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How to Mix and Inject Injectable Hydrocortisone (4425)

How to Mix and Inject Injectable Hydrocortisone (4425) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Pediatrics, Parenting

4425





How to Mix and Inject Injectable Hydrocortisone

Injectable Hydrocortisone

Your nurse will teach you how to mix and inject hydrocortisone. It is helpful for you to review
the steps in this information sheet every few months so that you will feel more confident in
case an injection is needed. The nurses are also happy to review the steps with you if questions
come up during your child's follow-up visits to the clinic.

Reminder: Whenever your child cannot take hydrocortisone by mouth or vomits more than once,
the medicine must be injected. If your child is weak, unconscious, or cannot wake up, 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, please give the injection of medicine FIRST and then call.

Provider Name______ Phone number _____ Emergency number 911

Dosage: If your child is over 3 years old, most often all of the medicine, 2 mL (100mg) is given.
If the child is less than 3 years old, most often 1 mL (50mg) is given.

Storage and Replacement
For convenience, it may be helpful to store all of your supplies in a small clean container.
Crucial supplies include:
- vial(s) of hydrocortisone
- syringes and needles
- alcohol wipes
- this handout

Unused vials: Store at room temperature (not warmer than 86ºF) in a dark, dry area.

Opened vials: After the hydrocortisone powder is mixed, label the vial with the date and time.
Once mixed, the hydrocortisone solution is good for only 3 days. Keep it at room temperature.

Expiration dates: Vials of hydrocortisone powder and bacteriostatic water have expiration
dates. Be sure to check these dates from time to time. Call for a new prescription if the
expiration date is near.

For more information on hydrocortisone and cortisol dependency, see
the handout, “Guidelines for the Child Who Is Cortisol Dependent”
HFFY #4424: uwhealth.org/healthfacts/parenting/4424.html






How to Mix If Powder and Water Come in One Vial (for example, Act-O-Vial)

Supplies: 1 vial of hydrocortisone powder and water, alcohol wipe, 3mL syringe and inch needle















1. Wash hands. Press down HARD on the plastic cap (Rubber divider will fall into lower
section).

2. Gently shake vial until all powder is dissolved.

3. Remove the plastic tab covering the center of the stopper. Wipe top of rubber stopper with
an alcohol wipe.

4. Connect the needle and syringe as instructed. To draw air into syringe, pull the plunger of the
syringe down to the ____mL mark. Remove the needle cap and insert the needle squarely
through the center of the stopper until you see the needle tip. Inject air into the vial. Do not
remove the needle.

5. 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.

6. Remove the needle and syringe from the vial. If you notice any large air spaces, point needle
upright and carefully press on plunger until the air space is gone. Be sure you have the proper
volume in the syringe before removing the needle. You are now ready to inject the
hydrocortisone.
















How to Mix If Powder and Water Are in Separate Vials

Supplies: 1 vial bacteriostatic water, 1 vial hydrocortisone powder, 3mL syringe and
inch needle












1. Wash hands. Remove plastic caps from both vials. Clean rubber stoppers with an alcohol
wipe.

2. After connecting the needle and syringe, pull the plunger of the syringe out to the
____mL mark (to draw air into syringe). Remove the needle cap and insert needle
squarely through the top of vial of water. Inject air into the vial.

3. Turn the water vial and syringe upside down. Make sure needle tip is in the water. Then pull
the plunger out to the ____mL mark (to draw water into syringe).

4. Remove the filled syringe and insert needle squarely through the center of the stopper into
the vial of powder. Inject the water without removing the needle. Gently shake vial until all
powder is dissolved.

5. Turn the hydrocortisone vial and syringe upside down. Keeping the tip of the needle below
the medicine line, pull the plunger out to the ____mL mark (to draw up the medicine).

6. Remove needle and syringe from the vial. If you notice any large air spaces, point needle
upright and carefully press on plunger until the air space is gone. Be sure you have the proper
volume in the syringe before removing the needle. You are now ready to inject the
hydrocortisone.













How to Inject

1. Select an injection site in the thigh (see diagram). Clean the
site with an alcohol wipe.

2. Hold the syringe like a dart at a 90º angle to the site.

3. With the other hand, hold the muscle firmly at the site.

4. Insert the needle straight into the skin with a quick firm
motion.


5. Slowly push down on the plunger until the syringe is empty.

6. Remove the needle quickly (at the same angle it was
inserted). Apply gentle pressure to the site with an alcohol
wipe, cotton ball or gauze. The site may bleed a bit.

7. Throw out the needle and syringe in a puncture proof
container (like a coffee can or Sharps ο container).



The Spanish version of this Health Facts for You is #7175:
uwhealth.org/healthfacts/spanish/7175.html









Your health care team may have given you this information as part of your care. If so, please use it and call if you have
any questions. If this information was not given to you as part of your care, please check with your doctor. This is not
medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health
needs are different, you should talk with your doctor or others on your health care team when using this information. If
you have an emergency, please call 911. Copyright ©10/2015. University of Wisconsin Hospitals and Clinics Authority.
All rights reserved. Produced by the Department of Nursing. HF#4425.