PTCB Immunization flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Deltoid IM site

Preferred intramuscular site for adults and children aged 3 years and older; inject into the central, thickest portion of the muscle mass.

Vastus lateralis site

Preferred intramuscular site for infants and toddlers, located in the anterolateral thigh; used when deltoid muscle mass is inadequate.

Subcutaneous injection angle

A 45-degree angle into fatty tissue such as the upper-outer triceps, using a 23-25 gauge needle that is 5/8 inch long.

Intradermal injection technique

A 26-27 gauge, 3/8 inch needle inserted at a 5-15 degree angle; a visible wheal confirms correct placement in the dermis.

Needle length by weight

For IM injections, adults under 60 kg use a 1 inch needle; adults 60 kg or more use 1 to 1.5 inches.

Aspiration before injection

Not recommended for any vaccine; inject the full dose and withdraw the needle at the same angle used for insertion.

Two vaccines, one visit

Use separate syringes and separate anatomic sites at least 1 inch (2.5 cm) apart when giving two injectable vaccines at the same visit.

Vaccine refrigerator temperature

Refrigerated vaccines are stored at 2 to 8 degrees C (36 to 46 degrees F), monitored with a calibrated digital data logger.

Frozen vaccine temperature

Frozen vaccines are stored at -50 to -15 degrees C (-58 to +5 degrees F); never place them in a freezer door or on a shelf.

Refrigerator placement rule

Store vaccines in the middle of the unit, away from walls, floor, and cold-air vents; do not store in doors or drawers.

Temperature monitoring frequency

Record minimum and maximum temperatures at least twice each workday, at the start and end of the day.

Temperature excursion response

Label affected vaccine DO NOT USE, quarantine it, and contact the manufacturer or immunization program for viability guidance.

Stock rotation rule

Rotate vaccine inventory first-expiry, first-out; check expiration dates monthly and remove expired product from usable stock.

Refrigerator power safety

Plug vaccine units into a dedicated outlet, not power strips or extension cords, and post a Do Not Unplug sign.

Contraindication screening

Check before every dose for severe allergic reaction to a prior dose or component; for live vaccines, pregnancy or significant immunocompromise.

Acute illness deferral

Moderate or severe acute illness, with or without fever, is a precaution to defer vaccination; mild illness is not a reason to defer.

Required dose documentation

Record vaccine name, manufacturer, lot number, expiration date, dose volume, route, site, date, and administering clinician.

IIS reporting

Each administered dose is reported to the state or local immunization information system within the timeframe required by that jurisdiction.

Egg allergy status

Egg allergy is not a contraindication to any routinely recommended vaccine; severe allergy to a vaccine component is a contraindication.

Post-vaccination observation

Observe patients for 15 minutes after vaccination, seated or lying down, to monitor for syncope, and document the observation period.

Guillain-Barre precaution

A history of Guillain-Barre syndrome after influenza vaccine is a precaution requiring risk-benefit discussion before repeat vaccination.

Vaccine Information Statement

Under the National Childhood Vaccine Injury Act, provide the current VIS before each dose and record its edition date and date given.

VAERS reporting scope

VAERS accepts reports of any adverse event after vaccination, whether or not causality is established; serious events and errors are reportable.

State pharmacist authority

Pharmacists administer vaccines under state authority; scope, age limits, and prescriptive authority vary by state and must be verified.

Epinephrine anaphylaxis dose

Give epinephrine 1 mg/mL IM in the mid-outer thigh at 0.01 mg/kg, maximum 0.5 mg per dose, repeat every 5-15 minutes as needed.

Emergency kit contents

At every vaccination site keep epinephrine, 1 mL syringes with 1 to 1.5 inch needles, and a means to call emergency services immediately available.

Needlestick injury response

Wash the site with soap and water, report immediately, and follow post-exposure evaluation for bloodborne pathogens.

Sharps disposal rule

Place used needles in puncture-resistant, closable containers immediately after use; never recap a needle using two hands.

Live vaccine contraindications

Live vaccines are contraindicated during pregnancy and in severe immunocompromise; inactivated vaccines are generally preferred in these groups.

Intramuscular needle gauge

Most adult IM vaccines use a 22-25 gauge needle; gauge affects flow rate and patient comfort, not injection depth.

VIS documentation elements

Record the VIS edition date and the date it was given, along with vaccine name, lot, expiration, site, route, and dose.

Anaphylaxis recognition

Signs include urticaria, angioedema, wheezing, stridor, hypotension, and tachycardia; epinephrine is the first-line treatment.