Administering Intradermal (ID)/Intracutaneous Injection

DEFINITION
- The injection of small amount of
- medication/fluid into the dermal layer of the skin just beneath the epidermis

PURPOSE
- Indicated for diagnosing allergies and tuberculine testing
- Used to administer vaccinations and local anesthetics

SITES
- Inner aspect of the forearm
- Subscapular region of the back
- Right deltoid (for BCG vaccine only)

EQUIPMENT
- Sterile 1 ml syringe
- Needle (25-27 gauge)
- Antiseptic or alcohol swabs
- Medication ampule or vial
- Medication card
- Disposable gloves (agency protocol)

PROCEDURE
1. Follow the general procedure for giving
injection:
a. Assess the medication record used in
your facility
b. Check the medications listed against
the physician`s order using the Rights
in drug administration
c. Review information regarding the
medication
d. Assess the size and general built of
the client
e. Assess the status of the client
f. Wash hands and prepare materials
needed
g. Withdraw the correct dosage of
medicine using the techniques
described for drawing up from a vial
or an ampule or for mixing
medication in syringe
h. Recheck your dosage calculation
i. Identify and explain the procedure to
the client. Provide privacy
RATIONALE
To identify whether any medication is to be gien
to an individual client on your shift
Prevents errors in drug administration
Ensure accuracy and prevents medication error
Knowledge on the drug/medicine to be
used/ordered can help health care provider to be
more competent
To choose the correct size of needle for the
injection
Determine the need for assistance to turn or
restrain the client during the procedure
For infection control
Facilitates proper aspiration of the ordered
medicine
To prevent medication error
To establish correct identity and reduce level of
anxiety
 j. Assist client into a comfortable
position. Divert client`s attention by
talking about an interesting subject
k. Wear clean gloves on your non-
dominant hand and select the
appropriate site of injection
l. Clean the site with alcohol
swab/alcoholized cotton ball using a
circular motion and moving from the
middle of the site outward. Allow
skin to air dry
m. While holding a clean dry cotton ball
between fingers of non-dominant
hand, pull cap from the needle,
touching only the inside of the cap
2. Using your non-dominant hand make the
skin taut in an appropriate manner in the
injection site chosen
3. Hold the 1 ml/tuberculine syringe with
gauge 25-27 needle at 10-15 degree
angle with bevel of the needle facing up
4. Insert the needle just until the bevel is no
longer visible. Do not aspirate
5. Inject the medication slowly while
watching for a small wheal/bleb to
appear
6. Withdraw the needle while applying
gentle pressure using the dry cotton ball.
Do not massage the site.
7. Encircle the wheal/bleb with a skin-
marking pen if the site must be assessed
for reaction or sensitivity
8. Discard the uncapped needle and syringe
in a safe receptacle
9. Remove gloves and wash hands
10. Document procedure done
11. Assess the site as the appropriate time of
interval (after 30 minutes)
Relaxation minimizes discomfort and diverting
client`s attention reduces anxiety
Protect yourself from potential blood spill
Circular motion and mechanical action of swab
removes secretions containing microorganism
Dry cotton ball remains accessible during
procedure. Prevents contamination of needle
An injection is less painful if the skin is taut when
pierced and allows the needle to enter the skin
more easily
Intradermal tissues will be penetrated when the
needle is held as near parallel to the skin as
possible
Facilitate proper introduction of the medicine
Small wheal/bleb indicates the medication was
deposited in the dermis
Supporting tissue around injection site minimizes
discomfort. Massage can disperse medication
into the tissue and altering test result
Encircling part of the wheal/bleb serves as basis
of reading
Decrease risk of accidental needle prick
Prevents transmission of microorganism
Maintains continuity of care
Determines reaction or sensitivity to the drug
Name ________________________________________ Date _____________________
Course & Year__________________________________ RLE Group_________________

Parenteral Drug Administration

Checklist on Administering an Intradermal Injection (ID)/Intracutaneous Injection

Able to Able to Unable to

perform perform perform
PROCEDURE with
assistance
2 1 0
Assessment
1. Check medications listed against physician`s order
2. Review information regarding the medication
3. Assess the size and general built of the client
4. Assess the need for assistance
Planning
5. Wash hands
6. Prepare needed materials and medicines prescribed
observing the rights of medication
7. Recheck dosage calculation
Implementation
8. Identify and explain the procedure to the client.
Provide privacy.
9. Assist client into a comfortable position and distract
him/her by talking about an interesting subject
10. Wear clean gloves, on non-dominant hand select
appropriate site of injection
11. Clean the site with alcohol swab/cotton ball with
alcohol using a circular motion moving from the
middle of the site outward
12. Allow the skin to air-dry
13. Hold dry cotton ball between fingers of non-
dominant hand and pull cap from needle
14. Using non-dominant hand, make the skin taut
15. Hold the syringe at a 10-15 degrees angle with the
bevel facing up and insert till it is no longer visible
16. Inject the medication slowly while watching for a
small wheal to appear
17. Withdraw needle and gently pat the injected site
with dry cotton ball
18. Circle area of injection using skin marking pen
19. Discard the uncapped needle and syringe in a safe
receptacle
20. Remove gloves and wash hands
Evaluation
 21. Assess the site at the appropriate time of interval
preferably after 30 minutes
Documentation
22. Document procedure done and its result