Section 3 Injections (注射术 )

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1 Section 3 Injections (注射术 )

2 Medication extraction
Contents Injection principles 1 Injection equipment 2 Medication extraction 3 Injection methods 4

3 Definition Injection is the prosess that injects a certain volume of sterile solution and /or biological into human body by using sterile syringe in order to prevent/ diagnosis/ and cure disease. 注射术是将一定量的无菌药液或生物制剂用无菌注射器注入体内，使其达到预防、诊断、治疗目的的技术。

4 intradermal injection 皮内注射法（ID） Subcutaneous injection 皮下注射法（H）
Injections According to the different levels of Injected into human tissue, Injections can divide into: intradermal injection 皮内注射法（ID） Subcutaneous injection 皮下注射法（H） intramuscular injection 肌内注射法（IM） intravenous injection 静脉注射法（IV） Arterial injection 动脉注射法（IA）

5 ★ Injection Principles
1、carrying out check principles stricktly .严格执行查对制度 1）Three Check 2）Seven Rights 3）Check the expiry dates and the package of each item including the drug and determine their quality.   4）As injecting multiple medications, check compatibility of medications.

6 ★ Injection Principles
2． Apply sterile technique.严格遵守无菌操作原则. 　　（1）Wash hands and wear mask before starting to prepare the injection 　　（2）During the procedure, such sections of syringe should be kept sterile as body of plunger, tip and shaft of needle （3）Disinfect the skin over the injection site. 注射部位的皮肤需消毒

7 Skin Disinfection The routine method : 常规消毒：2%碘酊（1）+70%乙醇（2）
以注射点为中心，螺旋式从内向外涂擦，直径≥5cm，待干 安尔碘：2遍

8 ★ Injection Principles
3． Abide sterile and isolation technique..严格执行消毒隔离制度 4. Appropriate syringe and needle. (选择合适的注射器及针头) 5. Appropriate injection site. (选择合适的注射部位) 6. Insert needle at appropriate depth and angle. (掌握合适的进针深度和角度)

9 ★ Injection Principles
7. Drow up medication from the container just before injection. (注射的药物应临时抽取 ) 8. Eject air thoroughly.(排空气) 9. Note blood return.(检查回血) 10．Give no- pain technique. (运用无痛注射技术)

10 Injection Equipments Medical tray 治疗盘 Medication （医嘱用药）
Medication card A sterile syringe and needle Sterile swabs 棉签 Antiseptic solution (alcohol and Anerdian) 消毒溶液 Sterile tweezers and vat （无菌镊子及缸） File or opener （砂轮、启瓶器） Sterile gauze blocks 无菌纱布 contamination Container （污物桶）

11 Needle and syringe Needle and syringe
Avoid touching the tip or inside of the barrel,the body of plunger ,bevel and shaft of the needle ,or the inside of hub . 避免接触注射器的乳头、空筒内壁、活塞体，针头的针尖、针梗和针栓内壁 Needle and syringe

12 三、 Drawing up medication from an ampule
安瓿的使用 砂轮锯痕 以棉签消毒锯痕处 折断安瓿颈

13 三、 Drawing up medication from a vial
自密封瓶内吸取药液: 结晶、粉剂溶解后吸取 混悬液摇匀后抽吸 油剂加温后抽吸（可能破坏药效者除外） 密封药瓶的消毒

14 Injection methods 常用注射术

15 intradermal injection 皮内注射术（ID）
Definition:An intradermal injection is the administration of a medication into the dermal layer of the skin just beneath the epidermis. 概念：将小量药液或生物制剂注射于表皮与真皮之间的技术。 Equipment ：Basic therapeutic tray(基础治疗盘) ， 4.5～5 -gauze needle。

16 Purposes and injection sites
Vaccination（ area around the end of deltoid） 预防接种（三角肌下缘） Medication allergy test （inner area of middle forearm ） 药物过敏试验（前臂内侧中下段） First step of topical anaesthesia 局部麻醉的起始步骤

17 Procedure of intradermal Injection
1、Prepare medication test solution and take equipment to client’s room. 2、Identify the client and medication. 3、Explain action of medication and procedure of administration. ask her history of hypersensitivity（过敏反应） 4、Select site for injection. Wash your hands and wear mask.

