Administer these vaccines by the intramuscular (IM) route: Diphtheria-tetanus (DT, Td) with pertussis (DTaP, Tdap); Haemophilus

influenzae type b (Hib); hepatitis A (HepA); hepatitis B (HepB); human papillomavirus (HPV); inactivated influenza (TIV); quadrivalent meningococcal conjugate (MCV4); and pneumococcal conjugate (PCV). Administer inactivated polio (IPV) and pneumococcal polysaccharide (PPSV23) either IM or SC.
Patient age Newborn (028 days) Use a needle long enough to reach deep into the muscle. Insert needle at a 90 angle to the skin with a quick thrust. (Before administering an injection of vaccine, it is not necessary to aspirate, i.e., to pull back on the syringe plunger after needle insertion. ) Multiple injections given in the same extremity should be separated by a minimum of 1", if possible. Infant (112 months) Anterolateral thigh muscle 1" (2225 gauge) 11" (2225 gauge) Anterolateral thigh muscle Toddler (12 years) Alternate site: Deltoid muscle of arm if muscle mass is adequate 1"* (2225 gauge)

How to Administer Intramuscular (IM) Vaccine Injections

90 angle

1"* (2225 gauge)

skin

Deltoid muscle (upper arm) Children (318 years) 11" (2225 gauge)
subcutaneous tissue

Alternate site: Anterolateral thigh muscle

muscle

Deltoid muscle (upper arm) Adults 19 years and older 11" (2225 gauge) Alternate site: Anterolateral thigh muscle *A " needle may be used only if the skin is stretched tight, the subcutaneous tissue is not bunched, and injection is made at a 90 angle.
A " needle is sufficient in adults weighing <130 lbs (<60 kg); a 1" needle is sufficient in adults weighing 130152 lbs (6070 kg); a 11" needle is recommended in women weighing 152200 lbs (7090 kg) and men weighing 152260 lbs (70118 kg); a 1" needle is

recommended in women weighing >200 lbs (>90 kg) or men weighing >260 lbs (>118 kg).

IM site for infants and toddlers

IM injection site
(shaded area)

CDC. ACIP General Recommendations on Immunization at www.immunize.org/acip

IM site for children and adults

acromion

level of axilla

(armpit)

IM injection site
(shaded area)

elbow Insert needle at a 90 angle into thickest portion of deltoid muscle above the level of the axilla and below the acromion. Insert needle at a 90 angle into the anterolateral thigh muscle.

www.immunize.org/catg.d/p2020.pdf Item #P2020 (11/10)

Technical content reviewed by the Centers for Disease Control and Prevention, November 2010.

Immunization Action Coalition 1573 Selby Ave. St. Paul, MN 55104 (651) 647-9009 www.immunize.org www.vaccineinformation.org admin@immunize.org

How to Administer Subcutaneous (SC) Vaccine Injections

Administer these vaccines by the subcutaneous (SC) route: measles, mumps, and rubella (MMR), varicella (VAR), meningococcal polysaccharide (MPSV4), and zoster (shingles [ZOS]). Administer inactivated polio (IPV) and pneumococcal polysaccharide (PPSV23) vaccines either SC or IM.
Injection site Needle size Patient age Needle insertion tissue over 45 angle triceps skin Fatty tissue " needle, 2325 over gauge anterolateral subcutaneous thigh or fatty tissue

Pinch up on subcutaneous (SC) tissue to prevent injection into muscle. Insert needle at 45 angle to the skin. (Before administering an injection of vaccine, it is not necessary to aspirate, i.e., to pull back on the syringe plunger after needle insertion.*)

Multiple injections given in the same extremity should be separated by a minimum of 1". Fatty tissue over the anterolateral thigh muscle " needle, 2325 gauge Birth to 12 mos.

12 mos. and older

*CDC. ACIP General Recommend ations on Immunizatio

n at www.immunize.org/acip

muscle

SC site for children (after the 1st birthday) and adults SC site for infants
acromion SC injection site elbow SC injection site
(shaded area) (shaded area)

Insert needle at a 45 angle into fatty tissue of the anterolateral thigh. Make sure you pinch up on SC tissue to prevent injection into the muscle. Insert needle at a 45 angle into the fatty tissue over the triceps muscle. Make sure you pinch up on the SC tissue to prevent injection into the muscle.

www.immunize.org/catg.d/p2020.pdf Item #P2020 (11/10)

Technical content reviewed by the Centers for Disease Control and Prevention, November 2010.

