Medication Administration 3: intradermal and sub-q

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Intradermal Injections:

- used for skin testing and local anesthetics

- sites are inner forearm and upper back

- skin tests: ensure site is free of lesions and hair (may interfere with accuracy)

- tuberculin or small syringe (1 mL or smaller) 1/2 to 5/8 inch, 25-27-gauge needle

- some agencies will require to cleanse site with alcohol, but always assure it is clean and dry

- pull patient's skin so that it is taut, and insert at 5 to 15 degree angle (almost parallel to skin)

- bevel facing up, needle will be visible under skin, insert about 1/8 inch

- give injection slowly, check for blanching and formation of wheal

- withdraw needle slowly and gently apply dry gauze

- DO NOT MASSAGE THE SITE

- bleeding/ no wheal at injection site indicates that the injection was given incorrectly

Subcutaneous injections:

-intended to be absorbed slowly because it is less vascular that muscle

- avoid any areas with lesions, trauma, inflammation or bony prominences.

- favored sites are large areas that are easy for the patient to reach for self-administration

- upper outer aspect of arm

- abdomen (2 inches away from umbilicus)

- anterior thighs

- scapular area (out of reach)

- upper ventrodorsal gluteal area

- rotate injections sites if regularly scheduled

Administration

- do not administer more than 1.5 mL with a single injection

- 25-31-gauge needle

- if you can pinch 1 inch of skin insert a 5/8 inch needle at 45 degree angle

- if you can pinch 2 inches of skin insert a 1/2 inch needle at 90 degree angle

1. grasp or gently pinch patient's loose fatty tissue with your non-dominant hand and quickly insert the needle 2. release pinch once inserted and stabilize syringe while administering the medication slowly with dominant hand

3. after administering, remove needle quickly at the same angle at which you inserted it

4. cover site with dry gauze immediately and apply gentle pressure

- DO NOT MASSAGE SITE

- for thin patients, the abdomen is usually the best site