18 Procedure of intradermal Injection
5、Cleanse area twice with alcohol swabs. 6、Check medication again. 7、Expel air. 8、Grasp the client’s arm and pull skin tightly. 9、Identify client again.

19 Procedure of intradermal Injection
10、Insert needle at a 5-degree angle with the bevel of the needle facing up. 11、After the whole bevel goes into skin, fix the syringe firmly. 12、Inject 0.1ml medication slowly. Observe for signs of wheal formation and blanching at the site.

20 Procedure of intradermal Injection
13、Withdraw needle. Do not massage the area. 14、Record time. 15、Communication 。 16、Dispose of equipment. 17、Wash hands, and recheck. including bed card and medication 。 18、20 minutes later, observe and record result.

21 Subcutaneous injection （H）皮下注射
Definition: Subcutaneous injections involve placing medications into the Subcutaneous tissue. 概念：将少量药液或生物制剂注入皮下组织的技术。

22 Subcutaneous injection （H）皮下注射
It provides: More rapid absorption Larger volume of medication But it is also: More dangerous More complicated Equipment ：Basic therapeutic tray(基础治疗盘) ， 4.5～5 -gauze needle。

23 Purposes and injection sites
Area around the end of deltoid. 三角肌下缘 Lateral aspects of upper arm. 上臂外侧 Abdomen, avoid umbilicus area.腹部（避开肚脐） Scapular and waist area of back. 后背（肩胛和腰部） Front and side of thigh. 大腿前外侧

24 Procedure of Subcutaneous injection
1、Prepare madication and take equipment to client’s room. 2、Identify the client and medication. 3、Explain action of medication and procedure of administration.

25 Procedure of Subcutaneous injection
4、Select site for injection and have the client assume a position appropriate for the site selected. 5、Wash your hands and wear mask. 6、Cleanse area with Anerdian swabs. 7、Check medication again. 8、Remove the needle cap and expel all air bubbles from syringe. 9、Using the non-dominant hand, gently grip the skin over the site.

26 Procedure of Subcutaneous injection
10、Identify client again. 11、Using the dominant hand, introduce 1/2~2/3 of the needle at a 30-40° angle quickly with the bevel of the needle facing up. 12、Release the skin once the needle is in position and fix the syringe firmly. 13、Pull back the plunger a little.

27 Procedure of Subcutaneous injection
14、If there is no blood in the syringe, slowly push the plunger to inject the drug solution until all the medication is gone from the syringe. 15、Withdraw the needle quickly. 16、Hold pressure on the site for a moment. 17、Dispose of equipment. 18、Wash hands, and recheck against the MAR.

28 Intramuscular injection（肌内注射）
Definition: Intramuscular injection is the method to inject certain medication solutions into muscles. 将一定量药液注入肌肉组织内的技术。

29 Purposes To inject medications that can not be administered orally or are inadequate by oral administration 。1.需在一定时间内产生药效，而不能或不宜口服的药物。 To produce rapid effects, but the medication can not be administered by intravenous injection 2.不宜或不能作静脉注射，要求比皮下注射更迅速发生疗效时采用。 To inject irritating medication or large volume medication. 3.注射刺激性较强或药量较大的药物

30 Equipment ：Basic therapeutic
（三）肌内注射术（IM） Equipment ：Basic therapeutic tray(基础治疗盘) ， 6～7 -gauze needle。

31 Principles for selecting the site
Selecting the site where the muscles are large and thick. Selecting the site that is away from large nerves, bones, and blood vessels under the location. Selecting the site that is away from infection, bruising, scar, birthmarks, dropsy, or abrasionsin the surface. Do not use areas that are tender or irritated. Change injection sites for patients who require repeated injections.

