SO, YOU KNOW?

THIS IS THE SECOND WEEK
OF A TWO-WEEK MODULE

AND WHAT YOU'RE
GOING TO BE DOING

IS JUST AGAIN,
MORE IM INJECTIONS,

DIFFERENT KINDS OF SYRINGES,

DIFFERENT LOCATIONS,
DIFFERENT MUSCLES.

WE'VE GOT TO LEARN 'EM ALL
AND LEARN ALL OF OUR
APPARATUS.

SO, IF YOU GUYS -- THIS IS THE
WORST SEATING OVER HERE.

IF YOU GUYS WANT TO MOVE
TO HERE YOU'LL SEE BETTER,

BEFORE WE GET THE CAMERA
GOING.

BECAUSE I'M GOING TO BE STANDING
AND DOING EVERYTHING HERE

AND YOU WON'T BE ABLE
TO SEE QUITE SO WELL.

SO A LITTLE SHIFT.

FIRST ONE WE'RE GOING TO DO
IS WE'RE JUST GOING
TO DO PEOPLE

AND GET IT OVER WITH,
BECAUSE THAT'S OUR HIGHEST
ANXIETY AREA.

AND SO WHAT I'D LIKE FOR YOU
TO DO IS GIVE TWO SHOTS
TO A PERSON

AND YOUR GOING TO BE IN
YOUR PARTNER GROUPS.

SO, I THINK ALL OF
THE GROUPS HAVE SIX.

THERE'S TWO IN EACH GROUP.

ONE GROUP HAS FIVE,
AND WE'LL JUST DO
A THREESOME AND A TWOSOME.

SO SOMEONE WILL STICK THAT ONE,
THAT ONE WILL STICK THAT ONE,

THAT ONE WILL STICK THAT ONE.
IT WILL ALL WORK OUT, OKAY?

WHAT WE'RE GOING TO DO
IS GIVE TWO SHOTS.

YOU CAN BARELY SEE IT. I'M
GOING TO TURN THE LIGHT UP
OVER THERE.

BUT YOUR GOING TO GIVE SODIUM
CHLORIDE, A HALF CC IM NOW,

AND THAT'S GOING TO BE
OUR DELTOID INJECTION.

AND THAT'S TO BASICALLY SIMULATE
OR MOCK THE FLU SHOT.

BECAUSE IF WE --
THEY DIDN'T ASK ME TO HELP

WITH THE FLU CLINIC THIS YEAR,
BUT YOU WILL.

THEY DID IT IN
FIFTH SEMESTER INSTEAD.

SO AT SOME POINT IF YOU'RE
INVOLVED IN FLU CLINICS,

THIS IS WHAT THAT INJECTION
IS TOTALLY LIKE.

AND THIS IS THE SYRINGE THAT THE
COUNTY USES TO GIVE THAT SHOT.

SO I WANTED YOU TO PRACTICE
WITH THAT EXACT SCENARIO.

THE SECOND SHOT YOU'RE GOING
TO BE GIVING IS THE 0.1 CC IV,

WHICH IS YOUR
INTRADERMAL INJECTION

AND THAT IS TO SIMULATE
YOUR TB SHOT.

THE SAME ONE YOU GET
WHEN YOU GO TO GET

YOUR TB SKIN TEST
TO SEE HOW THAT WORKS.

AND SO WE'RE USING THE SAME
VOLUME OF SOLUTION,

JUST SODIUM CHLORIDE.

EVERYTHING WITH US IS FAKE.

NOW, YOU'VE USED UP
YOUR SODIUM CHLORIDE.

YOU'VE PRACTICED.
IT'S CONTAMINATED.
IT'S NO GOOD.

SO YOU CAN USE IT
FOR PRACTICE AND TO,

YOU KNOW, HANDLE THE
SYRINGES AND SO FORTH.

BUT WHEN YOU COME TO
THE STATIONS NEXT WEEK,
WE'LL HAVE EVERYTHING THERE SET.

YOU DON'T HAVE TO GATHER UP ANY
SUPPLIES EXCEPT FOR THE INFANT

THAT YOU'RE GOING TO DO
THE VASTUS LATERALIS ON.

WE NEED TO MAKE SURE
EVERYTHING IS STERILE
BECAUSE IT'S REAL PEOPLE.

SO, YOU WILL DO THAT ONE
TOTALLY WITH US

AND GATHER UP YOUR SUPPLIES

SO WE CAN WATCH AND KEEP TRACK
OF ALL OUR SUPPLIES.

OKAY? SO THAT WILL HELP.

ALRIGHT, SHANNON'S
GOING TO HELP ME.

SHE'S GOING TO COME UP
HERE AND BE MY PERSON.

AND I WANT HER TO SIT
HERE WITH ME

BECAUSE WHEN YOUR
DRAWING UP YOUR STUFF,

I WANT YOU TO BE
DOING IT TOGETHER,

AND KIND OF CHECKING
EACH OTHER.

I'M REALLY NOT WATCHING
THAT MUCH ANYMORE

AND I DON'T REALLY CARE
TO EVER CHECK OFF ANOTHER DROP
IN A VIAL EVER AGAIN.

BECAUSE I'VE CHECKED YOU OFF
ALREADY ON INSULIN,

I CHECKED YOU OFF ON HEPARIN,
I CHECKED YOU OFF ON
AMPICILLIN,

I'VE CHECKED YOU, CHECKED YOU.
YOU KNOW THE PRINCIPLES OF IT.

SO, YOU GUYS BE THE CHECK
FOR EACH OTHER,

I'LL BE WATCHING FOR
BASIC BREAKS IN STERILITY
OR WHOEVER THE INSTRUCTOR IS.

SO, I'VE CHECKED
MY DOCTOR'S ORDER.

AND ACTUALLY, I COULD'VE
GIVEN YOU A LITTLE BETTER
GUIDANCE ON HERE.

IT SAYS YOU SELECT YOUR OWN
SYRINGE. YOU WON'T EVEN
HAVE THAT OPTION.

I'M GOING TO SELECT FOR YOU
AND I'LL TELL YOU WHAT
THEY ARE GOING TO BE.

BUT WE'RE GOING TO
GIVE OUR INJECTION

AND SO I AM GOING TO
GATHER UP MY SUPPLIES.

THE FIRST THING I WANT TO DO
IS GATHER UP MY SODIUM
CHLORIDE, WHICH I HAVE,

AND I'VE CHECKED
THE EXPIRATION DATE.

AND MY PARTNER APPRECIATES
THAT IT'S GOOD.

GOOD STUFF, OKAY?

I HAVE MY SODIUM CHLORIDE.
I HAVE A BAND-AID
BECAUSE SHE'S REAL

AND WE ARE REALLY GOING TO
PUT THEM ON NOW,

UNLIKE ON OUR PRACTICE PADS.

OKAY? SO I'M GOING TO REALLY
GET MY BAND-AID READY.

SHE'S GOT CLOTHES ON
AND SO VERSUS LIKE A GOWN --

EVEN THOUGH IT MAY NOT BLEED
-- WELL, SHE MAY OR MAY NOT,
I DON'T KNOW, BUT WHATEVER.

SOMETIMES YOU DO IT
AND IT LOOKS GOOD AND
YOU DON'T PUT ANYTHING ON,

BUT THEN THERE'S
THIS LITTLE OOZE.

HAVE YOU GONE FROM
THE DOCTOR'S OFFICE

AND THEN THERE'S THAT LITTLE
SPECK ON YOUR WHITE
SILK BLOUSE?

OH, MAN! SO GO AHEAD
AND PUT A BAND-AID ON

WHEN ANYONE'S IN PLAIN CLOTHES
AND TELL THEM THEY CAN TAKE IT
OFF IN 10 OR 15 MINUTES,

WHEN YOU KNOW IT'S
NOT GOING TO OOZE.

I LIKE TO HAVE
MY BAND-AIDS READY.

AND BY THE WAY, I REALLY
HAVE WASHED MY HANDS, REALLY.

AND I REALLY WANT YOU TOO.

I JUST DID IT LIKE TWO MINUTES
AGO BEFORE I STARTED.

SO I AM REALLY WASHED
AND REALLY CLEAN.

- YOU BETTER BE.
- I AM.

BECAUSE I LIKE YOU SHANNON,
I WILL DO THE BEST FOR YOU.

AND I'M GOING TO GET
MY BAND-AID READY.

I TAKE THE FIRST STRIP OFF.
THE SECOND ONE PROTECTS
THE TELFA.

BUT MY FIRST ONE KEEPS IT READY,
SO IT'S AN EASY STICK FOR ME.

SO MY BAND-AID IS READY.

AND I HAVE MY ALCOHOL
MY 2 BY 2'S
AND LOTS OF STUFF HERE.

ALRIGHT.
I NEED TO PICK A SYRINGE.

NOW YOU NEED TO THINK
AGAIN ABOUT VISCOSITY
AND MUSCLE, OKAY?

SO, SODIUM CHLORIDE?

PRETTY THIN.

SO HOW BIG A GAUGE
WOULD YOU WANT TO PICK?

WHAT'S OUR RANGE.
LET'S START WITH THAT.

WHAT'S THE RANGE?
- 20 TO 23?

- 20 TO 23. WE KNOW THAT 20 IS
GOING TO BE PRETTY BIG, RIGHT?

AND WE LIKE EACH OTHER
A LOT HERE.

AND THERE'S REALLY NO NEED
FOR THAT BIG, OLD NEEDLE
FOR NICE, SOFT MUSCLE.

SO WE'RE GOING TO GO
WITH THE 22 GAUGE.

THESE ARE PRE-ATTACHED.

SO I HAVE MY 22 GAUGE.

AND I ALSO KNOW THAT I'M
GOING TO BE IN THE DELTOID.

NOW, SHE DOES NOT HAVE
A HUGE DELTOID HERE.

AND SOME -- YOU KNOW,
I LOOK AT SOME OF THESE GUYS,

THEY HAVE BIGGER DELTOIDS.

THEIR MUSCLE MASS IS DIFFERENT
AND GREATER IN THE DELTOID.

SO WE ARE GOING TO PICK OUR
NEEDLE LENGTH APPROPRIATELY.

HONESTLY, ALMOST
EVERY AVERAGE ADULT,

UNLESS THEY ARE ANOREXIC
OR SO VERY, VERY LEAN,

CAN TAKE UP TO AN INCH.
AN INCH TO AN INCH AND A HALF

DEPENDING ON HOW BIG
THE MUSCLE -- HOW BIG
THAT BICEP IS.

SO, I'M PICKING A ONE INCH

BECAUSE IT'S GOING TO BE
SAFE AND I AM A SQUEEZER.

SO I SQUEEZE UP THE MUSCLE
AND I KNOW I WILL BE WAY FINE.

OKAY? SO 22 GAUGE,
ONE-INCH NEEDLE.

AND I PICKED A NEW SYRINGE
YOU HAVEN'T DONE YET.

AND THEY'RE MY FAVORITE.

THEY'RE SO FUN.

THEY'RE CALLED VANISHPOINT,
AND I'LL SHOW YOU
HOW IT WORKS.

IF I CAN GET IT TO OPEN HERE.

ON THE VANISHPOINT SYRINGE, THE
SAME FEATURES AS ALL THE OTHERS,

EXCEPT THAT AT THE END OF
THE PLUNGER IS A BUTTON.

OKAY? SO THERE'S A BUTTON.

WE'VE GOT A PLUNGER
THAT WILL RELEASE.

YOU HAVE GOT YOUR FLANGE.
YOU HAVE GOT YOUR BARREL.

BECAUSE THIS IS A HALF CC,
WE CAN GO WITH A 3 CC SYRINGE.

BECAUSE WE'RE RIGHT
AT THAT BREAKPOINT

AND WE DON'T HAVE ANY
"HUNDREDTH OF" TO DEAL WITH.

SO 0.5, WE'RE OKAY.

AND THEN WE HAVE THE NEEDLE.

NOTICE HOW I PULL AWAY STILL.
I'VE WATCHED A FEW OF THIS.

STILL SCARES ME.
DOCTOR, SCARE ME.

ALRIGHT.
WHEN YOU LOOK HERE AT THE HUB,

IF YOU LOOK CLOSELY,
THERE'S A SPRING IN HERE.

IT'S SPRING LOADED.

THERE'S ALSO --
AT THE END OF THE PLUNGER,

AND IT'S A LITTLE
DIFFICULT TO SEE,

BUT CAN YOU SEE THIS
YELLOW THING STICKING OUT?

THIS YELLOW IS CALIBRATED
SO THAT IT PUSHES
THE DOSE THROUGH.

I JUST NEED YOU TO
APPRECIATE THAT

SOMETIMES AIR BUBBLES GET
STUCK AROUND THAT YELLOW THING

AND YOU JUST CAN'T
GET THEM OFF.

DON'T WORRY ABOUT IT,
BECAUSE WHEN YOU LOOK,

IT DOESN'T GO ANY FURTHER
THAN THAT ANYWAYS, OKAY?

SO DON'T FIGHT THE AIR BUBBLES
STUCK ON THE YELLOW.

ALRIGHT, I JUST WANT YOU
TO SEE HOW THIS WORKS.

