How to Prepare and Inject Dexamethasone
Your nurse will teach you how to prepare and inject dexamethasone. It is helpful for you to review the steps in this handout every few months so that you will know what to do in case an injection is needed. The nurse will also review the steps with you during your child's follow-up visits to the clinic.
Whenever your child cannot take hydrocortisone by mouth or comits more than once, the medicine must be injected. If your child is weak, unconscious, or cannot wake up easily, the medicine must be injected. If your child is severely injured, appears very ill, or shows signs of adrenal insufficiency, the medicine must be injected.* In these situations, give the injection of medicine FIRST and then call.
Phone number _____________________________________
Emergency number _________________________________
Dosage: If your child is over 3 years old, all of the medicine (1 ml) is given. If the child is less than 3 years old, 0.5 ml is often given. Do not give a different amount than what is written unless told to do so by your doctor or nurse.
*For more information, see “Guidelines for the Child Who Is Cortisol Dependent”, HFFY #4424.
Storage and Replacement
It may be helpful to store all of your supplies in a small plastic container. You will need:
-vial(s) of Dexamethasone
-syringes and needles
Unused vials: Store at room temperature (not warmer than 86º F) in a dark, dry area.
Opened vials: After the vial is opened, label the vial with the date and time. Once opened, the solution is good for only 3 days. Keep it at room temperature.
Expiration dates: Vials of dexamethasone have expiration dates. Be sure to check these dates. Call for a new prescription if the date is near.
How to Prepare a Dose of Dexamethasone
Supplies: 1 vial of dexamethasone solution (contains 4 mg of dexamethasone in 1 ml fluid), alcohol wipe, 3ml syringe and ____ inch needle
- Wash your hands.
- Remove the plastic tab on the top of the bottle. Wipe the top of rubber stopper with an alcohol wipe.
- Connect the needle and syringe. To draw air into syringe, pull plunger of the syringe down to the ____ml mark. Remove the needle cap and insert needle straight through the center of the stopper until you see the needle tip. Inject air into the vial. Do not remove the needle.
- Turn the vial and syringe upside down. Keeping the tip of the needle below the medicine line, draw up ____ml of medicine into the syringe.
- Remove the needle and syringe from the vial. If you notice any large air bubbles in the syringe, point the needle upright and carefully press on plunger until the air space is gone. You are now ready to inject the dexamethasone.
How to Inject
1. Select an injection site in the thigh (see picture). Clean the site with an alcohol wipe.
2. Hold syringe like a dart at a 90º angle to the site.
3. With your other hand, hold the muscle firmly at the site.
4. Insert the needle straight into the skin with a quick firm motion.
5. Holding the barrel of the syringe, pull plunger back a bit to check for blood. This is rarely seen, but if it is, withdraw needle, replace with a new needle, and try another site.
6. Slowly push down on plunger until the syringe is empty.
7. Remove the needle quickly (at the same angle it was inserted). Apply gentle pressure to site with alcohol wipe, cotton ball, or gauze. The site may bleed a bit.
8. Throw out the needle and syringe in a puncture proof container (like a liquid detergent bottle or Sharps® container).
The Spanish version of this Health Facts for You is #6540.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 06/21/2011
Copyright © 06/21/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5909
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