32 Intramuscular injection sites
Deltoid三角肌注射部位 Dorsogluteal臀大肌注射部位 Ventrogluteal臀中、小肌注射部位 Vastus Lateralis股外侧肌注射部位

33 The dorsogluteal site for intramuscular injection
1.Cross method:

34 The dorsogluteal site for intramuscular injection
2.Line method: draw a line from anterior superior iliac spine to coccyx . The upper outer 1/3 area can be used for injection.

35 The ventrogluteal site for intramuscular injection
臀中、小肌注射区域定位方法 1. Triangle method: 以食指尖和中指尖分别置于髂前上棘和髂嵴下缘处，髂嵴、食指、中指构成一个三角形，即为注射部位。

36 The ventrogluteal site for intramuscular injection 臀中、小肌注射区域定位方法
2 .Three fingers method（三 指 法）:髂前上棘外侧三横指处（以患者的手指宽度为标准） Anterior superior iliac spine

37 The vastus lateralis site for intramuscular injection
the middle third and anterior lateral aspect of the thigh

38 The deltoid site for intramuscular injection
2–3 fingerbreadths below the acromion（肩峰） process on the lateral midline of the arm

39 Intramuscular injection Positions
Side-lying: lower knee flexed and the upper leg straight and relaxed

40 Positions Supine position: lie flat on the back or with the knee slightly flexed

41 Positions Prone position: pointing the toes inward.

42 Positions Sitting position

43 Procedure Preparation Inserting Injecting Withdrawing Arrangement
Prepare medication →Take equipment to client’s room→Identify the client and medication→Explain →Select site, assume position→Wash hands, wear mask→Cleanse area with Anerdian swab Check medication→Take a swab →Expel air bubbles→Make skin taut→Call client’s name→Insert 1/2~2/3 of the needle at a 90° angle Fix syringe→Pull back plunger→No blood returns, inject medication Withdraw needle→ Hold pressure on the site for a moment Get equipment back → Wash hands→check MAR →Instruct client Preparation Inserting Injecting Withdrawing Arrangement

44 （三）肌内注射术（IM）---注意事项 1、防疼痛 原因: 针头不锐利 体位不当 注射点选择不当 护士技术不熟练 药物刺激性强 预防：对应

45 （三）肌内注射术（IM）---注意事项 2、防晕厥 原因：病人精神紧张、恐惧， 体质虚弱、过度疲劳 药物刺激性强 注射快 预防和处理：分散病人的注意力 无痛注射 避免空腹注射

46 （三）肌内注射术（IM）---注意事项 3、防硬结 原因:药物吸收差 针头刺入过浅，未达肌层 长期注射 表现：触之有硬结、疼痛 预防和处理：进针直、深、正 长期注射应有计划更换注射部位 用热敷、仙人掌等治疗

47 4、防感染 （三）肌内注射术（IM）---注意事项 原因:执行无菌技术不严格造成 药物结晶体大，不易吸收 表现：红肿热痛
预防和处理：严格无菌操作 难吸收的药物应深部注射

48 5、防神经损伤 （三）肌内注射术（IM）---注意事项 原因:注射部位选择偏内下 注射药量过多过快 表现：坐骨神经损伤 影响关节内收屈曲
预防和处理：注射部位正确 50%硫酸镁局部热敷 注射ATP等改善神经营养

49 6、防断针 （三）肌内注射术（IM）---注意事项 原因:进针刺到髂骨 针头有裂纹 病人躁动、紧张 处理：保持镇静，一手固定局部，
下压肌肉，另一手用止血钳 夹断端，迅速拔出

50 Intravenous injection and blood sampling （IV）
定义 Definition: Intravenous injection and blood sampling is the method to administer medications into vein directly and collect vein blood as specimen. 自静脉注入无菌药液或抽取血标本的技术。

51 To inject medication which are not suitable for other routes .
Purpose To promote rapid absorption of the medication ,especially for the client with critical illness. To inject medication which are not suitable for other routes . To use for diagnostic test .for example ,X-ray examinations of liver,kidney. To get blood sampling .