I'M GOING TO CLEAN.
I'M GOING TO GET MY MED.

I'M GOING TO GIVE MY SHOT.

I'LL PROBABLY STABILIZE
MY SHAKY LITTLE HANDS.

DOES THAT BOTHER YOU?
- NO.

- GOOD, BECAUSE I HAVE
SHAKY LITTLE HANDS.

I AM GOING TO ASPIRATE.
I AM GOING TO GIVE MY DOSE

AND THEN I'M GOING TO
PUSH THIS BUTTON.

NOW, THIS BUTTON IS STIFF,

AND SO YOU HAVE TO HOLD
THE BARREL STEADY,

SO THAT WHEN YOU
PUSH ON HERE,

YOU DON'T PUSH INTO
THE CLIENT, OKAY?

SO IT'S A TECHNIQUE.

WHEREAS BEFORE REMEMBER
THAT WE DID LIKE Z-TRACK.

YOU WOULD HAVE TO
REALLY STABILIZE WITH
THESE FINGERS TO PUSH.

AND I AM JUST --
I AM STRONG TWO-HANDED.

SO I'M GOING TO TAKE THIS,
I'M GOING TO PUT IT IN,

PINCH UP, PUT IT IN,
STABILIZE,

IN, IN AND THEN LISTEN
TO THIS BUTTON.

IT'S GOT TWO CLICK FEATURES.

LIKE IN THE DRAWING
AND PREPARING OF YOUR MED,

YOU MIGHT PUSH THIS
BUTTON A LITTLE HARD

AND YOU DON'T WANT TO
RETRACT THE NEEDLE
OR IT'S ALL WASTED MED.

SO IT'S GOT
A TWO-CLICK FEATURE.

ONE, IN CASE YOU PUSH A LITTLE
HARD IN THE PREP OF MED,

BUT IT'S THE SECOND CLICK
THAT RETRACTS THE NEEDLE BACK.

SO IT WOULD BE IN
HER SKIN RIGHT NOW

AND I WOULD BE STABILIZING --

HAS EVERYONE GOT IT. ON CAMERA
AND EVERYTHING AND BE QUIET.

OKAY? SO YOU NEVER
TAKE IT OUT OF THEM,

YOU JUST GO CLICK-CLICK.

AND I COULDN'T HEAR IT
THE WAY I WAS PUSHING
BECAUSE I'M HAVING TO HOLD.

I'M JUST PUSHING FIRMLY.
I'M PULLING BACK
ON THE FLANGE.

PUSHING, SO THAT I'M NOT
PUSHING IT IN TO THE CLIENT.

YOU GOT TO KEEP IT STEADY.

OKAY? SO THAT'S WHAT YOU ARE
GOING TO WANT TO PRACTICE.

- SO YOU LET GO OF YOUR PINCH?

- UH-HUH. YEAH, YOU NEVER HAVE
TO HOLD ON TO THE PINCH.

IT'S JUST TO KEEP
THE SKIN TAUT

SO THERE'S NO PUCKERING
WHEN THE NEEDLE GOES IN.

AND THAT'S WHY WE
EITHER SPREAD OR PINCH

SO THAT SKIN IS TAUT.

PUT IT IN, GIVE IT
AND THEN STEADY, STEADY.

I HAVE STABILIZED HERE
AND HERE AND THEN PUSH.

AND IT'S JUST...DONE.

NO NEEDLE.
AND YOU SET IT DOWN

AND I NEVER FORGET THE BUTTON
BECAUSE THE BUTTON IS SO FUN.

DO YOU FORGET THE
LITTLE SHEAFY THING?

BECAUSE IT'S NOT FUN.
IT'S JUST NOT FUN.

OKAY. SO THIS WOULD STILL
GO IN THE SHARPS CONTAINER,

BUT IT'S SELF-CONTAINED
AND THAT'S THE BEAUTY OF IT.

ALRIGHT.
SO NOW WE'RE REALLY PREPARED.

AND WHAT I WANT YOU TO DO
BECAUSE WE'RE GOING TO
BE EFFICIENT

IS WE'RE GOING TO DRAW UP BOTH
SYRINGES AT THE SAME TIME.

BECAUSE YOU'RE GOING TO GIVE
BOTH TO THE SAME CLIENT.

JUST SO I WOULD CHECK
MY MAR TO THE NAME BAND

WHEN I IDENTIFY
MY CLIENT AND SO FORTH.

BUT THE GLOVES ARE TO PROTECT ME
FROM HER, NOT HER FROM HERSELF.

SO YOU WANT TO JUST KEEP
ONE SET OF GLOVES ON,

GIVE THE SHOT,
GIVE THE SHOT.

ALRIGHT. SO GO AHEAD
AND DRAW THEM BOTH UP.

I HAVE MY NEEDLE
FOR MY INTRADERMAL,

MY SHEDDING.
THANK YOU.

- ARE THESE EXPENSIVE NEEDLES?

- YES, THESE ARE
EXPENSIVE SYRINGES.

SO I DON'T PUT TONS OUT
FOR YOU TO JUST PUNCH
AND PUNCH THEM.

I REALLY ONLY WANT YOU
TO DO ONE.

THANK YOU FOR THAT REMINDER
BECAUSE THEY'RE VERY
EXPENSIVE.

A BOX OF A HUNDRED COSTS
ME ABOUT $150 TO $200,
SOMEWHERE IN THERE.

SO IT'S JUST LIKE TRA--
I MEAN, IT IS A LOT OF MONEY.

SO WE HAVE ENOUGH FOR YOU
TO GIVE AND ONLY ONE
TO PRACTICE WITH.

WE'LL HAVE OTHER SYRINGES
SO YOU CAN PRACTICE DARTING

AND HOLDING AND THINKING
THROUGH THE PROCESS.

BUT TO JUST SPRING ALL OF MY
NEEDLES, THAT WOULD BE NICE.

ALRIGHT, I'M GOING TO
POP MY LID OFF

AND BECAUSE I'M THE
FIRST ONE TO OPEN IT --

I DON'T REALLY NEED
TO CLEAN THAT OFF,

I HAVE GOT MY HALF CC OF AIR.

I LIKE TO HOLD IT,
SO I DON'T CONTAMINATE.

I DROP A LOT.

KEEP IT STRAIGHT.
KNOCK THOSE OUT.

CANDY IS GOING TO BE
MY PUNCTURE PERSON.

I HAD ASKED CONNIE,
BUT SHE WON'T DO IT.

AND I'M GOING TO SQUIRT
MY AIR STRAIGHT OUT.

- WELL, SHE SHOWING US SOMETHING
IN THE SKILLS LAB YESTERDAY,

DURING THE TEST
FOR PEOPLE THAT CAN'T DO THIS.

- HERE'S A FEW THINGS.

OR YOU CAN KNOCK IT
EVEN ON THE TABLE,

IF YOU WANT TO
GET 'EM LOOSENED.

THE KEY IS JUST TO GET IT --
GET YOUR SYRINGE STRAIGHT UP.

AND AIR TENDS TO GET CAUGHT
IN THE HUB AND THAT'S WHAT'S
TRIPPING YOU UP.

AND SO YOU'VE GOT TO
PULL IT OUT.

AND IF YOU PULL
THE PLUNGER DOWN,

IT WILL RELEASE THOSE
BUBBLES THAT ARE STUCK.

KIND OF SNAG IT.

AND THEN GET IT CENTERED
AND THEN STICK IT STRAIGHT UP.

BUT SOMETIMES IT HURTS TO
FLICK WITH YOUR FINGER.

YOU KNOW,
SO I TAP WITH THIS

OR YOU CAN HIT WITH YOUR PEN
TO LOOSEN THEM UP.

BUT DON'T FIGHT THOSE
LITTLE CHAMPAGNE BUBBLES,

FIGHT THOSE BIG ONES
THAT ADHERE TO THE SIDE
AND CHANGE YOUR DOSE.

SO I'M GOING TO LET HER CHECK
AND SEE IF SHE'S HAPPY
WITH HER DOSE

IF AND SHE'S GETTING IT.
ARE YOU HAPPY?

OKAY. STEADY DOWN,
NO SHAKY HANDS

AND GET IT IN THERE
NICE AND STERILE.

I AM NOT GOING TO LABEL
ANYTHING BECAUSE I AM NOT
LEAVING MY AREA.

I'VE GOT MY SOLUTION HERE.

WE'RE GOING TO DRAW AND GIVE,
SO DON'T WASTE YOUR TIME.

IF I WAS GOING SOMEWHERE,
I WOULD.

ALRIGHT. NOW I AM GOING TO GO
AHEAD AND DRAW UP
MY INTRADERMAL

AND I WANT TO TALK THROUGH
THIS SYRINGE A LITTLE BIT.

WE HAVE A O.1 CC
VOLUME OF WATER.

ALRIGHT. SO WHAT KIND OF
SYRINGE DO I NEED?

- ONE CC.
- ONE CC.

BECAUSE IT IS LESS
THAN A HALF OF A CC.

ANYTHING LESS THAN 0.5,
YOU NEED TO GO TO THE 1 CC

BECAUSE IT'S IN --
ACCURATE TO THE HUNDREDTH.

I PICKED A 1 CC SYRINGE

AND IT'S VERY THIN, WATERY.

AND SO I KNOW I DON'T NEED
A THICK GAUGE AT ALL.

AND I KNOW I AM JUST GOING
UNDER SKIN LAYER.

I AM INTO THE SKIN,
NOT EVEN UNDER.

I DON'T WANT TO GO
SUBCUTANEOUS AT ALL.

I WANT TO GO INTO SKIN.

I ALSO KNOW THAT WHEN
YOU DO AN INTRADERMAL,

YOU DON'T PUT THE
WHOLE NEEDLE IN.

YOU JUST MAKE THE SKIN TAUT

AND YOU ONLY PUT THE BEVEL
AND A LITTLE BIT MORE.

SO JUST EVER SO SMALL
OF AN AMOUNT

AND THEN YOU FORM
A WHEEL WITH THE SOLUTION.

SO I HAVE PICKED A 27 GAUGE,
HALF-INCH NEEDLE.

VERY, VERY THIN.
VERY, VERY SHORT.

AND ITS SAFETY FEATURE
IS GOING TO BE THE
SAFETY GLIDE.

SO I'VE GOT ALL THE FEATURES
I NEED IN THIS
PARTICULAR SYRINGE.

YOU KNOW HOW TO WORK
THE GLIDE.

SO -- I GOT TO GET
THE SPECS OUT HERE NOW.

THIS IS SERIOUS.
I CAN'T SEE THE LITTLE LINE.

DOES THAT MAKE YOU NERVOUS?
SEE, SHE'S GOOD. SHE'S OKAY.

ALRIGHT.
I HAVE MY LITTLE 0.1.

AGAIN SAME --
PULL IT AWAY FROM YOU.

HOLD ON TO THE CAP
OR SET IT IN YOUR PACKAGE.

AND STEADY MY LITTLE HANDS
DOWN AND DRAW --

I DRAW UP A WHOLE BUNCH.

MAKE SURE I CLEARED ALL
THE AIR OUT OF THAT HUB

AND THEN I AM GOING TO
SQUISH IT ON UP

AND GET MY O.1.

- DIANE, THE TEXT DESCRIBES
0.5 CC SYRINGES --

ARE THOSE JUST TOO SMALL
TO DEAL WITH?

- THE ONLY 0.5 I HAVE SEEN
IS IN AN INSULIN.

AND I HAVEN'T EVER
SEEN THE 0.5 SYRINGE

FOR GIVING INTRADERMAL INJECT--
THERE MAY BE OUT THERE.

JUST BECAUSE I DON'T KNOW, IT
DOESN'T MEAN IT DOESN'T EXIST.

I WORKED IN AN ALLERGIST'S
OFFICE FOR MANY, MANY MONTHS,

BUT EVEN THAT'S BEEN
A FEW YEARS.

SO, AND WE ALWAYS USED
JUST THE 1 CC.

OKAY. SO SHE'S BLESSED
BOTH OF THESE.

I'M GOING TO CLEAN UP MY AREA

AND GET ME SOME GLOVES.

NOW, I WANT TO DO
ONE OTHER THING.

THIS IS A MULTI-DOSE VIAL,
RIGHT?

SO -- BECAUSE I AM THE ONE
THAT OPENED IT.

BEFORE I GET AWAY FROM IT HERE,
I AM GOING TO SAY A DATE,

WHICH IS -- 4TH TODAY?

- HMM-MM.

- 2/4/04, 13:00 DB.

SO IF YOU CAME TO THE VIAL --

YOU ARE THE NEXT ONE
AT THE STATION AND
YOU DON'T FIND THESE,

THE FIRST PEOPLE,
THE ONE-O'CLOCKERS

ARE GOING TO BE THE ONES
TO OPEN MY VIALS.

I AM GOING TO USE A
FRESH ONE EVERY DAY.

SO YOU WILL OPEN IT
AND YOU WILL TIME AND DATE IT.

THE ONE'S OF YOU
THAT COME AFTER,

YOU'RE GOING TO CHECKING IS
THE EXPIRATION DATE GOOD
FROM THE MANUFACTURER.

