Introduction to InjectionsIntroduction to InjectionsAdminister and Monitor Medication in the Work Administer and Monitor Medication in the Work

EnvironmentEnvironment

Topic 8 IntradermalTopic 8 Intradermal

Intradermal InjectionIntradermal Injection

Administered usually into the forearm. Other sites include the upper chest, the upper arm, and shoulder blades.

- given into the dermal layer of the skin, just under the epidermis.

- Injected at about a 10 – 150 angle.

Intradermal InjectionIntradermal Injection

- Only a very small dose can be given < 0.5ml, usually 0.01 – 0.1ml.

- Used for TB & allergy testing.

- As there is a reduced blood supply, drug absorption can occur slowly.

Subcutaneous InjectionSubcutaneous Injection

Administration sites include: abdomen, anterior thigh, and the fat pad over the deltoid muscle in the upper arm

- given under the skin into the loose fat & connective tissue

- Absorption of drug is via the capillaries ... slower acting than IM or IV

- slow, steady absorption

Injection RoutesInjection Routes

Subcutaneous- should never be given into scar tissue, a

lesion or over a bony prominence- As subcutaneous tissues contain pain

receptors, only a small volume < 2ml should be given

- Unsuitable for any drug that may be irritating to the tissues

Injection RoutesInjection Routes

Intramuscular - given into the muscle tissue below the fatty subcutaneous layer

- Rich blood supply ... readily absorbed into the bloodstream

- Suitable for drugs that are soluble, non irritant to soft tissue & require quick absorption

Injection RoutesInjection Routes

Intramuscular

- Up to 4ml can be injected without causing undue discomfort

- Solution can be more viscous than that given by SC route – permits thicker, oil based compounds

Administering injectionsAdministering injections

Intradermal

- these medications are very potent requiring very slow absorption

- Only very small amounts can be administered 0.01 – 0.1ml

- The needle is inserted at an angle of 10 – 15 0 to the skin

- a small bleb should appear on the surface of the skin

Administering injectionsAdministering injections Intradermal- if a bleb doesn’t appear, most likely the

medication has entered the sc tissue & any results from the skin testing will be invalid

- The inner forearm & upper back are the most common sites used

Administering injectionsAdministering injections Intradermal

What equipment do you need?

ProcedureProcedure

Intradermal injection - perform the standard protocol for beginning the procedure

- Select injection site & clean skin with an alcohol swab; allow to dry

- Expel any air from the syringe- Pull the skin taught & insert the needle into

the skin approximately 3mm at a 10 – 150

angle, bevel face upwards

ProcedureProcedure

Intradermal- do not aspirate but inject slowly – it should

produce a small bleb under the skin- Withdraw the needle smoothly & wipe the

injection site- Do not massage – may disperse

medication into sc layer- Complete the standard protocol for the

completion of a procedure

Things to consider…Things to consider…

Client must be observed closely as they may have a severe anaphylactic reaction if a test allergen is being injected

The site chosen should be free of lesions & only lightly pigmented – enables clear inspection & assessment of any changes from the injection