52 Venipuncture sites in common use
Dorsal vein Median cubital vein Cephalic vein Basilic vein Small saphenous vein Greater saphenous vein Dorsal arch

53 Intravenous injection （IV）
Equipment ：Basic therapeutic tray (基础治疗盘) ， 注意：另备 Blood Collection Needle（采血针） Tourniquet（止血带） Tape（胶布） Container of specimen（标本容器）

54 Procedure of Intravenous injection
1、Prepare medication and take equipment to client’s room. 2、Identify the client and medication. 3、Explain the procedure to client. 4、Select site for injection and set the protective pad under arm. 5、Wash your hands and wear mask. 6、Apply Anerdian to selected venipuncture site.

55 Procedure of Intravenous injection
7、Apply tourniquet 6cm above selected site. 8、Check medication again. 9 、Connect syringe with winged needle. Expel all air bubbles from syringe and winged needle. 10 、Pull the skin taut. 11 、Call client’s name. Ask client to close fist. 12、With needle bevel up, enter client’s skin at an angle of 20-30。 and then enter into vein at an angle of 5-15。.

56 Procedure of Intravenous injection
13、Observe flashback of blood. 14、Flatten needle once it goes into vein and carefully advance needle up course of the vein. 15、Release tourniquet and fist. 16、Pull back the plunger. If blood returns, inject medication slowly. Observe client’s situation.

57 Procedure of Intravenous injection
17、Withdraw needle quickly, and press sterile swab over venipuncture site. Hold firmly until bleeding stops. 18、Dispose of equipment. 19、Wash hands, and recheck against the MAR.

58 静脉注射 持针姿势---平执式 绷皮手法 开皮 静脉穿刺 （上方、侧方） 潜行 见回血 平行进针少许

59 提高四肢静脉穿刺成功的方法 病人 肥胖 水肿 休克 老年 寒冷 特点 脂肪厚 血管不显 充盈不良 易滑动 静脉收缩 静脉深 脆性大 较固定
病人 肥胖 水肿 休克 老年 寒冷 特点 脂肪厚 血管不显 充盈不良 易滑动 静脉收缩 静脉深 脆性大 较固定 方法 静脉上方 按压局部 按揉局部 手指固定 局部热敷 角度稍大 显露静脉 血管充盈 静脉上下 显露静脉 进针 快速穿刺 后穿刺 两端穿刺

60 针头未刺入血管（Ａ） 原因：刺入过浅，针 头滑出静脉
静脉注射失败的常见原因 针头未刺入血管（Ａ） 原因：刺入过浅，针 头滑出静脉 表现：抽吸无回血 推注药液至皮下 局部隆起并疼痛

61 静脉注射失败的常见原因 针尖刺破对侧管（Ｂ） 原因：进针角度大 刺入过深 表现：抽吸可见回血 推注药液有痛感

62 静脉注射失败的常见原因 针头斜面未完全刺入静脉（Ｃ） 原因：针头斜面部分在血管外 表现：抽吸可见回血 推注药液局部隆起 并疼痛

63 针尖穿透对侧管壁（Ｄ） 原因：进针角度大 刺入过深 表现：抽吸无回血
静脉注射失败的常见原因 针尖穿透对侧管壁（Ｄ） 原因：进针角度大 刺入过深 表现：抽吸无回血

64 Key points 1、Select a vein that is easily palpated and feels soft and full,naturally splinted by bone,large enough to accommodate the needle to be used;keep the vein away from joint and vein valve.(选择粗、直、弹性好、不滑动的静脉,避开关节和静脉瓣.) 2、Long-term injectors， select vein from distal limbs to proximal limbs gradually. ( 长期注射者，先下而上,由远而近选择静脉)

65 Key points 3、Prevent medication spillover。(防止药液外溢) 4、Control the injection speed according to the nature of medication and condition of client。Observe local and whole body conditions。(根据病情及药物性质，掌握速度，随时听取患者的主诉，观察局部情况及病情变化)

66 Femoral Intravenous injection
Purpose： 1、 rescue the client who is in life-threatening situation. （抢救危重病人） 2、collect blood samples。 （采集血标本）

67 Femoral vein (股静脉) Femoral Triangle area , 0.5cm Medial femoral nerve and femoral artery (股三角区， 股神经和股动脉内侧) femoral artery:the middle point of line between superior Anterior and pubic tubercle 股动脉：髂前上棘和耻骨结节联线的中点