AND DID THEY SIGN THIS
WHEN THEY OPENED IT.

AND THEN AFTER THAT
EVERYONE THAT USES THIS

HAS TO CLEAN THE TOP
WITH ALCOHOL, OKAY?

SO IT'S DATED. GOOD.

ALRIGHT. SO I'M DONE IN
THE MED ROOM.

I HAVE PLANS AND I KNOW
WHAT I AM GOING TO DO.

I HAVE MY GLOVES
SO I AM READY FOR MY CLIENT.

I AM GOING TO IDENTIFY
MY CLIENT.

SHE'S AN ADULT CLIENT.
THIS IS SHANNON.

IT HAS TO BE A STUDENT NURSE,
STUDENT NURSE.

OKAY. AND PRIVACY. SORT OF,
YOU DON'T GET ANY TODAY.

SHANNON, I'M GOING TO GIVE
YOU YOUR DELTOID SHOT FIRST

AND FOR WHATEVER YOU
WANT IT TO BE,

BUT I'LL PRETEND FLU SHOT.

AND, OH, SHANNON HAS SOME
FRECKLES AND THAT IS SO COOL.

BECAUSE I LIKE FRECKLES,
AND EVEN TATTOOS,

BECAUSE IT'S LANDMARKS
FOR YOU.

SO WE WILL HELP THEM
TO BE OUR BULL'S EYES.

NOW, THE OTHER THING I WANT TO
TALK ABOUT A LITTLE BIT
BEFORE IS NEEDLE ANXIETY.

PEOPLE HAVE IT, IT'S REAL.
ADULTS HAVE IT AND IT'S REAL.

SO I JUST WANT TO SAY
THAT IF YOU ARE ONE
THAT HAS NEEDLE ANXIETY,

IF YOU'VE EVER PASSED OUT
WITH A SHOT,

IF THEY JUST MAKE YOU NERVOUS
AS CAN BE, LET US KNOW.

SO THAT WE CAN JUST BE
A LITTLE MORE AWARE.

THAT SHOULDN'T BE A SECRET
AND YOU SHOULDN'T BE
EMBARRASSED ABOUT IT.

YOU NEED TO TELL US.
YOU'RE A SHOT GIVER.

I PASSED OUT TWICE
OR WHATEVER.

OR I AM SCARED TO DEATH.

AND ALSO I JUST NEED TO MENTION
I WON'T FORCE ANYONE TO DO IT.

IF YOU'RE JUST TOO SCARED
AND THIS IS JUST TOO MUCH
AND OVER THE TOP.

YOU DON'T HAVE TO DO IT.
I'M NOT --

YOU KNOW, I CAN'T
MAKE YOU DO THAT.

BUT YOU PROBABLY
WANT TO GIVE ONE.

AND SO IF YOU WON'T TAKE ONE,
I WON'T LET YOU GIVE ONE

AND IT ALL BALANCES OUT
LIKE THAT. OKAY.

NEEDLE ANXIETY. LET'S SAY
SHANNON HAD NEEDLE ANXIETY.

WE HAVE ALREADY TALKED ABOUT
THIS AND SHE DOESN'T.

BUT IF SHE DID,
I WOULD WANT TO MAKE SURE

THAT SHE WAS SITTING
SO THAT SHE'S COMFORTABLE.

I WANT TO HELP HER RELAX.
I WANT TO GIVE HER
DISTRACTIONS.

AND I'M GOING TO BE
WATCHING FOR SOME CUES.

PEOPLE WITH NEEDLE ANXIETY
HAVE DONE --

SOMETIMES THEY LOOK SO
NORMAL AND THEN BINK.

BUT IF YOU KNOW, THEIR COLOR
TENDS TO PALE OUT
IN THEIR FACE.

THEY GO WHITER THAN WHITE.

SOMETIMES THEY GET
REALLY FLUSHED.

I'VE WATCHED THEM GET
REAL FLUSHED IN THE NECK
AND IN THE CHEEKS

AND YOU WATCH THE COLOR RISE
AND YOU KNOW THE ANXIETY LEVEL

HAS JUST GROWN
TO ALMOST UNBEARABLE.

THE OTHER THING I WATCHED --
ONE DAY I WAS GIVING SHOTS
IN A FLU --

IN A HEPATITIS CLINIC.
HEPATITIS B CLINIC
AT AN ELEMENTARY SCHOOL.

AND WE WERE GIVING
THEM TO KIDS.

AND I WAS WONDERING ABOUT
HOW THAT WAS GOING TO BE.

IT WAS MY FIRST TIME
DOING IT WITH THAT GROUP.

AND I WAS WORKING WITH
ANOTHER NURSE WHO IS
A VETERAN OF KID SHOTS.

AND SHE WAS GIVING THE SHOTS
AND I WAS THE HELPER.

BUT SHE WAS JUST, I MEAN,
SHE WAS JUST DOING 'EM
AND SENDING 'EM,

DOING 'EM AND SENDING 'EM,
AND NOT REALLY LOOKING AT 'EM.

I WAS KIND OF LOOKING AT 'EM.

AND I LOOKED OUT AT THIS
LITTLE GAL AND SHE TURNED
WHITE AS A GHOST.

AND SHE WAS REALLY QUIET.
AND THAT'S USUALLY
A CUE, QUIET.

QUIET ISN'T ALWAYS
A GOOD SOUND.

AND I LOOKED ACROSS THE TOP
OF HER UPPER LIP

AND LITTLE BEADS OF SWEAT
WERE COMING OUT.

AND I WENT,
"SHE'S GOING."

SO, "OKAY, HONEY, ARE YOU OKAY?
I WANT YOU TO TAKE SOME
GOOD, DEEP BREATHS FOR ME.

GOOD DEEP BREATHS,
LOOK AT ME. TALK TO ME.

GOOD, DEEP BREATHS,
IN YOUR NOSE."

DISTRACT THEM,
GET THEM BREATHING,

GET THEM BREATHING,
TALK TO THEM

AND THEN I SAT HER DOWN
ON THE FLOOR.

YOU KNOW, IT WAS KIDS AND IT
WAS IN A GYM KIND OF DEAL.

AND SO GET THEM DOWN,
SO THAT THEY ARE NOT
GOING TO HARM THEMSELVES

AND HELP THEM
KEEP THEIR BEARINGS.

AND I ALSO KEEP AMMONIA SALTS
IN MY POCKET,

SO THAT I AM READY
FOR A QUICK WHOOSH

AND WE'LL HAVE THEM ALL
FOR THAT DAY ANYWAYS,

BUT JUST TO, KIND OF,
YOU KNOW, WAKE THEM UP.

SO IF YOU ARE GIVING SHOTS.

OKAY. WE NEED ONE OTHER PLAN
AND THAT'S HOW DO WE FIND

OUR LANDMARKS FOR
THE DELTOID INJECTION.

WHEN YOU ARE LOOKING
AT THE ARM,

IT'S BASICALLY
JUST TO EYEBALL IT.

IT'S THE UPPER THIRD
OF THE ARM.

SO WE ARE GOING
FOR UPPER THIRD.

BUT YOU DON'T WANT TO BE INTO
THIS BONY AREA AT ALL,
UP AT THE SHOULDER.

SO, THIS BONE THAT COMES OFF
THE SHOULDER BONE HERE

IS THE ACROMION PROCESS.

SO YOU WANT TO PUT ONE FINGER
ON THE ACROMION PROCESS.

AND DEPENDING ON WHICH
TEXT YOU READ ON --

YOURS SAYS THREE FINGERS, ONE
FINGER AND THREE FINGERS DOWN.

YOU DRAW THE BASE
OF THE TRIANGLE

AND THEN THE TRIANGLE
AND IT'S RIGHT THERE.

SO THAT GETS YOU OFF
OF THAT BONY AREA.

YOU CAN FEEL THE DIFFERENCE
EVEN WITH YOUR FINGERS.

THAT TO THE CONSISTENCY
OF THE TISSUE.

SHE'S GOT A SMALLER ARM
SO THREE FINGERS WOULD WORK.

BUT EITHER WAY,
IT'S STILL GOING TO PUT ME
IN THAT TERRITORY.

SO, REALLY, THIS FRECKLE
IS KIND OF THE BASE
OF THE TRIANGLE

AND THIS EVER SO TINY LITTLE
FRECKLE IS GOING TO BE
MY LANDMARK, OKAY?

I AM GOING TO SQUEEZE UP
AND GO RIGHT IN THERE,
ALRIGHT?

ACROMION PROCESS.
THAT RIGHT THERE.

OKAY. NOW, THAT'S IS THE OTHER
THING, SHE KEEPS LOOKING.

WHEN SHE DOES, THIS MUSCLE
GETS REALLY, REALLY TIGHT.

AND THAT'S THE OTHER
THING THAT HAPPENS

TO PEOPLE THAT ARE
NERVOUS OR LOOKING.

SO I AM GOING TO TELL SHANNON,
"YOU KNOW, IT WILL HELP
IF YOU RELAX THIS MUSCLE

BECAUSE YOU WANT TO KEEP IT
NICE AND SOFT.

IF YOU KEEP YOUR ELBOW BENT
AND JUST RELAX ACROSS
YOUR LAP THERE

AND THEN THEY NOT TO TWIST.
I DON'T CARE IF YOU LOOK,

BUT THAT WILL TIGHTEN
UP THE MUSCLE.

SO CHECK THE MUSCLE
AND AGAIN DISTRACTION.

IF YOU CAN GIVE 'EM HEADSETS
TO LISTEN TO MUSIC,

IF YOU CAN GET A TV GOING,
TALKING,

SOMETHING TO RELAX
AND DISTRACT WILL HELP.

THEY ALSO SUGGEST FOR KIDS,
IF YOU ARE GIVING SHOTS
AND YOU HAVE TIME,

THERE IS A PRODUCT CALLED
IMLA. HAVE I TALKED
ABOUT THAT YET?

IT'S A TOPICAL ANESTHETIC.
AND YOU CAN PUT IT ON THE
SKIN, IT'S A CREAM,

AND THEN YOU PUT LIKE SARAN
WRAP OVER IT AND IT SITS THERE
FOR ABOUT AN HOUR.

AND IT JUST NUMBS OUT THAT
AREA, SO THEY DON'T HAVE PAIN
WITH THE SHOT.

SO IT'S KIND OF NICE IF YOU
HAVE THE TIME TO DO IT,

BUT SOMETIMES WE DON'T
HAVE THAT LUXURY.

- THEY USED THAT TO -- LIKE,
I HAD MOLES REMOVED AND THEY
--

IS THAT THE SAME THING?
- YES.

IT HAS THE ANESTHETIC
TYPE PROPERTY SO THERE'S
NOT SO MUCH PAIN.

AND ALSO, IF YOU HAVE EVER
HAD AN ANESTHETIC
THAT THEY PUT IN,

DOESN'T THAT HURT WORSE THAN
USUALLY ANYTHING ELSE.

AND SO IF YOU CAN PUT THAT CREAM
ON, THEN YOU DON'T EVEN FEEL
THE ANESTHETIC GOING.

SO THEY MAY HAVE DONE
TWO THINGS FOR YOU.

SO I PUT IN NOVOCAIN ON
TOP OF IT SO THAT --

WITH THE SUTURING OR
FOR WHATEVER THEY DID.

ALRIGHT. SO, THERE IS NOT
MUCH TO IT AT THIS POINT.

I AM JUST GOING TO
GIVE A SHOT.

SHANNON AND I HAVE ALREADY
TALKED ABOUT IT, WE ARE GOING
TO DO IT A LITTLE SLOW,

SO WE COULD TALK THROUGH
EACH PIECE OF WHAT

THE SHOT LOOKS LIKE
AND YOU CAN APPRECIATE THAT.

AGAIN, IF YOU CAN'T SEE,
JUST MOVE OVER.

I HAVE FOUND MY SPOT
AND I AM GOING TO CLEAN IT
GOOD WITH ALCOHOL.

I AM ALSO GOING TO WIPE IT
WITH ALCOHOL IN THE END.

SO YOU CAN DO
A COUPLE OF THINGS,

YOU CAN STICK YOUR
LITTLE PAD THERE

TO KIND OF POINT TO YOUR TARGET
AND IT WILL BE READY

OR YOU CAN STICK IT
IN YOUR FINGERS.
SO WHATEVER HELPS YOU.

CHECKED MY DOSE. MY THIRD
CHECK. IT'S A HALF CC.

MAKE SURE YOU GET BEVEL UP.

I AM GOING TO PULL HERE.

AND YOU CAN WATCH EACH OTHER
IF YOU WANT TO OR WHATEVER.

AND THEN I AM GOING TO
MAKE MY DART.

SO WATCH HOW HARD I DO IT
AND HOW IT GOES IN.

READY. LITTLE POKE.

DID YOU FEEL IT?
SHE FELT IT, OK. BUMMER.

ALRIGHT, NOW, I LIKE TO KEEP
MY OWN PERSONAL SCORE.

I AM GOING TO TAKE MY HANDS AND
HOLD IT AND I AM GOING TO
ASPIRATE IT.

