March 22, 2016

Chris practices his immunization technique (notice the cap is on the syringe) while Dr. Bohan observes and advises

One of the courses the 3rd Year Pharmacy students at Wilkes University take is the APhA (American Pharmacist Association)  Immunization Certification Course. The course includes about 7 hours of didactic lectures, 12-24 hours of home study, a final written exam, and a final practical exam in which the students have to demonstrate the technique of immunization by giving 3 normal saline injections to their classmates.

Chris now actually injects David with normal saline as he gives him an Intramuscular injection. This would be the same technique as administering an Influenza Vaccine.

Normal saline is salt water and doesn’t hurt to be injected and it doesn’t cause any harm to the person receiving it. The students need to give successfully 2 Intramuscular injections and 1 Subcutaneous injection.  Most pharmacy employers in the USA are requiring this certification in their applicants. Although drug administration didn’t used to be a primary role of a pharmacist, we have found that we can increase the overall number of people who are receiving vaccines to prevent serious illnesses by having immunizations available at the local community pharmacies.

Dr Nicole Pezzino gives advice to Ashley as she prepares to practice her immunization technique on Krista

I think that this would be an excellent role for the pharmacists in Uganda. There are so few healthcare providers in Uganda and I think that training pharmacists and having vaccines available could really make a huge positive difference in the health of the Ugandan population. Over the past 20 years, access to childhood vaccinations for kids under 5 years old has really increased. Just about any child can and does receive their childhood immunizations free of charge. This has been made possible by all of the financial support that other countries and private organizations have given Uganda (and other developing countries) to improve health. This has reduced child and infant mortality but older children and adults are not routinely receiving booster vaccines and many people are affected and die each year from Tetanus infection. Tetanus is an easily preventable illness when people get the routine booster every 10 years or even if people are just receiving it when they have a cut and need to get an injury taken care of at the hospital. But, in Uganda, many people don’t seek medical care for cuts and small injuries. Even large lacerations may be treated at home with home remedies or by traditional healers. And, yes, the cut will heal. But if the cut was infected with Tetanus, which can be found in dust and dirt, then the patient can develop this serious infection about 3-21 days after the initial cut.  Unfortunately, with severe illnes, 1 out of every 3 people infected will die.  I’d like to encourage my Ugandan pharmacy students and pharmacist friends to consider thinking about training to give immunizations and then working with humanitarian organizations to obtain the vaccines to run clinics for older children and adults. For example, if someone got a cut but didn’t want stitches, at least they could go to the pharmacy and get the tetanus booster to prevent this illness. Many lives could be saved.

The video below shows how Ashley accidentally pulled out the syringe too fast and the fluid spurted out. You can’t see the fluid but you can see her reaction. I post this because it is pretty funny but also to show how it is important to practice ahead of time. The only way to learn how to do this is to have the opportunity to practice and learn from your mistakes. Since this is a really common and easy mistake to use, I hope other can learn from it because when you are immunizing real patients, it is easy to become nervous and make a simple mistake. Thanks to Ashley who is allowing me to post these 2 videos.