Immunization Action Coalition 1573 Selby Ave. St. Paul, MN 55104 (651) 647-9009 www.immunize.org www.vaccineinformation.org admin@immunize.org Angka 1 diwakili oleh jari
telunjuk, 2 diwakili jari telunjuk dan jari tengah demikian seterusnya sampai 4 ditunjukkan ketika jari telunjuk sampai kelingking terbuka. Angka 5 diwakili oleh jempol saja. Lalu 6 ditunjukkan dengan jempol dan telunjuk, demikian seterusnya hingga angka 9 ditunjukkan jika semua jari tangan kanan terbuka. Contoh : 1 + 5 + 3 2 = 7 1 (buka jari telunjuk) +5 (buka jempol) +3 (buka jari tengah, jari manis, kelingking) -2 (tutup jari kelingking dan jari manis) sampai disini kita akan mendapati jempol, jari telunjuk dan jari tengah terbuka dan ini menunjukkan angka 7. Jika sudah terbiasa, maka dengan sendirinya jari-jari akan bergerak dengan lincah. Metode Jarimatika ini bisa digunakan untuk operasi penjumlahan dan pengurangan sampai dengan 9999 dan untuk operasi perkalian/pembagian 2-3 digit (atau bahkan lebih)? Untuk informasi selengkapnya mengenai jarimatika ini dapat menghubungi alamat di bawah ini: www.jarimatika.com KANTOR PUSAT : Jl. Margosari PR 4 Salatiga Telp : 0298 325016 HP : 0812 867 1598 CABANG MAKASSAR : Kursus & Sanggar Anak MENTARI Jl. Pengayoman Ruko Jasper III No. 11 Panakkukang Mas Makassar Telp: (0411) 435566 Untuk Tekhnik Dasar Jarimatika Mungkin Rumus Dibawah Ini Bisa Membantu

Teknik Jarimatika

1)Penjumlahan dan Pengurangan

Tangan Kanan sebagai satuan dan tangan kiri sebagai puluhan. Tangan Kanan: - Telunjuk dibuka = 1 - (Telunjuk + Jari Tengah) dibuka = 2 - (Telunjuk + Jari Tengah + Jari manis) dibuka = 3 - (Telunjuk + Jari Tengah + Jari manis + Kelingking) dibuka = 4 - (Telunjuk + Jari Tengah + Jari manis + Kelingking) ditutup + Jempol dibuka = 5 - (Jempol + Telunjuk) dibuka = 6 - (Jempol + Telunjuk + Jari Tengah) dibuka = 7 - (Jempol + Telunjuk + Jari Tengah + Jari Manis) dibuka = 8 - (Jempol + Telunjuk + Jari Tengah + Jari Manis + Kelingking) dibuka = 9 Tangan Kiri: - Telunjuk dibuka = 10 - (Telunjuk + Jari Tengah) dibuka = 20 - (Telunjuk + Jari Tengah + Jari manis) dibuka = 30 - (Telunjuk + Jari Tengah + Jari manis + Kelingking) dibuka = 40

- (Telunjuk = 50 - (Jempol + - (Jempol + - (Jempol + - (Jempol +

+ Jari Tengah + Jari manis + Kelingking) ditutup + Jempol dibuka Telunjuk) dibuka = 60 Telunjuk + Jari Tengah) dibuka = 70 Telunjuk + Jari Tengah + Jari Manis) dibuka = 80 Telunjuk + Jari Tengah + Jari Manis + Kelingking) dibuka = 90

Check with your doctor or nurse to make sure your baby is receiving all vaccinations on schedule. Many times vaccines are combined to reduce the number of injections. Be sure you ask for a record card with the dates of your babys vaccinations; bring this with you to every visit. Heres a list of the diseases your baby will be protected against: HepB: hepatitis B, a serious liver disease DTaP: diphtheria, tetanus (lockjaw), and pertussis (whooping cough) PCV: pneumococcal conjugate vaccine protects against a serious blood, lung, and brain infection Hib: Haemophilus influenzae type b, a serious brain, throat, and blood infection Polio: polio, a serious paralyzing disease RV: rotavirus infection, a serious diarrheal disease Influenza: a serious lung infection MMR: measles, mumps, and rubella HepA: hepatitis A, a serious liver disease Chickenpox: also called varicella