AND YOU HAVE TO PULL
A LITTLE BIT ON THESE
TO GET IT TO COME BACK.

CAN YOU FEEL THAT?
- I CAN'T FEEL THAT.

- OKAY. SOME PEOPLE
SAY THEY DO.

NO BLOOD. I AM GOING
TO GO ON IN, SLOWLY,

AND SEE HOW THIS HAND
IS HOLDING AND I AM
STABILIZING.

I AM DONE. THERE IS NO NEED
TO STAY 10 SECONDS, BUT I GOT
TO PUSH THIS OUT.

- I CAN FEEL THAT.
- DONE.

I GOT A LITTLE BLOOD.
BLOOD HAPPENS. AND RUB.

YOU FELT IT GOING OUT?
- I FELT MORE WHEN GOING IN.

- REALLY?
WAS IT SLOW?

- MAYBE. WELL, IT DIDN'T HURT.

- SO IF THEY HAVE LIKE A LOT OF
BLEMISHES OR MOLES --

- YOU JUST DON'T HIT 'EM
OR YOU GO AROUND.
YOU GO AROUND.

BECAUSE YOU CAN AIM
FOR 'EM LIKE THIS --

- WHAT IF THERE'S A MOLE
RIGHT IN YOUR SPOT?

- YOU GOT A WHOLE LOT OF SPOT,
REMEMBER I --

OH, THERE'S BLOOD
ON THAT TOO. SORRY.

- OH, SHE'S GETTING FLUSHED,
BACK UP.
- BREATHE.

- DID YOU HEAR THE JOKE ABOUT
THE FARMER'S DAUGHTER AND...?

- THAT'S GOING TO BE SOAKING IN
BLOOD, DON'T PUT BLOOD
ON THERE.

BECAUSE WE HAVE REAL BLOOD
AND WE DON'T HAVE
A WAY OF TRACKING.

- THIS DOESN'T BOTHER ME.

- I AM JUST GOING TO
DRY THIS OFF.

I DIDN'T REALIZE I HAD BLOOD
ON THAT ONE PIECE.

- YOU NEED A MIT.

- MESSES HAPPEN.

I WON'T THINK OF IT ONE SECOND
WHEN I GO HOME.

I AM OVER IT. I AM OVER MESSES.
YOU KNOW WHAT I MEAN?

GET OVER IT.
MESSES HAPPEN.

I AM GOING TO GO AHEAD
AND PUT THIS ON.

TRY NOT TO TOUCH THE
SURFACE OF THE BAND-AID.

- SOME NURSES WILL LEAVE THE
2-BY-2 UNDER THERE?

- YES. USUALLY FOR PRESSURE,
LIKE WHEN WE DO IV'S.

AND WE JUST GIVE IT
A LITTLE PRESSURE ON THERE
TO STOP THE BLEEDING FASTER,

BUT WE DON'T NEED
PRESSURE, PARTICULARLY.

THERE, CLEAN UP MY MESS.

OK, I THINK MY GLOVES
ARE CLEAN TO DO MY NEXT SHOT.

ALRIGHT. I WILL WRITE IN A
MINUTE, BUT MY HANDS HAVE
MAYBE GOT BLOOD THEM.

SO, WE ARE DONE.
ANYTHING YOU WANT TO SHARE?

DID YOU FEEL
THE MEDICINE GO IN?

OKAY, SO SHE FELT THE NEEDLE
GO IN A LITTLE BIT.

SHE DIDN'T FEEL ASPIRATED,
SHE DIDN'T FEEL MEDICINE GO IN

AND THEN SHE FELT
THE NEEDLE COME OUT.

THAT'S HER STORY.

YOU WILL HAVE YOUR OWN STORY.

YOU MAY NEVER FEEL IT AND STILL
GO, "I DIDN'T FEEL
THAT AT ALL."

AND THEY WILL ASPIRATE AND GO,
"OH, I FEEL THAT."

GIVE THE MED,
NEEDLE COMES OUT, NOTHING.

YOU KNOW, EVERYONE'S
DIFFERENT.

BUT I ALWAYS TRY
TO WARN THE CLIENT,

YOU MAY FEEL A LITTLE SOMETHING
AND I ALWAYS WE SAY
A LITTLE POKE.

TO WARN 'EM SO THAT
THEY DON'T JUMP.

YOU NEED THEM TO KNOW
THAT YOU ARE COMING,

BECAUSE IF THEY DON'T,
THEY WILL JUMP ON YOU.

ALRIGHT. THE NEXT THING,
SHANNON, I THINK --

SIT STRAIGHT.

ALRIGHT, INTRADERMAL.

INTRADERMALS NEED TO GO
IN THE FOREARM AREA

AND THEY NEED TO BE IN THIS
MIDDLE PART OF THE FOREARM.

SO, YOU ARE BASICALLY GOING
TO PUT A HAND ON THE WRIST
AND NOT USE ANY OF THE WRIST,

AND YOU ARE GOING TO PUT
THREE OR FOUR FINGERS DOWN
FROM THE ANTECUBITAL,

AND, BASICALLY,
USE THIS SPOT RIGHT HERE.

WHEN YOU GET TO THIS MIDDLE
SPOT OF THE FOREARM,

YOU ARE GOING TO LOOK AGAIN
FOR HAIRY AREAS.

BECAUSE YOU ARE TRYING TO SEE
IF THERE IS REACTION.

SO YOU DON'T WANT TO
BE IN SOMETHING THAT WILL
NOT ALLOW YOU GOOD VISIBILITY.

SO YOU WANT TO MOVE UP THERE,
YOU WANT TO AVOID VEINS,

BRUISES, DISCOLORATION,
ABRASIONS.

ANYTHING THAT MIGHT DETER
FROM YOUR ABILITY TO READ
THE SKIN TEST.

WHAT ARE WE LOOKING FOR
WHEN WE DO A TB SKIN TEST?

- AN ALLERGIC REACTION.

- A RESPONSE TO
THE ANTIGEN HERE.

SO WHAT HAPPENS IS AFTER YOUR
48 OR 72 HOURS, RIGHT?
IS WHAT THEY DO.

YOU ARE LOOKING TO SEE
IF THERE'S BEEN INDURATION.

NOT REDNESS.

JUST COS IT TURNS
A LITTLE RED,

DOESN'T MEAN YOU HAVE HAD
A REACTION TO THE TB TEST.

BUT IF IT'S INDURATED.

IF YOU CAN FEEL THE BORDERS,
THE EDGES, IF THERE IS
A LUMP THERE,

THAT'S WHEN WE START
GETTING WORRIED.

AND THE OTHER CRITERIA
IS THAT INDURATION

HAS TO BE ONE CENTIMETER
OR GREATER.

IF IT IS LIKE A LITTLE HALF
OF A CENTIMETER SPECK,
NO ONE CARES.

IT'S THAT FULL CENTIMETER THAT
MAKES SOMEONE BE CONCERNED.

ALRIGHT. SO WE NEED TO FIND
A GOOD PLACE IN THE FOREARM.

JUST LET ME SAY THAT
THE MORE YOU GO TOWARDS
THE INNER ASPECT HERE,

THE TENDERER IT IS
FOR THE INJECTION.

THE CLOSER YOU COME TO THIS --
THE CARRIER EDGE OF YOUR ARM
IS WHERE THE SUN HAS BEEN

AND THE SKIN ISN'T GOT QUITE
AS SENSITIVE AS IT IS
OVER TO THE EDGE.

WE WILL BASICALLY COME HERE
OR TOWARDS THE MIDDLE
WHEREVER WE CAN AVOID A VEIN.

SOMETIMES YOU MAY HAVE TO
GIVE ONE OR TWO SHOTS

OR YOU DON'T WANT TO MISS
WHERE YOU GAVE THE SHOT.

SO YOU MAY GIVE THE SHOT
AND THEN WITH A SKIN PENCIL,

OR A MARKER THAT'S
BEEN APPROVED,

YOU WILL CIRCLE WHERE
YOU GAVE THE SHOT

SO YOU KNOW EXACTLY WHERE
TO LOOK FOR THE REACTION.

- HOW ABOUT DRAWING
A KITTY FACE?

- I MEAN, THAT'S
A LITTLE OVERKILL.

I DON'T WANT KITTY FACES ON ME.
BUT, YEAH, SO THEY CAN FIND IT.

AND IT IS USUALLY
A SKIN PENCIL.

SOMETHING THAT HAS BEEN
APPROVED FOR DRAWING ON SKIN.

SO THEY FIND IT, YOU KNOW?

COS EVERYONE DOES IT
IN A LITTLE DIFFERENT SPOT
AND THEY WANT TO MAKE SURE.

ALRIGHT.

MY GOAL HERE IS THAT I WANT
TO STRETCH THE SKIN DOWN...

WITH ONE HAND.

SEE IF SHE HAS GOT FLEXIBILITY
HERE IN HER SKIN TISSUE.

I AM GOING TO PULL IT DOWN
AND THEN I AM GOING TO SLIDE
MY NEEDLE ALMOST FLAT.

LIKE A FIVE DEGREE ANGLE
UNDER THE SKIN.

STAYING IN SKIN SO THAT YOU
CAN ALMOST SEE THE BEVEL
OF THE NEEDLE IN THE SKIN.

AND THEN I NEED TO
GIVE THE SHOT.

OR YOU WILL SEE THAT
WHEN I GO TO DO THIS,

I SLIDE IT UNDER
BY THE PLUNGER.

AND I NEED ANOTHER HAND.

BUT I GOT TO HOLD
THIS REALLY STEADY

BECAUSE IF I JUST HAVE
EVER SO LITTLE BEND
IN THAT LITTLE BEVEL,

IF I RELEASE HER SKIN TO
PLUNGE, HER SKIN IS GOING TO
GO WHOOSH,

COS IT IS STRETCHY.
IT IS GOING TO SLIDE OFF.

SO I AM GOING TO PULL,
PUT MY SYRINGE IN

AND AS I RELEASE WITH MY THUMB,
I AM GOING TO DO IT
EVER SO SLOWLY

AND FOLLOW IN WITH MY SYRINGE,
WITH THIS HAND.

I AM MOVING A LITTLE BIT
WITH THE SKIN.

SO I CAN TAKE THIS HAND.
THIS HAND IS NOT MOVING,
IT IS HOLDING THAT SYRINGE

AND THEN THIS ONE IS
GOING TO PLUNGE IT IN.

THERE IS NO ASPIRATION ON THIS
BECAUSE WE ARE NOT
IN ANY THING

WHERE THERE WOULD
BE A BLOOD VESSEL.

WE'RE IN THE SKIN LAYER, OKAY?

YOU HAVE TO GET A WHEEL OR
YOU ARE IN SUBCUTANEOUS TISSUE

AND IT'S NOT GOING TO BE
AN EFFECTIVE TEST,
SO IT HAS TO BE A WHEEL.

YOU HAVE TO SEE SHADOWING
OF THE NEEDLE.

NOW, THIS ISN'T VERY
EASY TO SEE

SO IF YOU GUYS WANT TO
COME AROUND AND KIND OF
COME BACK BEHIND THEM.

YOU HAVE GOT TO BE ABLE
TO SEE THE BEVEL AND HOW FAR,

BUT YOU CAN'T STAND, LIKE, RIGHT
HERE IN FRONT
OF THE CAMERA,

SO JUST GET LIKE THIS.

ONE OTHER THING I WANT
YOU TO KNOW IS THAT,

ON THIS PARTICULAR INJECTION,
I DON'T USE ALCOHOL.

IN YOUR BOOK IT SAYS,

CLEANSE WITH ALCOHOL
AND LET IT DRY COMPLETELY.

WHEN I WORKED IN THE
ALLERGIST'S OFFICE, WE HAD
SOME FALSE, POSITIVE READINGS,

AND IT WAS BECAUSE PEOPLE
DIDN'T LET THE ALCOHOL DRY.

AND IT GOT DRUG IN A LITTLE
BIT WITH THE INJECTION AND SO
REDNESS CAME UP,

AND IRRITATION RELATED
TO ALCOHOL.

AND HE WAS A BIG RESEARCHER
AND THE TRUTH IS

WHEN IT'S YOUR SKIN AND YOUR
FLORA THAT YOU CAN HANDLE IT.

SO IF IT WERE SOILED,
YOU COULD WIPE IT WITH
JUST WATER OR SOMETHING,

BUT THE ALCOHOL
REALLY ISN'T NECESSARY.

SO I AM NOT GOING TO
USE ANY AT ALL

AND I REFUSE IT
WHEN THEY DO MINE.

IF THEY PUT ALCOHOL ON YOU,
YOU KNOW IF IT'S DRY,

YOU CAN FEEL IF THE
COLDNESS HAS GONE AWAY.

YOU MAKE SURE THAT THING
IS DRY, DRY, DRY.

NOW THERE IS A WHOLE
SCHOOL OF PEOPLE THAT JUST
CAN NOT GET UP THEIR ALCOHOL.

YOU KNOW? IT IS A PROBLEM.
ALRIGHT.

I TAKE MY CAP OFF
AND I AM NOT GOING TO RECAP
SO I WILL JUST DROP THAT.