68 1、 Supine position , sterilize local skin 。 （仰卧位，消毒局部皮肤）
Key points 1、 Supine position , sterilize local skin 。 （仰卧位，消毒局部皮肤） 2、Sterilize the index finger and third finger （操作者：消毒食和中指） 3、 Injection angle: 90 or 45 degree 。 （进针角度：90 °或4５ °） 4、 Position : 0.5cm of Medial femoral artery 。 （进针部位：股动脉内侧0.5cm）

69 5、 Extract dull red blood 。(抽出暗红色血)
Key points 5、 Extract dull red blood 。(抽出暗红色血) 6、Press site 3~5min. (拔针后加压止血3~5min) 7、 If extract bright red blood,withdraw needle at once ,press site 5~10min.(抽出鲜红色血,立即拔针,按压穿刺点5~10min。)

70 syringe pumps微量注射泵 syringe pumps 微量注射泵 用于 将小剂量药液持续、均匀、定量输入人体静脉的注射装置 小儿
某些药物： 毛花苷丙、硫 酸镁、抗心律失常药物

71 操作要点： 插好电源 将抽吸好药液的注射器妥当地固定在注 射泵上

72 打开开关 设定注射速度

73 注射器与静脉穿刺针连接 消毒皮肤，穿刺进针；用胶布将穿刺针固定 按“开始”键，注射开始

74 当药液即将注射完毕时，“即将结束”键闪烁并报警，注射继续进行。
药液注射完毕，机器自动停止，“完毕”键闪烁并发出连续铃声

75 按压“静音”键，停止铃声； 再次按压“静音”键关闭“完毕”和“操作”灯 拔出针头或松开注射器与静脉穿刺针连接 取出注射器，关闭微量注射泵，切断电源

76 Arterial injection and blood sampling 动脉注射与采血术
Definition: Arterial injection and blood sampling is the nursing skill to inject medications into arterial and collect arterial blood as specimen. 定义 :是自动脉内注入无菌药液或抽取血标本的技术。

77 锁骨下动脉 桡动脉 肱动脉 锁骨下动脉 肘动脉 颈总动脉 尺、挠动脉

78 Arterial injection and blood sampling
Common site部位 Femoral Artery 股动脉 最常用 Carotid Artery 颈总动脉 Subclavian Artery 锁骨下动脉 Radial Artery 桡动脉 Brachial Artery 肱动脉

79 Purpose 1.to get artery blood sample。
To prepare for some special test,for examp ,cerebral angiography。 3.To give some medication for treatment 4.To make artery blood transfusion。

80 Key points of Arterial injection and blood sampling
1、 Sterilize local skin . (消毒局部皮肤) 2、Sterilize the index finger and third finger. (操作者：消毒食和中指) 3、 Injection angle: 90 or 40 degree 。 (进针角度：90 °或40 °角) 4、 position : the most clear artery pump site . （进针部位：股动脉搏动最强处。） 5、 Extract bright red blood 。（抽出鲜红色血） 6、Press site 5~10min. （拔针后加压止血5~10min）

81 Section 3 Medication anaphylaxis testing and anaphylactic reaction treatment

82 Contents 4. Iodic preparation anaphylactic test
Characteristics of anaphylactic reaction to medication 2. Penicillin anaphylactic test 3. TAT anaphylactic test 4. Iodic preparation anaphylactic test

83 anaphylactic reaction(过敏反应)
药物过敏反应又称为超敏反应，是由于药物或生物制品进入人体后作为抗原，刺激机体产生抗体，当人体再次接触同种药物或生物制品时，发生抗原抗体结合反应，造成组织损伤或生理功能紊乱，是一种病理性的免疫反应。

