ADMINISTERING AN INTRADERMAL, SUBCUTANEOUS AND INTRAMUSCULAR INJECTIONS

Rosella Marie M. Ocampo, RN

Intradermal Injections
Given to a patient in which the goal is to empty the contents of the syringe between the layers of the skin Small thin needle of 25 or 27 gauge and 3/8 to 3/4 inch (1-2 cm) Diagnostic measure, such as for tuberculin testing (screening test for tuberculosis referred to as a tine test) and allergy testing (placing very small amounts of the suspected antigen or allergen in a solution under the skin)

Subcutaneous Injection
Up to 2 ml of a drug solution can be injected directly beneath the skin drug becomes effective within 20 minutes the method used to administer drugs when a small amount of fluid is to be injected, the patient is unable to take the drug orally, or the drug is destroyed by intestinal secretions

Intramuscular Injection
An injection given directly into the central area of a specific muscle. In this Way, the blood vessels supplying that muscle distribute the injected medication via the cardiovascular system. Offers a faster rate of absorption than the subcutaneous route, and muscle tissue can often hold a larger volume of fluid without discomfort Absorbed less rapidly and takes effect more slowly that medication that is injected intravenously Are given directly into the central area of selected muscles

STEPS INTRADERMAL INJECTION

Assemble equipment and check physicians order. Explain procedure to patient. Perform hygiene. Don disposable gloves. If necessary, withdraw medication from ampule or vial. Select area on inner aspect of forearm that is not heavily pigmented or covered with hair. Upper chest or upper back beneath the scapulae also are sites for intradermal injections. Cleanse the area with an alcohol swab by wiping with a firm circular motion and moving outward from the injection site. Allow skin to dry. If skin is oily, clean area with pledget moistened with acetone.

INTRADERMAL INJECTION

Use nondominant hand to spread skin taut over injection site. Remove needle cap with nondominant hand by pulling it straight off. Place needle almost flat against patients skin, bevel side up. Insert needle into skin so that point of needle can be seen through skin. Insert needle only about ? inch. Slowly inject agent while watching for a small wheal or blister to appear. If none appears, withdraw needle slightly. Withdraw needle quickly at the same angle it was inserted.

INTRADERMAL INJECTION
Do not massage area after removing needle. Do not recap used needle. Discard needle and syringe in the appropriate receptacle. Assist patient into a position of comfort. Remove gloves and dispose of them properly. Perform hand hygiene. Chart administration of medication. Observe the area for sign of reaction at ordered intervals, usually at 24- to 72periods. Inform the patient of this inspection.

Subcutaneous Injection
Subcutaneous shots can be given straight in at a 90 degree angle (2 inches of skin), or at a 45 degree angle (1 inch of skin). Open the foil covering the first alcohol wipe. Wipe the area where you plan to give the shot. Let the area dry. Take the cover off the needle. Hold the syringe with your writing hand and pull the cover off with your other hand, like taking a cap off a pen.