JUST A BIT RELAXED, OKAY?
I AM NOT GOING TO GO HERE.

I AM NOT GOING TO GO HERE.
SHE HAS JUST NOTHING

AS FAR AS MARKS
OR ABRASIONS, VEINS,

SO I AM GOING TO JUST GO RIGHT
HERE. IT WON'T BE AS TENDER.

OKAY.

THIS IS A TINIEST THING
AND YOU LITTLE -- SLIDE CLAMP,

HERE HOLD THIS. IT'S CALLED
A LITTLE SAFETY GLIDE

CAN GO ON THE TOP
AND IT SWIVELS.

SO MOVE IT SO THAT YOU CAN
GET THIS NICE AND FLAT, OKAY?

I AM NOT GOING TO WORRY
ABOUT THE SAFETY GLIDE TILL
I GET IT OUT OF HER SKIN.

LIKE GET IT OUT OF THE WAY
AS WELL. OKAY,
MY DOSE IS GOOD.

THE OTHER THING I WANT TO MAKE
SURE WHEN YOU DRAW THESE UP,

MAKE SURE YOU DRAW UP A LOT SO
THAT YOU KNOW YOU HAVE GOT
SOLUTION AND NOT AIR.

IT'S SUCH A TINY DOSE, THAT SOME
PEOPLE HAVE MISTAKENLY GO,
"SEE, I AM GOOD."

CAN YOU SEE THAT
IT'S AIR OR SOLUTION.
IT'S REALLY HARD TO TELL.

MAKE SURE YOU'VE GOT
SOLUTION.

ALRIGHT, I AM GOING TO
STRETCH YOUR SKIN DOWN.

I AM LIKE LAYING THIS.
I HAVE SHAKY HANDS,
YOU GUYS KNOW THAT.

SO I STEADY MYSELF
DOWN ON HER,

AND THEN I AM GOING TO JUST --
LITTLE POKE -- GO IN
EVER SO SHALLOWLY.

I HAVE JUST CLEARED THE BEVEL
AND A LITTLE BIT MORE.

I AM GOING TO RELEASE.
SEE HOW I AM KIND OF MOVING.

AND THIS HAND IS HOLDING
IT EVER SO SECURELY.

YOU CAN ALMOST SEE THE SHADOW
OF THE NEEDLE IN THERE.
CAN YOU SEE?

YOU CAN SEE THE NEEDLE.

I AM JUST GOING TO PUT IT IN
AND I HAVE --

I HAVE TO BE STABLE HERE
BECAUSE THERE IS RESISTANCE
IN SKIN.

NOT LIKE WITH A MUSCLE.
IT GOES IN REAL EASY.

SO YOU HAVE TO HOLD IT VERY,
VERY STEADY AND PUSH FIRMLY

AND I GOT A BEAUTIFUL WHEEL.

AND THEN SLIDE OUT.

AND THEN CLICK DOWN.

I CAN'T DO ALL THAT
SLIDE, HOLD, CLICK.

SO STAY BEHIND THE NEEDLE
AND YOU ARE GOOD TO GO.

AND TA-DA.
YOU CAN SEE HOW FIRM I HELD.

THAT'S MY FINGERNAILS.

SORRY.
AND THAT WAS IT.

SO, SHANNON, DID YOU FEEL
THE NEEDLE GO IN?

DID YOU FEEL THE SOLUTION?
DID YOU FEEL ANYTHING?

OKAY, I GET A POINT. THAT'S MY
OWN PRIVATE SCORING SYSTEM.

ONE, NO PAIN. ACTUALLY,
PEOPLE SAY THAT THIS
ONE HURTS,

AS MUCH OR MORE THAN ANY.

JUST BECAUSE IT IS THAT
SURFACE AND LIKE SCRAPING

AND SO SOMETIMES
THAT WILL HURT.

ALSO BECAUSE IT'S SO SHALLOW
AND BECAUSE WE ARE BEING
PARTICULARLY SLOW.

SOMETIMES YOU WILL SEE LITTLE
NEEDLE TRACKING,
LIKE A BRUISE,

JUST A LITTLE,
SMALL LITTLE THING

AND THAT'S JUST GOING TO
HAPPEN WITH THE SHOT.

OKAY. THAT'S IT.

MY NEEDLE IS IN
THE SHARP'S CONTAINER

WHICH YOU WILL HAVE
AT THE STATION.

AT THIS POINT YOU WOULD
REALLY WANT TO WASH YOUR HANDS

BECAUSE YOU DID A REAL PERSON.

WE WILL HAVE GELS
OR SOMETHING THERE.
GO TO THE SINK AND WASH.

AND THEN YOU WILL DOCUMENT
JUST LIKE YOU DID YESTERDAY.

I AM NOT EVEN GOING TO
GO OVER DOCUMENTATION.

YOU GUYS JUST WERE
PERFECT YESTERDAY.
IT WAS BEAUTIFUL.

SO, WHEN WE LOOK AT THIS,
WE GAVE IT AT 1:15.

BOTH OF THEM,
1:15, 1:20, WHATEVER.

THE IM ONE IS GOING
TO BE LEFT DELTOID

AND SO THEIR KEY CODE
WHEN I GO TO IM IS LD,

LEFT DELTOID AND
THEN MY INITIALS.

AND THEN THEY DON'T HAVE
ANYTHING FOR INTRADERMAL,

SO I WOULD WRITE AGAIN
MY OWN KEY CODE.

AND I WOULD JUST
SAY LEFT FOREARM.

SO, LFA.

AND THERE'S JUST NOT MUCH
MORE TO SAY THAN THAT
WHEN YOU DO YOUR SITE.

SO THAT WE KNOW WHERE THAT
PARTICULAR ONE WAS GIVEN.

OKAY, ANY QUESTIONS?

ONE OF THE HARDEST THINGS ABOUT
THIS PARTICULAR DRILL IS THAT

YOU CANNOT PRACTICE
ON EACH OTHER.

YOU HAVEN'T GOT ME THERE.

NO PRACTICING ON PEOPLE.

SO YOU'RE JUST GOING
TO HAVE TO DRAW UP,

YOU KNOW, GET COMFORTABLE
WITH THE SYRINGE.

YOU ALREADY KNOW HOW TO DART,
YOU KNOW HOW TO DO
MOST EVERYTHING

THAT YOU NEED TO KNOW.
I PASSED YOU YESTERDAY
ON ALL OF YOUR SKILLS.

SO, IT'S JUST BEING COMFORTABLE
WITH THIS SYRINGE
AND KNOWING THAT.

THE OTHER ONE THAT I THINK
IS THE MOST AWKWARD

AND I THINK YOU MAY WANT TO
PRACTICE IS THIS INTRADERMAL,

JUST CO-COORDINATING THAT
PULL-PUSH, MOVE,
THIS AND HOLD.

AND SO WE HAVE THESE LITTLE
INTRADERMAL MANNEQUINS.

MAY I SAY, THEY'RE PATHETIC.

BUT AT LEAST YOU CAN GET YOUR
SYRINGE AND JUST, KIND OF,

PRACTICE THE LOOK, AND KIND
OF WORK THROUGH YOUR STEPS.

AND I WILL SHOW YOU HOW IT
WORKS, AND IT'S JUST SAD.

GLOVES, CLEAN, CLEAN,
AND DO YOUR THING.

CLEAN WITH ALCOHOL,
JUST WANT A DOSE HERE.

DRAW UP A LOT,
SQUEEZE BACK THE REST.

YOU CAN BARELY SEE
THAT THERE'S

THESE FOUR LITTLE BUTTONS
ON EACH SIDE OF IT.

FOUR LITTLE BUTTONS.

THEY'RE SUPPOSED TO BE
KIND OF LIKE BALLOONS,

SO LIKE YOU PUT
THE MEDICINE IN,

AND IT SWELLS A LITTLE BIT
AND THEN YOU SAY,
"OH, GOOD, WE'LL..."

THEN YOU HAVE TO SUCK
THE MEDICINE BACK OUT.

BUT TO KEEP IT
FROM STICKING,

WHICH IT PROBABLY WILL WHEN
I DEMONSTRATE THIS.

THERE'S LITTLE SLITS
IN THE STUFF

AND SO IT SQUIRTS OUT
ALL OVER THE PLACE.

AND IT JUST DOESN'T WORK VERY
GOOD, BUT YOU CAN STILL
KIND OF DO IT.

SO, I'VE DONE MY HIGH FIVE.
I AM GOING TO SWIVEL
THIS AROUND.

I WOULD PULL.
I WOULD SET THIS DOWN.

I WOULD SLIDE IT IN
EVER SO SLIGHTLY,

AND JUST GET THE BEVEL PLUS
A LITTLE MORE. NICE AND FLAT.

AS I RELEASE, I'M
GOING TO RIDE IN,

PULL IT, SEE IT, BUT WHAT
HAPPENS IF IT JUST KIND
OF PLUCKS OUT?

WELL, IT'S THEIR FLORA,
SO TRY AGAIN.

STRETCH, SLIDE IN, GO A LITTLE
BIT FURTHER, BUT NOT MUCH,

RELEASE, HOLD STEADY,
COME BACK,

NO ASPERATE, AND YOU CAN SEE,

IT COMES OUT
ALL OVER THE PLACE
AND THEN YOU SLIDE OUT.

YEAH, SO IT'S NOT PERFECT,
BUT AT LEAST YOU CAN DO

THE HOW TO HANDLE EVERYTHING
AND THEN WORK THROUGH.

NOW, SOME PEOPLE LIKE TO DO ALL
SORTS OF INTERESTING THINGS,

BUT THINK THROUGH
THIS WITH ME.

SOMEONE WILL SAY, "WELL,
WHY DON'T I PULL THIS WAY?
AND GO IN THIS WAY?"

WELL, IT COULD WORK.

I MEAN, THEORETICALLY IT COULD
WORK AND YOU COULD GO IN.

BUT NOW WHAT DO YOU DO
WHEN THE SKIN RELEASES?

- IT GOES UP.
- IT'S GOING TO GO UP HERE.

SO YOU'RE GOING TO
HAVE TO SHIFT BACK.

SO IT'S GOING
TO GIVE SOME WAY.

SO YOU GOT TO BE PREPARED,
AND SO IF THE SKIN COMES
BACK ON IT,

IT'S GOING TO PUCKER UP ON IT,
AND BE TOO THICK,
IF YOU DON'T RIDE.

THE OTHER TECHNIQUE
I'VE SEEN IS

PEOPLE LIKE TO STRETCH BOTH
WAYS AND GO IN SIDEWAYS.

AND THAT WORKS OKAY.

AND THEN SOME PEOPLE ARE
REALLY COORDINATED

AND THEY'LL DO
A ONE-HANDED DEAL.

AND THAT'S OKAY, IF YOU CAN.

THE BOTTOM LINE IS THERE'S
AN ASTERISK ON WHETHER YOU
GOT A WHEEL OR NOT.

YOU GOT TO GET THE WHEEL.

SO YOU KNOW, LIKE
THERE'S A MILLION WAYS
TO SKIN A CAT.

FIND YOUR WAY THAT'S
MOST STEADY,

THAT HOLDS THIS AND THAT YOU
CAN STABILIZE THIS SYRINGE

BECAUSE YOU'RE GOING TO HAVE
TO PUSH A LITTLE BIT.

BECAUSE THERE IS
RESISTANCE IN SKIN

VERSUS JUST PUTTING IT INTO
SUBCUTANEOUS TISSUE

AND IT JUST GOES REAL EASILY.

ANY QUESTIONS ON THOSE TWO?

ALRIGHT, PRACTICE,
THINK IT THROUGH,

AND WE WILL BE STANDING BY
YOUR SIDE COACHING YOU.

WILL YOU APPLY A BAND-AID
ON THE TB SKIN TEST?

ON A REAL TB SKIN TEST,
I DON'T LIKE TO BECAUSE
IT KIND OF SWEATS IT OUT,

AND SO IF IT'S NOT BLEEDING,
I'LL NOT PUT ANYTHING.

IF I DO FEEL LIKE THERE'S A
LITTLE OOZE AND I'LL PUT
ONE ON A CLIENT,

AND SAY, "REMOVE THIS
IN 10 MINUTES,

YOU DON'T WANT THIS TO
SWEAT THIS TEST OUT."

YOU WANT IT OFF OF THERE.
AND THEY CAN SHOWER WITH IT,
AND SO FORTH.

AND TELL THEM NOT TO WORRY
ABOUT REDNESS THAT COMES UP
IN THE FIRST 48 HOURS

BECAUSE YOU'RE NOT EVEN GOING
TO READ IT TILL THE 48TH HOUR.

SO THEY DO TURN KIND
OF RED SOMETIMES IN THAT FIRST
24 AND YOU'RE GOING,

"OKAY, I SEE I'VE GOT IT. I
FINALLY GOT IT." AND IT'S NOT.

IT'S JUST THE BODY RESPONDING
TO THE LIQUID.

ALRIGHT, BEFORE I FORGET, I'VE
DECIDED TO GIVE YOU HOMEWORK.

AS IF YOU DIDN'T HAVE
ENOUGH TO DO, RIGHT?