84 Characteristics of anaphylactic reaction to medication
1. Anaphylaxis only happens to a few people. (反应不具普遍性，只发生于少数人) 2. Anaphylaxis happens with relation to physical factors. (过敏的发生与体质因素有关) 3. Anaphylaxis happens with no relation to dosage. (很少剂量可发生过敏反应，致敏剂量往往少于常规治疗量，而剂量又往往和反应程度无关) 4. The clinical manifestations with no relation to normal pharmacological response or toxicity response. (临床表现与正常药理反应或毒性无关) 5. Anaphylaxis generaly happen to who take the medication for the second time .(一般均在再次用药后发病)

85 Mechanism of Penicillin anaphylaxis

86 The clinical manifestations临床表现
1. anaphylactic shock (过敏性休克) 2. serum sickness reaction (血清病型反应) 3. anaphylaxis of organ and tissue (各器官或组织的过敏反应)

87 anaphylactic shock symptom clinical manifestations
Respiratory failure symptoms chest tightness、shortness of breath，even feel dying Cardiovascular failure symptoms facial paleness 、cold sweat 、cyanotic 、rapid and weak pulse、 decreased blood pressure、dysphoria Central nervous system symptoms dizziness、quadriplegia、loss of consciousness、twitch 、excrement and urine incontinence

88 serum sickness reaction血清病型反应
Fever ( 发热) Edema pain in arthrosis (关节肿痛) Sinusoid swelling of lymph nodes (全身淋巴结肿大) Abdominal pain (腹痛) Urticaria (荨麻疹) Pruritus (皮肤搔痒)

89 anaphylaxis of organ and tissue
1、cutaneous anaphylaxis--- skin eruption (Urticaria) Exfoliative dermatitis ( 皮肤过敏反应---搔痒、荨麻疹、严重者发生剥脱性皮炎) 2、Respiratory anaphylaxis—asthma (呼吸道过敏反应---哮喘) 3、alimentary anaphylaxis--- Abdominal pain/hematochezia (消化道过敏反应---腹痛、便血)

90 Cautions of Penicillin administeration
1. Ask medical history 、 allergic history、and family allergic history before anaphylactic test 。 2.If the test is suspected positive, the nurse should do comparative test. 3.Use fresh allergic test reagent. 4. It is not appropriate that the patient is limosis during the test and administeration. 5. Observe the patient strictly during the anaphylactic test and administeration.

91 Cautions Penicillin Administeration
6.Be ready for the first aid before doing the test and administering the medication. 7.Inform the patient and his family the results. The nurse should record the positive result. 8. Equipment and NS should be dedicated. 9. Allergic test should redone in the following situation:when patient has stopped using for 3 days and should reuse it ;when the batch of the medication is changed.

92 Step of anaphylactic test 过敏试验的步骤
Before test： Ask、dilute、prepare Ask medical history 、 allergic history、and family allergic history in detail before anaphylactic test 。

93 method of anaphylactic test
“三抽两推” 青霉素 含青霉素量 生理盐水 （ml） 浓度 （u/ml） 80万 80万 20万 4 取0.1ml 2万 0.9 2万 推0.9 ml 2000 0.9 剩0.1ml 2000 推0.9 ml 200 0.9 200 剩0.1ml

94 Step of anaphylactic test
Prepare emergency medication box : one Epinephrine, one Dexamethasone, file, gauze , syringe； 备:急救药盒（0.1%盐酸肾上腺素1支、地塞米松1支、砂轮、纱布、注射器）

95 Step of anaphylactic test
After test Inform after inject No Press、no scratch . Do not go out。Do not walk around。 Observe the result in 20min。 If the patient feel uncomfortable，tell the nurse immediately. Observe 5min at bedside。 Observe result on time。

96 Result Determination Negative Result：No redness 、 swelling、blush、papula and the patient has no uncomfortable feelling.

97 Result Determination 皮试结果的观察
Positive Result: the wheel becomes large.there is skin redness、 swelling .The diameter of wheel is more than 1cm ,or there is pseudopodium.And the patient has pruritus feelling、dizziness, nausea , palpitation， anaphylactic shock may occur in severe case.

98 结果判断的注意事项 Suspected positive: Use NS to do comparative test.
Ask others to observe positive result. If the result is positive ,record the sign .

