Overview
This lecture reviews the key steps and considerations for administering intradermal, intramuscular, and subcutaneous injections, including needle selection, injection technique, and safety protocols.
Intradermal Injections
- Injected into the dermis, just below the epidermis, usually in the forearm.
- Use a 25–27 gauge needle, 1/4 to 1/2 inch long, and a syringe measured to the hundredth and tenth.
- Perform hand hygiene and don gloves before administration.
- Confirm the five rights of medication administration.
- Cleanse the area with alcohol and allow to dry.
- Hold syringe at a 5–15° angle, inject to form a small wheal under the skin.
- Wait 10 seconds before removing the needle, engage safety shield, and dispose in sharps container.
- Never recap needles to prevent accidental sticks; remove gloves, perform hand hygiene, and document the procedure.
Intramuscular (IM) Injections
- Administered into muscles such as vastus lateralis, deltoid, ventrogluteal, or dorsogluteal (facility dependent).
- Select the appropriate needle size and gather supplies.
- Perform hand hygiene and don gloves.
- Recall the five rights of medication administration.
- Cleanse the area with alcohol and allow to dry.
- Hold syringe perpendicular (90° angle) to skin; use the Z-track method to displace skin.
- Inject the medication like throwing a dart, wait 10 seconds before needle removal.
- Engage safety shield, dispose in sharps container, never recap needles.
- Remove gloves, perform hand hygiene, and document.
Subcutaneous (SubQ) Injections
- Given in the abdomen, thigh, upper arm, or lower back—choose a fatty area and rotate sites routinely.
- Use a 25–27 gauge needle, 3/8 to 5/8 inch long.
- Perform hand hygiene and don gloves.
- Confirm five rights of medication administration.
- Cleanse the injection site with alcohol and let dry.
- Hold syringe like a pencil or dart; inject at a 45° or 90° angle.
- Pinching the skin is optional to reduce pain.
- Wait 10 seconds after injecting, engage safety shield, dispose needle in sharps container.
- Remove gloves, perform hand hygiene, and document.
Key Terms & Definitions
- Five Rights of Medication Administration — Right patient, drug, dose, route, and time.
- Z-track Method — Technique to prevent medication from leaking into subcutaneous tissue by displacing the skin before injection.
- Sharps Container — A puncture-proof container for disposing of needles and other sharp medical instruments.
Action Items / Next Steps
- Review and memorize steps for each injection type.
- Practice safe needle handling and disposal procedures.
- Complete recommended readings or assigned practice on injection technique.