BUT IT'S NOT BAD. I JUST
WANT YOU TO LOOK AT...

I GAVE EACH OF YOU THREE
LABELS
FOR WHICHEVER BOOK YOU HAD.

AND I WANT YOU TO TURN IT IN
WITH YOUR CHECKLIST NEXT WEEK.

SO JUST STAPLE IT ON THE BACK,
AND I HAVE TWO PAGES,

AND ONE LOOKS SIMPLER
THAN THE OTHER, BUT THEY'RE
ACTUALLY QUITE EVEN.

WHO HAS THE BLUE BOOK? DID
ANYONE DO THE BLUE BOOK?

THE DIMENSIONAL ANALYSIS.

IF YOU DO, YOU GUYS HAVE
IT FAIRLY SIMPLE.

TAKE THIS SHEET
AND THEY NUMBERED EACH
AND EVERY QUESTION.

IF YOU HAVE THE WHITE BOOK,
WHICH IS THIS ONE,

WHAT THEY DID WAS LIKE
QUESTION NUMBER FIVE,

THEY HAD LIKE FIVE QUESTIONS
UNDERNEATH IT,

BUT THEY DIDN'T NUMBER THEM
IN ANY WAY, A, B, C, D.

AND I JUST WANT
THE ANSWERS TO THOSE.

NOW I KNOW YOU COULD JUST COPY
THE ANSWERS OUT OF THE BOOK

AND THAT'S JUST A WASTE
OF EVERYONE'S TIME.

WHAT I WANT IS FOR YOU
TO LOOK AT THE LABEL,

MAKE SURE YOU CAN
FIND EVERYTHING,

AND THEN WHERE THERE'S MATH
INVOLVED, SHOW ME YOUR MATH.

LIKE IF IT SAYS HOW MANY
MILLILITERS WOULD YOU GIVE
FOR THIS DOSE

OR TO ADMINISTER THIS DRUG?
THEN YOU WORK THE MATH.

SO I CAN SEE EVERYONE'S
FLARE AND REMIND IT
AND GOOD TO GO ON THAT.

BOTH OF THE BOOKS HAVE
A LOT OF GOOD LABELS.

SO I GO THROUGH ALL
OF THEM WITH THAT,

BUT I DON'T WANT YOU
TO RIP OUT YOUR BOOKS

AND IF SOMEONE DIDN'T GET ONE
AND THEY WANT TO SHARE A BOOK,

AND BLAH, BLAH,
FEEL FREE. OKAY.

- VIDEO.
- NO. WE HAVE ONE LAST SHOT
TO GIVE,

AND THEN IT'S ENDED HERE.

OKAY, YOU HAVE TO GIVE
A SHOT TO A BABY SO,

YOU MAY NOT START BY GIVING
THE SHOT TO EACH OTHER,

EVEN THOUGH THAT'S
YOUR HIGH ANXIETY.

WE MAY SEND YOU TO THE
BABY STATION FIRST.

AND SO, SOMEBODY BACK
THERE, CAN YOU TURN...?

JENNIFER OR SOMEBODY,
CAN YOU SWITCH THE MAR
OFF OF THE OVERHEAD?

AND THAT'S ON TOP
OF THE KEYBOARD.

- I HAVE A QUESTION.

DO WE HAVE TO ACTUALLY WRITE
UP THESE MED CARDS AND STUFF?

- YES.
- YEAH.

YEAH, AND THERE...

NOTICE I DIDN'T QUIZ
YOU A LOT ABOUT THEM,

BUT I WANT YOU TO
KNOW THESE DRUGS

BECAUSE THEY'RE THE
MOST COMMON DRUGS

YOU WILL EVER HAVE ON
THE FACE OF THE EARTH.

THE LIKELIHOOD OF BEING
TESTED ON THEM ON
YOUR BOARDS IS LIKE HIGH.

AND YOU WILL ALSO HAVE THEM
EVENTUALLY IN ALL
YOUR CLASSES.

SO THEY'RE THE MOST COMMON,
COMMON OF ANY MED SEARCH DRUG.

I REALLY WAS PLEASED,
A LOT OF PEOPLE DID

GOOD NURSING INTERVENTIONS
RELATED TO THE DRUG.

FOR EXAMPLE, GIVING DEMEROL.

THERE WERE A LOT OF
PEOPLE WHO TOOK VITAL SIGNS
PRIOR TO GIVING IT.

IT'S NOT ON THE CHECKLIST
BECAUSE I DON'T KNOW

WHICH DRUG I'M GOING TO ALWAYS
GIVE ON THAT CHECKLIST.

BUT TAKING VITAL SIGNS,
KNOWING YOUR CLIENT,

MAKING SURE YOU HAD GOOD
RESPIRATIONS RELATED
TO THAT DRUG.

SO, YEAH, SO MAKE IT MAKE
SENSE TO YOU.

I'M GOING TO COME BACK ON --
YOU KNOW I AM TEACHING
ABOUT CONSTIPATION.

I'M GOING TO TEACH THEM,
YOU KNOW THINGS WHAT
I AM WATCHING FOR.

I'M GOING TO CHECK THIS AFTER
AND THAT KIND OF STUFF.

WATCH FOR IF THE STAT CHANGES,

AND I REALLY HEARD A LOT OF
GOOD INFORMATION YESTERDAY.

SO, MAKE IT MAKE SENSE TO YOU,

LIKE YOU'RE REALLY TAKING CARE
OF A CLIENT, AND IT HELPS.

I DID WANT TO CLARIFY AND I
THINK I DID AT MOST STATIONS.

THE CODEINE VERSUS
DEMEROL SCENARIO.

A LOT OF PEOPLE SAID
I WON'T GIVE IT.

THEY'RE ALLERGIC TO CODEINE SO
I AM NOT GOING TO GIVE
DEMEROL.

AND I WOULD SAY, "I WOULD."

BUT WE TALKED THROUGH THAT,

AND IT'S KIND OF LIKE BEING
ALLERGIC TO AN ANTIBIOTIC.

I'M ALLERGIC TO AMPICILLIN
AND SULFA AND KEFLEX AND
I HAVE AN INFECTION.

ARE YOU GOING TO SAY SORRY
FOR YOU, YOU GET TO ROT?

NO, YOU JUST FIND
ANOTHER ANTIBIOTIC,

ANOTHER, YOU KNOW, ANOTHER
FAMILY OF DRUGS.

SO, SAME THING WITH NARCOTICS.

IF THEY'RE ALLERGIC, REALLY
ALLERGIC TO CODEINE,

YOU CAN STILL TRY DEMEROL,
BUT IF YOU'RE GOING
TO WATCH THEM CLOSELY

TO MAKE SURE THAT THEY
DO OKAY WITH THIS ONE.

AND IF THEY HAVE THE SAME
KINDS OF EFFECTS,

YOU WILL BE WATCHING
FOR THAT SO.

KNOW YOUR CLASSIFICATIONS.

YOU WOULDN'T GIVE AMPICILLIN
TO SOMEONE WHO

IS ALREADY ON PENICILLIN COS
THEY'RE OF THE SAME FAMILY.

SAME GROUP OF DRUGS,
BUT YOU MIGHT TRY.

OH I DON'T KNOW,
ZITHROMAX, A Z-PATCH

BECAUSE IT'S A DIFFERENT
GROUP OF DRUGS.

OKAY, WE NOW ARE GOING TO
DO THE VASTUS LATERALIS.

FINALLY, OUR LAST MUSCLE.

AND ON THIS ONE WE'RE GOING
TO DO IT ON THE BABY

BECAUSE THAT'S THE MOST
COMMON SHOT THAT YOU WILL
GIVE IN THE LEG.

SO OUR DRUG.
I CAN'T THINK VERY WELL.

YOU HAVE IT IN YOUR
THUMB SHEETS THERE.

AQUAMEPHYTON,
ONE MILLIGRAM IM NOW.

AQUAMEPHYTON,
ANYONE KNOW WHAT THAT IS?

VITAMIN K.

EVERY BABY THAT'S BORN
IN A HOSPITAL GETS
A SHOT OF VITAMIN K.

EVERY SINGLE ONE.

THE LIKELIHOOD OF YOU
GETTING TO DO THAT IN OB
IS PRETTY HIGH.

YOU KNOW IF YOU SEE
A DELIVERY,

YOU FOLLOW THAT BABY
INTO THAT NURSERY AND SAY,
I WANT TO GIVE THAT SHOT.

BECAUSE THAT SHOT IS
SUPPOSED TO BE GIVEN

WITHIN THE FIRST HOUR
OF BIRTH.

WHY DO THEY NEED VITAMIN K?

- WHAT DOES IT DO?
- SKIN PIGMENTATION.

BLOOD CLOTTING.

ALRIGHT, AND VITAMIN K IS ALSO
THE ANTAGONIST FOR WHAT DRUG?

IT CLOTS BLOOD.

- HEPARIN.
- HEPARIN. ALRIGHT,
SO IF THEIR PT...

THEIR PTT GETS TO HIGH, THEIR
BLOOD IS GETTING TOO THIN

THEY MIGHT GIVE THEM
SOME VITAMIN K

SO THAT THEY INCREASE
THEIR CLOTTING, OKAY.

BUT BABIES BECAUSE THEIR FLORA
IS SO IMMATURE IN THEIR VALVES

THAT'S WHERE VITAMIN K IS
CREATED, IS IN THE VALVES

BECAUSE THEY DON'T HAVE
A LOT OF FLORA IN THERE

AND BECAUSE WE DON'T
WANT THEM TO BLEED,

THEY ALL GET A SHOT
OF VITAMIN K.

AND THIS IS THE DOSE AND THIS
IS EXACTLY THE SCENARIO.

ALRIGHT, ON AN ADULT,

IF YOU WERE GOING TO DO
THE VASTUS LATERALIS,

IT'S LATERAL, NOT MEDIAN,
RIGHT?

SO IT'S GOING TO BE
OFF TO THE SIDE.

YOU WOULD COME TO
THE THIGH MUSCLE,

YOU WOULD PUT IT ONE HAND
AT THE GROIN AND DOWN

AND ONE HAND ABOVE THE KNEE.

MY PANTS HAVE A NICE SEAM
HERE, SO THAT'S MEDIAN.

SO LATERAL WOULD BE
OFF TO THE SIDE.

SO NOT ABOVE THIS HAND,

BELOW THIS HAND, AND RIGHT
HERE IN THE SIDE.

OKAY, IF YOU DO THE TOP YOU'RE
IN THE RECTUS FEMORIS,

AND WE DON'T WANT RECTUS
FEMORIS, WE WANT
VASTUS LATERALIS.

SO, IT'S A LITTLE BIT
SIDE-MIDDLE LEG.

IF I WAS ON A BABY AND I
PUT MY HAND ON MY HEAD,

THE THIGH IS GONE.

SO BASICALLY IT GETS TO DOING
A FINGER OR TWO OFF.

BE OFF THE KNEE AND BE OFF
THE GROIN AND BE IN THAT
MIDDLE STRIP

OF THE THIGH AND IT'S
THE SAME PRINCIPAL.

IT'S NOT CENTER, IT'S LATERAL.
IT'S OFF TO THE SIDE.

SO IT'S SIDE-MIDDLE MUSCLE.

OKAY.

WE'RE GOING TO GIVE
AQUAMEPHYTON. WE'VE
CHECKED OUR DOCTOR'S ORDERS.

OH, YOU KNOW WHAT I NEVER
SAID THIS WHOLE TIME?

TAKE OFF TWO POINTS.
DO YOU HAVE ANY ALLERGIES?

I KNOW NO ONE IS ALLERGIC
TO SODIUM CHLORIDE,

BUT YOU STILL GOT TO SAY
IT TO GET YOUR POINTS.
SO TAKE OUT A POINT.

AQUAMEPHYTON. I'M GOING TO
THINK ABOUT ALLERGIES
FOR MY BABY

COS THIS IS A REAL DRUG,
AQUAMEPHYTON.

WHAT'S THE LIKELIHOOD
OF US KNOWING ANY ALLERGIES
FOR BABY ONE HOUR...?

NONE, SO THEY -- IT KIND OF, ON
THIS DRILL BECOMES A NON-ISSUE,

BUT YOU DON'T WANT TO GET
OUT OF THE HABIT OF

NOT THINKING THROUGH
ALLERGIES.

I'VE CHECKED MY ORDERS,
I'VE CHECKED MY CARE PLAN,

I'VE CHECKED MY ALLERGIES.
I AM GATHERING
UP MY EQUIPMENT.

AND WHAT I AM GATHERING IS,

WELL, THE FIRST THING I WILL
GATHER IS MY AQUAMEPHYTON.

AQUAMEPHYTON IS GOING
TO BE IN YOUR AMPOULE.

SO YOU'RE PRACTA-AMP
THAT YOU GOT -- DID I GIVE
YOU GUYS ONE OR TWO?

- ONE.
- OKAY, YOU HAVE A PRACTA-AMP

AND I WANT YOU TO
LABEL IT AQUAMEPHYTON,

2 MILLIGRAMS PER MILLILITER.

THAT'S HOW IT'S ACTUALLY
PACKAGED FROM THE
MANUFACTURER.