99 attention for Negative Result

100 过敏性休克的急救 就地抢救，争分夺秒 时间上―治疗上― 抗休克，抗过敏 过敏性休克的急救 沉着、冷静 态度― 处理― 及时、准确 观察―
严密、细致 100 100

101 First aid of Penicillin anaphylactic shock
Emergency treatment on site 立即停药，就地平卧，进行急救。 1 Administering Epinephrine immediately 立即皮下注射0.1%肾上腺素0.5-1ml. 2 Correcting hypoxia and improving respiration 纠正缺氧，改善呼吸。 3 Treating allergic shock 抗过敏休克。 4 Correcting acidosis and Administering anti-histamine medications 纠正酸中毒，和应用抗组胺药物。 5 Observing the client intensively and recording information 密切观察，详细记录。 6

102 The cause of anaphylaxis:Immune serum of equine
TAT anaphylactic test The cause of anaphylaxis:Immune serum of equine 过敏原因：免疫马血清 Allergic test should be done in the following situation: 1、 Use for the first time ; 2、when patient has stopped using for 7 days and should reuse it ;

103 The method of TAT anaphylactic test
Dilute the original TAT fluid (1500IU per milliliter) 0.1ml to 1ml,which is 150IU per milliliter.this solution is the reagent. 皮试液的配制：取每ml含TAT 1500IU的原液0.1ml加入生理盐水至1ml ，皮内注射TAT试验液0.1ml(含TAT 15IU)

104 Result Determination（结果判断）：
TAT anaphylactic test Result Determination（结果判断）： Positive Result：The wheel becomes large.there is skin redness、 swelling .The diameter of wheel is more than 1.5cm ,and blushing with diameter larger than 4cm. 阳性：红晕直径>4cm，硬结直径>1.5cm Negative Result：No local redness 、 swelling ， no abnormal systemic reaction. 阴性：局部皮丘无变化，全身无反应

105 TAT desensitized injection
Mechanism of desensitized injection: IgE be consumed principle of desensitized injection: 1、inject small dosages ,Increase dosages gradually; 2、inject at the interval of 20 minutes; 3、observe the patient strictly; 脱敏注射原则： 少量多次，逐渐加量 注射间隔为 20 分钟 密切观察

106 TAT desensitized injection
times TAT Normal saline Administration route 1 0.1ml 0.9ml IM 2 0.2ml 0.8ml 3 0.3ml 0.7ml 4 remainder dilute to 1ml

107 Iodic preparation anaphylactic test碘过敏试验
Iodic preparation anaphylactic test:Iodide is a kind of contrast agent.It is commonly used in the clinically. If it is the first time to use, Allergic test should be done 1 or 2 days before graphy with iodide .If the result is negative ,angiography can be done. 碘过敏试验：碘化物为一种造影剂，在首次用药前1-2天做过敏试验，为阴性者方可做检查。

108 The method of Iodic preparation anaphylactic test
Oral Administration: Take 5%-10% potassium iodide（碘化钾）5ml for oral administration three times a day. Observe the result in 3 days. 口服法：5%-10%的碘化钾5ml，每日3次，共3天。

109 The method of Iodic preparation anaphylactic test
Intradermal injection: Take iodide contrast medium 0.1ml for intradermal injection,and observe the result 20min later. 皮内注射法：取造影剂0.1ml做皮内注射，20分钟后观察结果。

110 The method of Iodic preparation anaphylactic test
Intravenous injection: Take iodide contrast medium 1ml for intravenous injection,and observe the result in 5 to 10min. 静脉注射法：取造影剂1ml，静脉推注，5-10分钟后观察结果。

111 Result Determination：Positive Result
Oral Administration:paralysis of mouth, dizziness ,palpitation, nausea and vomiting 口服后：有口麻、头晕、心慌、恶心呕吐等症状 Intradermic injection: local skin becomes red and swelling or sclerosis appears,with the diameter more than 1cm . 皮试后：局部有红肿、硬结，直径超过1厘米。 Intravenous injection:Blood pressure, pulse, respiration and face color of the client have changed. 静脉推注后：血压、脉搏、呼吸和面色等改变。

112 Thank You !