule in your hand and snap off the top at the thin portion (neck). You may wish to wrap a paper towel around the neck while snapping it off, to avoid being cut.
   
   
3. Take the cap off the needle.
   
   
4. Place the needle into the ampule containing water and pull back on the plunger until all of the water enters the syringe (the black plunger should be at the 2cc mark). You will use one ampule of water to dilute up to four ampules of Pergonal/Metrodin.
   
   
5. Open the ampules of Pergonal powder in the same manner you opened the ampule of water.
   
   
6. Add all the water to the powder by slowly depressing the plunger so the liquid enters the ampule of powder. The powder will dissolve readily. Do not shake the solution.
   
   
7. Pull back on the plunger of the syringe until the dissolved solution fills the syringe (the plunger should again be at the 2cc mark).
   
   
8. Repeat steps 6 and 7 until the prescribed medications are mixed.
   
   
9. Change the needle by twisting the needle cap until it comes off. Place the new needle on the syringe and twist it securely in place.
   
   
10. The injection is now prepared (refer to instruction sheet for giving intramuscular injections).

Instructions For Intramuscular Injections

Use instruction sheets that accompany the medication that you will be using in order to prepare the medication that you will be giving.

After the medication is prepared and it is time to receive the injection, assume a comfortable position. Lying on your side with your legs drawn up slightly will promote comfort as well as permit good visualization of the injection site.

1. Locate the injection site. Divide the side of the buttock that you will be giving the injection into four (4) quadrants. The horizontal line, (line A), begins at the crease of the buttock and extends outward. The vertical line, (line B), intersects line A in the middle. An imaginary cross is made. You will give the injection in the outermost upper quadrant.
   
   
2. Cleanse the skin with an alcohol swab.
   
   
3. Using the thumb and first two fingers of your non-dominant hand, hold the skin in position. Remember to stretch the skin, do not pinch.
   
   
4. When ready to inject, quickly thrust the needle into the skin at a 90-degree angle. Once the needle is in place, release the grasp of the skin.
   
   
5. As soon as the needle is in place, slowly pull back on the plunger with your non-dominant hand (the hand that just let go of the skin). If blood is noted to enter the syringe at this time, withdraw the needle from the site, change the needle and repeat the steps for IM injection using another site.
   
   
6. If no blood appears, inject the medication.
   
   
7. Withdraw the needle, and massage the area gently with a gauze pad or tissue.
   
   
8. Please rotate the sites for giving the injections each night. For example, if you give the first injection in the right buttock, then you will give the second injection in the left buttock.

I've been looking around for some kind of do's and dont's when injecting but haven't found anything yet.  When I do I'll post it here.

JH