SO, I PUT A LITTLE TAPE ON HERE
SO I KNOW THE SOURCE OF MY DRUG.

THAT WAS THE ONE POINT
I WANTED TO MAKE REAL CLEAR

YESTERDAY
WITH THE DEMEROL.

FROM WHAT SOURCE DID
YOU DETERMINE THIS .6?

HOW DID YOU COME UP WITH THAT?
SO, THAT MATH WAS GOOD.

OKAY, SO WE GOT TWO
MILLIGRAMS PER MILL,

AND I NEED TO GIVE ONE
MILLIGRAM. SO WHAT AM I
GOING TO GIVE?

ONE MILL.

- HALF A MILL.
- HALF A MILL.

HALF A MILL.

SO, IF I'M GOING TO GIVE
A HALF AND I AM GOING TO
GIVE IT TO A BABY,

I'M PROBABLY JUST GOING TO
GO WITH A ONE CC SYRINGE.

YOU COULD GO WITH A THREE CC.

AGAIN WE DON'T HAVE ANY
HUNDREDTHS TO WORRY ABOUT,

BUT IT'S EASIER
TO DROP THE DOSE.

OKAY, SO I HAVE MY MED.

I HAVE GATHERED MY SYRINGE.
SO I'VE GOT A ONE CC SYRINGE.

NOW, I NEED TO CONSIDER
THE NEEDLE THAT'S GOING TO
GO INTO BABY THIGH.

LET'S TALK ABOUT GAUGE.

WATERY, IT'S ACTUALLY KIND OF,
OILY. THE STUFF, REALLY.

BUT IT'S STILL FAIRLY
A WATERY-OILY, IT'S NOT THICK,
THICK STUFF.

SO IT DOESN'T NEED
TO BE REAL THICK.

USUALLY ON THE BABY WE
GO WITH A 25 GAUGE.

THE SOFTEST OF MUSCLE,
OH MY GOODNESS,

THEY'RE SOFT AND THEY DON'T
TENSE UP, YOU KNOW, SOFT.

LENGTH, BABY THIGH.

THERE'S ACTUALLY TWO
RECOMMENDATIONS.

AND WHEN THEY WERE MAKING
THE RECOMMENDATIONS
FOR IMMUNIZATIONS,

THEY SAID ON KIDS TO GO
WITH THE ONE INCH NEEDLE.

BUT YOU WILL SEE IN
THE NURSERY STILL WE VISUALLY
CAN'T GET OVER IT,

AND WE'RE GOING TO GO WITH
FIVE EIGHTH INCH NEEDLES.

SO, WHEN I WENT TO
GET MY SUPPLIES

WELL WE HAD JUST RUN OUT OF ALL
OF THOSE PRE-ATTACHED NEEDLES.

SO ON THIS ONE IT'S A 27 GAUGE,
HALF INCH NEEDLE.

THAT WILL DO ME NO GOOD,
AND I NEED A SAFETY DEVICE.

ACTUALLY, YOU KNOW WHAT?
I DIDN'T GET ONE WITH
THE SAFETY DEVICE,

I'LL HAVE TO WORK ON THAT.

I DON'T EVEN HAVE
A SAFETY DEVICE HERE,
SO, I BETTER BE SAFE.

I'VE PICKED ANOTHER NEEDLE
THAT I AM GOING TO ATTACH

WHICH IS A 25 GAUGE,
FIVE EIGHTHS.

AND I THINK I HAVE A
BOX OF SAFETY GLIDES

AND I'LL TRY TO PULL THOSE
OUT SO WHEN YOU TEST,

YOU'LL HAVE ANOTHER
SAFETY GLIDE.

BECAUSE I WANT YOU TO GET USED
TO ALL THESE DIFFERENT THINGS,

BUT OBVIOUSLY I PULLED THE
WRONG THING HERE TODAY.

I HAVE A 25 GAUGE, FIVE
EIGHTHS INCH NEEDLE.

SO I AM GOING TO HAVE TO
TAKE THIS NEEDLE OFF.

I HAVE A FILTER NEEDLE COS WHEN
I BREAK THE TOP OFF THIS

GLASS AMPOULE THERE IS A
CHANCE THAT GLASS COULD
GET INTO THE AMPOULE.

SO I GOT TO DRAW THE MED
OUT WITH A FILTER NEEDLE.

THEN I AM GOING TO
ATTACH THE 25 GAUGE,
FIVE EIGHTHS INCH NEEDLE.

WE ARE IN THE NEEDLE SWAP,
OKAY.

THIS IS ALSO A DIFFERENT
KIND OF SYRINGE.

IT DOESN'T HAVE LUER LOCK.

REMEMBER WITH THE JAR THREADS
THAT SCREW ON THE NEEDLE?

IT'S JUST PLASTIC TO PLASTIC,

SO WE'RE GOING TO HAVE TO USE
A LITTLE DIFFERENT TECHNIQUE

TO STABILIZE OUR NEEDLE
AND I'LL GO THROUGH THAT.

SO, I HAVE ALL MY SUPPLIES,
I HAVE ALCOHOL, BAND-AID,

AND A TWO BY TWO FOR
MY BABY TO DRY OFF.

AND I REALLY DON'T NEED TAPE,
I'M NOT GOING TO
LABEL MY SYRINGE

BECAUSE I'M JUST GOING TO BE
RIGHT HERE WITH THE BABY.

YOU DRAW IT UP NEXT TO
THE BABY AND GIVE IT
TO THE BABY,

SINCE THEY'RE IN THE ROOM
SO NOT REALLY NECESSARY.

ALRIGHT, GATHER MY SUPPLIES.
I HAVE WASHED MY HANDS,

AND I'LL IDENTIFY MY CLIENT
WHEN I GET IN THERE,
AND SO FORTH.

OKAY, I GAVE YOU A PRESENT.

AND THE REASON FOR
THE PRESENT IS THAT

IT'S WHAT YOU'RE GOING
TO SNAP THIS OFF WITH.

IT'S YOUR GRIPPER SO THAT
YOU DON'T CUT YOUR HANDS.

WHEN YOU'RE READING IN
YOUR BOOK, I THINK SOMEONE
MENTIONED IT EARLIER,

THEY SUGGEST THAT YOU
USE AN ALCOHOL SWAB

OR TWO BY TWO'S,
AND THAT'S NICE.

LET ME EXPLAIN A FEW
THINGS ABOUT THESE.

THE ONES THAT THE
MANUFACTURERS
MAKE, THE AQUAMEPHYTON,

REALLY COMES IN AN AMPOULE.

THEY'RE A LITTLE STURDIER
THAN THE GLASS

THAT THEY DO THESE FOR
THE PRACTA-AMPS

AND I HAVE HAD A LOT OF
THEM SHATTER IN STUDENT'S

TWO BY TWO'S AND SO FORTH.
AND IT CUT A COUPLE OF TIMES.

WE HAD TO COME UP WITH
SOMETHING A LITTLE
SAFER FOR THESE

BECAUSE THEY'RE JUST
A LITTLE LESS STURDY.

IF IN THE WORKFORCE,

YOU DIDN'T HAVE A LITTLE
SNAPPER LIKE THESE

AND THEY'RE GETTING MORE OF
THEM. IT'S A NEW PRODUCT

AND IT JUST CAME OUT
IN THE LAST YEAR,

I WOULD USE MY ALCOHOL SWAB
WITH THE PACKAGE OVER IT.

NOT JUST TAKE
THE ALCOHOL SWAB,

BECAUSE YOU'RE GOING TO GET
MORE PROTECTION FOR YOUR HANDS

IF IT WERE TO SHATTER
OR BREAK.

AND THAT'S THE WHOLE THING,
IS TO PROTECT YOU.

MOST OF THE TIME, THEY DON'T.

I WANT YOU TO PRACTICE
WITH YOUR AMP,
I'LL GIVE YOU ANOTHER ONE.

THIS IS CLUMSY MORE
THAN IT IS HARD,

JUST CLUMSY WORKING
WITH THESE THINGS.

ALRIGHT, I NEED TO
DRAW UP MY DOSE.

SO, WHAT YOU WANT TO DO
IS JUST KIND OF TAP THIS.

DON'T HIT IT REAL HARD OR
SOMETIMES WHEN YOU HIT IT

YOU WILL FLICK IT RIGHT OFF.

AND YOU WANT TO MAKE SURE

THAT WHEN YOU'RE DOING IT,
YOU'RE NOT FACING ANYBODY.

YOU WOULDN'T DO THIS
OVER THE BABY'S HEAD,

I WOULDN'T SHOOT TOWARDS YOU.

YOU'RE ALWAYS GOING TO SHOOT
AWAY OR TOWARDS THE WALL,

SO THAT NO ONE GETS
INADVERTENTLY SHOT AT.

GRAB HERE AND FLICK,
BUT WE'RE GOING TO DO THIS
BECAUSE IT WORKS BETTER.

WHEN YOU GRAB IT
IT'S REAL SIMPLE.

YOU CAN SEE THE
DEMARCATION LINE HERE.

I PUT MY THUMB HERE AND PUSH
AND MY FINGER UP ABOVE IT

AND PULL WHILE I AM HOLDING
THE BOTTOM, AND YOU JUST SNAP.

AND I JUST DROPPED IT
THIS MORNING AS WELL,

SO THERE'S ANOTHER LITTLE PIECE
OF GLASS SOMEWHERE IN HERE.

THESE REALLY, VERY OFTEN
THEY WILL HOLD ON TO THAT

TOP PIECE AND IT WOULD ALL GO
INTO THE SHARPS CONTAINER.

SO FOR NOW, YOU CAN JUST DUMP
IT IN AND THEN SAVE THIS

AND BRING IT FOR TESTING SO,
YOU WILL HAVE
YOUR LITTLE SNAPPER.

OKAY, SO NOW I'VE GOT
AN OPEN-ENDED VIAL

AND I NEED TO GET
MY MED OUT OF IT.

- SO.
- WHY DOES IT COME OFF THAT?

I DON'T KNOW. I DON'T KNOW
IF IT HAS SOMETHING
TO DO WITH THE METAL.

WHY THEY DON'T JUST PUT IT IN
A VIAL? I JUST DON'T KNOW.

THERE'S TWO OR THREE MEDS THAT
ARE ALSO IN YOUR CRASH CARTS

THAT ARE DONE IN VIALS,
AND I DON'T HONESTLY KNOW WHY.

- THAT'S GOT TO BE HARDER.

- IT'S NOT REALLY.
- I MEAN THE PACKAGE.
- IT'S CLUMSY.

I WOULD THINK. HOW DO YOU
MAKE A -- I DON'T KNOW.

I JUST KNOW IT'S TRUE.

SOME THINGS ARE
JUST NOT TO KNOW.

YOU GET TO HEAVEN AND YOU CAN
ASK ALL THOSE QUESTIONS.

ALRIGHT, I AM GOING TO GO AHEAD
AND TAKE MY NEEDLE OFF HERE.

AND I AM GOING TO PEEL BACK
AND PUT THE FILTER NEEDLE ON.

NOW, NO THREADS.
IT'S PLASTIC TO PLASTIC.

SO, YOU GOT TO TWIST ON,
PULL CAP OFF.

TWIST THE NEEDLE ON, PULL.

TWIST-PULL.

IF YOU TWIST-TWIST, IT WILL
KEEP PULLING YOUR NEEDLE OFF

BECAUSE IT'S THE PLASTIC KIND
OF CATCHING ON ITSELF
THAT MAKES IT STICK.

ALRIGHT, HERE'S WHERE
CLUMSY HAPPENS.

BECAUSE I HAVE SHAKY HANDS,

YOU DON'T PUT AIR INTO THESE
OR IT WILL JUST BUBBLE ALL OUT

BECAUSE IT'S NOT
A SEALED TAUT.

SO, YOU GOT TO PUT
YOUR NEEDLE IN HERE

AND SUCK OUT WHAT YOU NEED,
AND SUCK OUT A LOT.

AND NOW,
FOR THE STEADIER HAND,

I JUST NEED YOU TO APPRECIATE,

THAT YOU CAN HOLD THESE UPSIDE
DOWN AND NOTHING
WILL COME OUT.

AND THEN YOU CAN PUT
YOUR NEEDLE IN,

AND NOT ALL THE WAY AND THEN
YOU CAN SUCK IT OUT.

IT'S HARD TO SEE HERE AND
IT JUST KIND OF COMES OUT.

I DON'T KNOW, BUT IT DOES IT.

I DIDN'T KNOW THAT FOR
THE LONGEST TIME AND
I WAS IN A CODE ONE DAY

AND THEY WERE PULLING THE
CODE MEDS OUT, AND THIS NURSE
WAS WITH THIS DOCTOR,

I DON'T KNOW AND THERE WAS
SOMEBODY FLIPPING THEM OVER,
AND I WAS LIKE...

HERE THIS POOR GUY'S
DYING AND I'M GOING,

"HOW DOES THIS COME OUT?"

SO I DON'T THINK
THAT'S THE TIME

THAT YOU'RE SUPPOSED TO BE
GAWKING AT DUMB STUFF
LIKE THAT

WHEN THERE IS THEM, YOU KNOW.
OKAY, WELL THAT SORT OF THING.

