• deposit medication into dermal layer of the skin
• forearm and back. site free of superficial blood vessels
• needle at 10 to 15 degrres bevel up
• look for small bump or wheal to form
• do not rub or massage the site

• place medication into the subcutaneous tissue promotes slow absorption
• upper arms, thighs, or occasionally abdomen. site free of superficial blood vessels , nerves, and tendons
• 45 degree bevel up 
• 1-3 ml's
• can use the sublingual tissue
• gently rubbing or massaging the site will help initiate systemic absorption

• deposit medication into muscle tissue
• deltoid up to 2 ml's
• dorsal gluteal 5 ml's or more
• vastus lateralis 5 ml's or more
• rectus femoris up to 5 ml's
• 90 degrres bevel up
• rubbing or massaging the site helps initiate systemic absorption

Intravenous Access

(cannulation)

Peripheral Venous access

• fluid and blood replacement, medication administration, obtaining venous blood for testing
• anticubital(basilic or cephalic veins), dorsal(hand or foot hand preffered)and external jugular vein
• work distal to proximal with attempts

Intraosseous Infusion

(IO)

• inserting a rigid needle into the cavity of a long bone or into the sternum
• proximal tibia, medial malleolus of the distal tibia, humeral head, an the sternum
• patients in shock, cardiac arrest, pediatric hypovolemia, multiple trauma