Summary of "Vaccinating young children - training video"

This training video provides a comprehensive guide to the vaccination process for young children, covering clinic setup, pre-assessment, vaccine preparation and administration techniques, and post-vaccination procedures. It emphasizes safety, proper technique, legal and ethical considerations, and effective communication with parents and carers.

Main Ideas, Concepts, and Lessons

1. Clinic and Room Setup

Use child-friendly decorations (pictures, mobiles) to distract children.
Ensure an accessible anaphylaxis kit in every clinic room.
Maintain vaccines in recommended cold chain temperatures using a vaccine fridge or monitored esky.
Check and record fridge temperatures daily on a temperature monitoring chart.
Prepare a clinic tray with disposable liners and all necessary equipment.
Keep sharps containers accessible but out of reach of children.
Use a running sheet to track vaccine counts and follow up on discrepancies.

2. Pre-Assessment and Consent Procedures

Introduce yourself and your role to the client.
Check the child’s immunisation history through child health records or the Australian Childhood Immunisation Register.
Ask if the client identifies as Aboriginal to assess vaccination needs.
Consider age, minimum intervals between vaccines, catch-up schedules, risk factors, and Aboriginal status.
Use a pre-vaccination checklist to confirm medical fitness and vaccine requirements (to be completed by a registered nurse or medical officer).
Explain the risks and benefits of vaccines using consent resources.
Obtain voluntary, informed consent from a legally competent person.
Inform clients about the recommended 15-minute post-vaccination observation period.
Allow time for questions.

3. Vaccine Preparation

Verify vaccine fridge temperature before removing vaccines.
Check vaccine name, batch number, expiry date, and appearance.
Some vaccines require reconstitution (e.g., Infanrix Hexa, MMR, Varicella).
Do not use vaccines with abnormal color or particles.

4. Vaccine Administration Techniques

Three administration routes: oral, intramuscular (IM), and subcutaneous (SC).

Oral Vaccine (Rotavirus):

Administer oral rotavirus vaccine before injections.
Position infant in a nursing/feeding position.
Administer vaccine slowly between cheek and gum.
Do not force vaccine too far back to avoid gag reflex.
Stimulate swallowing by touching lips/mouth or stroking throat (for infants 5 months+).
Discard applicators in biological waste or sharps containers.

Intramuscular Injection:

Preferred sites:
- Infants (<12 months): Vastus lateralis muscle (outer thigh).
- Older children (12 months+): Deltoid muscle.
Positioning:
- Infants: Cuddle position or lying on exam bed with carer support.
- Older children: Sideways on carer’s lap or facing away with legs straddled over carer’s lap.
Identify anatomical landmarks carefully to avoid neurovascular damage.
Use 23-gauge, 25 mm needle (shorter 16 mm needle for premature or small infants).
Insert needle at 90 degrees, do not aspirate.
If blood appears, withdraw and select a new site.
Apply gentle pressure post-injection; avoid rubbing.
For multiple vaccines:
- Separate injections by at least 2.5 cm if given in the same site.
- Record injection sites for monitoring adverse reactions.

Subcutaneous Injection:

Administered at 45 degrees using a 25 gauge, 16 mm needle.
Commonly given over the deltoid or anterolateral thigh.
Used for some influenza vaccines and other specific vaccines.

For adults and adolescents (e.g., Boostrix vaccine), use deltoid with appropriate needle length (23 gauge, 25 or 38 mm depending on size).

5. Post-Vaccination Care

Comfort and distract children immediately after vaccination (swaddling, toys, music).
Discuss common side effects and adverse event management.
Provide vaccine safety information leaflets with contact details for reporting reactions.
Record all vaccination details on personal and clinic records.
Submit immunisation data to relevant registers (Australian Childhood Immunisation Register, National HPV Vaccination Register).
Observe clients for 15-30 minutes post-vaccination for immediate adverse events.
Advise adults not to drive or operate machinery for 30 minutes post-vaccination.
Encourage clients to bring immunisation records to every visit.
Provide guidance on contacting healthcare providers or health departments for concerns.

Detailed Methodology / Instructions for Vaccination Process

Clinic Setup:
- Decorate room with child-friendly items.
- Ensure anaphylaxis kit is accessible.
- Maintain cold chain with fridge/esky.
- Prepare equipment tray and sharps container.
- Use running sheet for tracking.