Skin Test

Drug delivery / injection through intracutan ( IC )

 Preliminary
Skin test is one of the two kinds of tests are considered valid allergic reactions and has been
applied for many years .
Skin test is a test done on the skin to identify the allergy substance ( the allergen ) that
trigger allergic reactions .
Skin tests are usually performed in patients who will be given treatment and was suspected
of having an allergy to ingredients and certain medications, such as in patients with allergic
rhinitis , asthma , food allergies , and so forth .
The reason why skin test is a test that should be performed frequently and on patients in
hospitals and clinics is that every individual has a different sensitivity to various kinds of
materials and obat.Selain , the skin test is relatively easy to do , convenient for the patient ,
not expensive , and the results can be obtained in just 15-20 minutes .
Testing begins with scraping or puncturing the skin with a special sterile needle , and
deposited a small amount of allergen extract into the skin . Wait 15 - 20min , then the
evaluation of skin reactions . If the skin appears reddish bumps , like a mosquito bite , and a
positive test result means the patient is allergic to the material being tested . If the skin does
not cause a reaction , that is safe for continued treatment plan . This test is painless and
does not cause bleeding in patients because the needle only into the surface of skin.
Skin tests can also be done by injecting the allergen under the skin , or by attaching an
allergen on the skin in a specific time period of 48 hours .

Definition

Deliver drugs by injection intracutan / intradermal is an act to help the healing process by
injection into the skin or intra- dermal tissues .
 Injection is done by injecting drugs under the skin surface antebrachii the inside.
 Used for tuberculin skin test or tests .
 Intradermal have minimal blood circulation and medicinal drugs will be absorbed
slowly ( very slowly ).
 Beneficial to skin tests because some clients will experience anaphylactic reactions if
the drug into the body quickly .
 Using a small needle size ( 1/4-1/2 inch ) or a special needle tuberculin test.
 Injection of 5 - 15o angle.
 Place the injection : the bright surface of the skin , a little hair , no lesions and edema
.
 The amount of fluid injected 0.01-0.1 cc .
Example : 1 gram of ampicillin was diluted 5 cc distilled water . Take the solution was
then diluted himgga 0.1 cc 1 cc . Enter the medication intradermally / intracutan
0.01-0.1 cc .
Destination
 Patients receive treatment according to physician's treatment program .
 Streamlining the treatment process and avoid errors in drug administration .
 Help determine diagnosis of certain diseases ( eg tuberculin test ) .
 Protects patients from the effects of allergy medications ( tuberculosis skin test ) .

Principle
 Before giving medications nurses should know the patient's medical diagnosis ,
indications of drug delivery , and drug side effects , with 10 correct principle is really
patient , right medication , right dose , right timing , right route of administration ,
correct information about the patient's medication administration , properly about
the history of drug use by the patient , right about the drug in patients with a history
of allergy , the reaction was about giving some different drugs when administered
together , and correct documentation of drug use .
 To Mantoux test ( PPD administration ) was given 0.1 cc 2-3 times read after 24
hours from the time of injection drugs .
 After disinfecting the injection was not done .
 The nurse should ensure that patients get the medicine , when there is refusal on
some type of medication , the nurse can assess the cause of rejection , and can
mengkolaborasikannya with doctors who deal with patients , when patients or
families still refuse treatment after giving informed consent , the patients and
families responsible for proving signed a letter of rejection rejection therapy .
 Intracutaneous injections were performed to test the type of antibiotic , the
antibiotic is done by dissolving the appropriate provisions , then take 0.1 cc in a
syringe and add aquabidest 0.9 cc in a syringe , which is injected in the patient only
0.1 cc .
 Injections were performed to test Mantoux , PPD taken in 0.1 cc syringe , directly
injected to the patient .

Procedure

1 . Preparation

a. Explain the purpose and procedures of drug administration .

b. Provide a comfortable position on the patient .
c. Tools and materials .

o Drugs that appropriate treatment program physician .

o The patient's medication list .
o syringe 1 cc or 0.5 cc disposible .
 o Needle as needed , saws ampoule if necessary .
o Perlak and pedestal .
o Cotton alcohol or cotton that has been soaked in 0.9 % NaCl in place.
o Handschoen .
o Nierbeken .

2 . Implementation

1) Wash hands.
2) Stand on the right / left of the patient as needed .
3) Check the list of medications the patient to provide the drug .
4) Bring a list of medications and the presence of the drug to a patient while matching the
name of the place sleeping with your name on the list of drugs.
5) Injects the patient matches the name on the list of drugs
6) Keep the patient's privacy .
7) Injection intrakutan done by syringe filled with medication as the dose .
8) Determine the location of the injection is third on the inner forearm .
9) Clean the puncture site with normal saline cotton or cotton alcohol when needed , wait
for it to dry stretched skin .
10) Needle hole facing up and making angles between 5-150 from the skin surface.
11) Incorporate medication slowly until small bubbles form , the dose given 0.1 cc or
appropriate drugs .
12) After the injection of the injection area can not be disinfected .
13) If the intracutaneous injection test performed to antibiotics , do injection marking area by
circling the injection area with a diameter of approximately 2.5 cm diameter 1inchi or .
Assessment reactions were performed 15 minutes after injection . Positive value if there
are signs of rubor , dolor , calor beyond the area that has been marked , meaning that the
patient is allergic to the antibiotic .
14) When the injection is intended to test Mantoux tuberculin test , the results can be
assessed 2 to 3 times in 24 hours , if there is a positive rubor dolor calor exceeding 1 cm
in diameter on the injection area .
15) Give an explanation to the patient or family to the valuation of the injection area and
advise not to scratch , or give any memasage on penyutikan area . Drug store drugs and
the rest of the patient's medication list into place .
16) Observe the patient's general condition .
17) Removing handschoen , wash hands .
18) Create documentation includes :
 Actions and patient response.
 Name obvious nurses take action , injection time and the time of assessment , and
the injection site.