SO YOU'RE GOING TO HAVE TO
REALLY FLICK IT HARD.

AND GET YOUR AIR OUT.

AND THEN REMEMBER, AND I'M
MAKING SURE MY AIR PASSES
THROUGH MY HUB.

REMEMBER THAT THIS IS, KIND OF,
AN OILY, SLIPPERY STUFF.

AND THEN YOU WOULD GO TO YOUR
TRASH CAN AND SET YOUR DOSE.

2.5, OH WELL,
THERE'S THOSE NUMBERS.

ALRIGHT, TO GET THIS NEEDLE
OFF, IT'S SLIPPERY.

SO IF YOU'VE GOT ANY OF IT ON
YOUR HANDS, YOU WANT TO DRY.

MAKE SURE YOU PUT THE CAP ON,

HOLD THE FLANGE BEING CAREFUL
NOT TO PLUNGE OUT YOUR DOSE.

HOLD THE FLANGE AND THEN TWIST
OFF, THE OPPOSITE WAY.

TWIST IT AND IT WILL RELEASE
THAT SEAL YOU CREATED
WITH THE PLASTIC.

ALRIGHT, THROW THESE AWAY
AND THEN NOW YOU'RE
GOING TO PUT ON...

I DON'T THROW MY AMPOULE AWAY
UNTIL I'VE TOTALLY GOTTEN,

GIVEN MY DOSE, IN CASE
I INADVERTENTLY HIT THIS
AND SQUIRT SOME DOSE OUT.

I'M GOING TO PUT ON
MY 25 GAUGE.

MY HANDS ARE SHAKY TODAY,
25 GAUGE, FIVE EIGHTHS
INCH NEEDLE,

TWIST AND IT SHOULD BE
ON NICE AND STURDY.

ALRIGHT, I'M GOING TO GET
RID OF ALL MY TRASH.
SAVE THESE NEEDLES.

CONNIE AND I'LL PUT A LITTLE BOX
OUT SO THAT YOU CAN SAVE THEM.

SOME OF THEM HAVEN'T EVEN
BEEN USED. SO WHO KNOWS
WE USE THEM FOR SOMETHING.

CLEAN UP YOUR AREA,
AND THEN...

DOUBLE CHECK.

ONE MILLIGRAM, HALF CC,
AND I'M HAPPY.

I'M GOING TO GIVE MY SHOT
TO MY BABY. ALRIGHT.

BABY. YOU'RE GOING TO COME
IN AND DO YOUR BABY.

NOW, YOU NEED TO APPRECIATE

THAT YOU'RE NOT GOING TO
HANDLE A BABY THAT'S ONE
HOUR OLD WITHOUT GLOVES.

BECAUSE THAT BABY PROBABLY
HASN'T HAD A BATH YET.

THE BABY HAS GONE THROUGH
THE BIRTH CANAL,

THE BABY'S BEEN EXPOSED TO
MOM'S AMNIOTIC FLUID,
MOM'S BLOOD,

MAYBE EVEN MOM'S STOOL
OR URINE, DEPENDING
ON THE SCENARIO.

SO THERE'S A LOT OF BODY
FLUIDS ON THIS BABY.

EVERYTHING DONE BEFORE
BATH IS WITH GLOVES.

EVEN TO UNWRAP THEM BECAUSE
OF BODY FLUIDS.

SO, I CAN'T REALLY CHECK
THE MAR TO THE NAME BAND

UNTIL I UNWRAP, AND SO YOU'RE
GOING TO UNWRAP
AND GET DOWN AND...

OH BOY, WE HAVE THIS ONE REALLY
PACKAGED UP NICELY.

THAT'S IT.
I SHOULD HAVE CHECKED.

I NEED TO GET DOWN TO DIAPERS.

THEY'RE JUST GOING TO BE IN
A DIAPER AND A T-SHIRT,

NOT A CUTE LITTLE
OUTFIT ALREADY.

I NEED TO GET DOWN

TO NAME BAND AND TO THIGH.

OKAY.

I'M GOING TO CHANGE
THE NAME BAND.

THEY USUALLY HAVE A BAND
ON THE HAND AND THE FEET.

SO MAR, I HAVE INFANT BABY,

OH IT'S AN RN'S BABY, AND IT'S
BABY BENEFIEL. OH HOW SWEET.

OKAY, IT'S MY BABY.
TAKE GOOD CARE OF HIM.

OKAY, I HAVE MY BABY.

AND NOW I WANT TO CHECK,
AND WHAT WE TYPICALLY DO,

I'M GOING TO JUST TILT HIM
UP A LITTLE BIT FOR
YOU SO YOU CAN SEE...

IS WE USUALLY GIVE THE
AQUAMEPHYTON IN THE LEFT THIGH

FOR RIGHT-HANDERS ESPECIALLY.

AND THIS IS THE REASON THAT
WHEN I GO TO DO THE THIGH,

IF I COME IN FROM
THIS DIRECTION,

ALL THESE OTHER EXTREMITIES
ARE GOING TO BE
INADVERTENTLY SWATTING AT ME.

BUT I DO WANT TO TEACH YOU HOW
TO PAPUSE THIS BABY

SO THAT THEY DON'T
WIGGLE ON YOU.

THEY DON'T BITE TOO MUCH
AND I DON'T USUALLY WRAP THEM,

BUT ON KIDS THEY'RE A LITTLE
MORE BIGGER, SO I DO.

OKAY, WHAT YOU WANT TO DO.

GET YOUR BABY SWADDLE

AND EXCUSE ME THERE, BABY.

I NEED TO GET THIS BLANKET
SO I CAN SHOW THEM.

OKAY, ON YOUR BLANKET,
THIS ONE IS KIND OF SQUARE.

OFTEN TIMES THEY'RE
A LITTLE RECTANGLE.

YOU'RE GOING TO TAKE
AND FOLD DOWN A PIECE
LIKE THIS FOR THEIR HEAD

BECAUSE YOU DON'T WANT THEIR
HEAD PARTICULARLY WRAPPED UP.

SO GET YOUR BABY, PUT HIM THERE,
SUPPORT THOSE HEADS
COS THEY FLOP.

ALRIGHT, THEN YOU'RE
GOING TO TAKE -- I WANT THIS
LEG TO STAY EXPOSED.

SO YOU'RE GOING TO TAKE
THIS FIRST WRAP HERE,

AND WRAP IT NICE AND SNUG,
KEEPING THIS LEG OUT.

THEN YOU'RE GOING TO PULL
THIS UP THROUGH, KEEPING
THAT NICE AND SNUG,

AND THIS IS A PITIFULLY
SMALL BLANKET.

OH IT'S TERRIBLE,
I NEED A BIGGER BLANKET.

AND THEN TAKE THIS EDGE AND WRAP
IT TIGHT, TIGHT, TIGHT, AROUND.

SO THAT ALL THAT'S STICKING
OUT IS A BABY LEG.

OKAY, SO PRACTICE SWADDLING.

I LIKE THE RECTANGLE ONES THAT
ARE LONG ON ONE SIDE BECAUSE I

AND GET THEM REALLY
TIGHT IN THERE.

OKAY, I WANT TO IDENTIFY
MY LANDMARKS WHICH IS
BASICALLY A FINGER AT THE...

BELOW THE GROIN HERE AND
A FINGER ABOVE THE KNEE.

HERE'S THE MEDIAN LINE,
AND HERE TO THE SIDE IS
THE VASTUS LATERALIS.

MY GRIP FOR THE BABY IS TO
PUT THE KNEE IN THE WEBBING

OF MY HAND TO STABILIZE IT.

AND I PUT MY THUMB
ON ONE SIDE OF THE MUSCLE
AND MY FINGER HERE,

AND THEN I SQUEEZE MY THUMB AND
FINGER TOGETHER, LIKE THIS.

AND IT POPS THAT LITTLE
MUSCLE UP, AND IT'S AS
PRETTY AS CAN BE.

AND THAT'S WHAT YOU
WANT RIGHT HERE.

SO THAT'S MY GRIP.
THAT WAY THAT LEG'S GOING
NOWHERE, THE BABY IS WRAPPED,

IT'S JUST ME THAT'S GOING
TO BE HOLDING ON.

OKAY, ONCE YOU SHOW US
THE GRIP, IT NEEDS
A RUBBER PAD HERE.

YOU'RE ACTUALLY GOING TO
GIVE THE SHOT IN THAT.

PULL AWAY. PULL IT STRAIGHT,
NO TWIST.

GOT TO CLEAN THAT LITTLE THIGH,
AND YOU CAN LEAVE
IT THERE IF YOU WANT.

USUALLY WHEN YOU CLEAN THERE'S
BLOOD AND YOU CAN
SEE THE STUFF.

I'M SQUEEZING UP BETWEEN
MY THUMB AND FOREFINGER

AND PINCHING THAT LITTLE
MUSCLE UP AND THEN YOU
CAN JUST PUSH THIS IN.

OH! BABY, I'M SO SORRY.

ASPERATE, PUT IT IN. PUT
IT IN FAIRLY SLOW,

AND THEN IF YOU HAVE ONE
OF THOSE SAFETY GLIDES,

YOU'RE GOING TO
SAFETY GLIDE OUT,

BUT I DON'T HAPPEN TO HAVE A
NEEDLE SAFETY DEVICE TODAY.

SO NEEDLE OUT,

YOU'RE GOING TO JUST STAND
HERE A MINUTE AND HOLD

BECAUSE WHAT AM I
AT RISK FOR HERE?

THEY'RE GOING TO BLEED. THAT'S
THE WHOLE POINT OF THIS SHOT.

SO THEY USUALLY GIVE YOU A
TRICKLE DOWN THEIR LEGS.

SO, I LIKE TO KEEP
SOME PRESSURE ON.

YOU MIGHT WANT TO TRY
A DRY TWO BY TWO.

HOLD, BABY'S GOOD.
I KNOW THEY'RE WRAPPED.

I NEED TO GET RID OF THIS IN
MY SHARP AND IT'S NOT FAR.

AND MAYBE DRY.

I ALWAYS PUT A BAND-AID
ON BABIES BECAUSE THEY
DO OOZE MOST OF THE TIME.

YOU DON'T HAVE TO ON MY
MANNEQUINS, PLEASE.
IT'S NOT NECESSARY.

AND THEN YOU WANT TO
REPOSITION THE BABY,

AND THIS IS HOW YOU WRAP HIM
NOW THAT ONE SIDE STILL GOOD.

BRING THIS ONE UP AND
TAKE THIS ONE ALL THE WAY
AROUND, NICE AND SNUG

AND THEN THEY EITHER
LAY ON THEIR SIDE

OR ON THEIR BACK WITH
THEIR HEAD TURNED.

- SO IT'S NOT REALLY A MASSAGE,
JUST PRESSURE?

- JUST PRESSURE. YEAH, THERE'S
NO NEED FOR A MASSAGE.

IT MIGHT CAUSE BRUISING,
I WOULD THINK.

- IF YOU'RE LEFT-HANDED DO
YOU DO IT THE OTHER WAY?

- YOU CAN. IT DEPENDS ON
THEIR HOSPITAL POLICIES.

SOMETIMES THEY STARTED THE
HEPATITIS B SERIES ON BABIES

AND SO THEY MAY DO THE
HEPATITIS -- IT'S WHAT
WE DO IN OUR HOSPITAL.

HEPATITIS WAS RIGHT LEG,
AND AQUAMEPHYTON WAS LEFT

JUST SO IN CASE THEY
HAD A LITTLE SWELLING

OR IRRITATION, WE KNEW
WHICH SHOT DID WHAT.

SO STAY WITH YOUR
HOSPITAL POLICIES

AND THEN BECAUSE OF MONEY THEY
QUIT DOING THE HEPATITIS B

AND THEY STARTED DOING IT IN
THE DOCTOR'S OFFICES.

AND I DON'T KNOW WHAT THEY'RE
DOING RIGHT NOW WITH THAT.

SO, TAKE YOUR GLOVES OFF, WASH
YOUR HANDS, DISPOSE OFF.

NOW YOU CAN GET RID OF
YOUR AQUAMEPHYTON

IN THE SHARPS CONTAINER
BECAUSE IT IS GLASS.

ALL THESE OTHER NEEDLES
WOULD GO IN SHARPS.

WASH YOUR HANDS AND DOCUMENT.

AND WE'RE GOING TO DOCUMENT
THAT OUR SHOT WAS GIVEN
AT TWO O'CLOCK.

AND IT WAS GIVEN IN THE LT.

LEFT THIGH.

BY ME, DB, WHO IS
DIANE BENEFIEL RN.

AND YOU ARE SN CSUF, OKAY.

AND THAT IS IT.

THEY'RE NOT REALLY HARD.
JUST THIS ONE IS CLUMSY.

AND THE OTHER IS HIGH ANXIETY,
BUT PAST THAT,

IT'S REALLY NOT, THEY'RE NOT
BASICALLY HARD SKILLS.

SO PRACTICE WITH THAT STUFF
AND GET COMFORTABLE.