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BOTOX InjectorTraining
Now you can help!
November 2004
Marks owned by Allergan, Inc.
2004 Allergan, Inc., Irvine, CA 92612
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Overview of Injector Training
Patient preparation
Supplies needed
Iodine starch test
BOTOX reconstitution
BOTOX injection
Please see important safety information on slide 12.
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Patient Preparation
Shave underarms
Abstain from use of over-the-counter
deodorants or antiperspirants for 24 hoursprior to treatment
Rest comfortably without exercise, hotbeverages, etc., for approximately
30 minutes prior to treatment
Please see Important Safety Information on slide 12.
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Supplies Needed
Reconstitution
0.9% nonpreserved
sterile saline only BOTOX 100 units
20-gauge, 1-inchextraction needle
Iodine Starch Test
Iodine solution
Starch Powder
Surgical pen
Alcohol (to cleanarea)
Injection
30-gauge, -inch
injection needle
Please see Important Safety Information on slide 12.
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Perform the Iodine Starch Test
Dry affected axilla
Paint area with iodine swab
Be sure to cover excessarea around axilla
Let dry
Brush area with starchpowder
Wait 10 minutes
Please see Important Safety Information on slide 12.
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Perform the Iodine Starch Test
Blue-black mark willidentify affected area
Circle affected area with
surgical marker, thenclean area inside circle withalcohol
Please see Important Safety Information on slide 12.
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Perform the Iodine Starch Test
Use a surgical pen andstandard ruler to mark injectionpoints:
1 to 2 cm apart
Staggered to allow for ringeffect of intradermalinjections
Count injection points andallocate recommended dosageof BOTOX solution perinjection, based on:
50 Units per axilla
Please see Important Safety Information on slide 12.
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BOTOX Reconstitution
Be certain youve received actual BOTOXproduct from Allergan
Look for holographic film on vial; Allerganshould appear within rainbow lines
If you do not see rainbow lines or Allergandoes not appear, do not use product and
please contact Allergan, Inc., directly at(800) 890-4345 from 8:00 a.m. to 4:00 p.m.Pacific time.
Please see Important Safety Information on slide 12.
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BOTOX Reconstitution
Using a 21-gauge, 1 - inch length needle, draw up 4 mL of 0.9%nonpreserved sterile saline into syringe
Insert needle at a 45angle and slowly inject saline into BOTOX
vial Ensure vacuum is present in vial, which means sterility of vial is intact
Do not use vial if there is no vacuum present
Release vacuum by disconnecting syringe from reconstitutionneedle (with needle remaining attached to bottle) and allowing air toflow into vial and neutralize pressure
Gently mix BOTOX
with saline by rotating vial; do notinvert vial
Attach a new sterile syringe to remaining needle and draw fluid frombottom corner of vial for full extraction; do not invert vial
Remove reconstitution needle from syringe and attach a 30-gaugeinjection needle, which is recommended needle for axillary injections
BOTOX
Must Be Properly ReconstitutedWith Only 0.9% Nonpreserved SalineSolution Prior to Injecting
Please see Important Safety Information on slide 12.
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BOTOX Injection
Inject at a 45 angle to skinsurface
Bevel side up to minimizeleakage and ensure injections
remain intradermal A depth of approximately
2 mm
Be sure not to inject directly
on ink mark to avoida permanent tattoo effect
Please see Important Safety Information on slide 12.
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BOTOX Injection
Clean treated area withalcohol
Treatment complete
Please see Important Safety Information on slide 12.
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Important Safety Information
BOTOX treatment is contraindicated in the presence of infection at the proposedinjection site(s) and in individuals with known hypersensitivity to any ingredient in theformulation. Serious and/or immediate hypersensitivity reactions have been rarelyreported. These reactions include anaphylaxis, urticaria, soft tissue edema, anddyspnea. If such a reaction occurs, further BOTOX injection should be discontinuedand appropriate medical therapy immediately instituted. BOTOX should only bediluted with 0.9% nonpreserved sodium chloride. Other diluents, including lidocaine,should not be used for reconstitution. Individuals with peripheral motor neuropathicdiseases (eg, amyotrophic lateral sclerosis or motor neuropathy) or neuromuscularjunctional disorders (eg, myasthenia gravis or Lambert-Eaton syndrome) should onlyreceive BOTOX treatment with caution. Individuals with neuromuscular disordersmay be at increased risk of clinically significant systemic effects including severedysphagia and respiratory compromise from typical doses of BOTOX. The mostfrequently reported adverse events (3%-10% of patients) were injection-site pain andhemorrhage, non-axillary sweating, infection, pharyngitis, flu syndrome, headache,fever, neck or back pain, pruritus, and anxiety.
Please see accompanying full prescribing information or visit www.botox.com.
http://www.botox.com/http://www.botox.com/8/2/2019 Botox Hh Training
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Back Up
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Hyperhidrosis Disease Severity
Scale (HDSS) HDSS is a 4-point scale designed to assess severity
of hyperhidrosis in everyday clinical practice or inclinical research and effectiveness of hyperhidrosis
treatment HDSS can be administered by an interviewer or self-
completed by patient
HDSS assesses disease severity based on extent of
excessive-sweating-related impairment of dailyactivities
Please see Important Safety Information on slide 12.
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Hyperhidrosis
DiseaseSeverity Scale
Please see Important Safety Information on slide 12.