Overview
This lecture covers the step-by-step procedures for intradermal, subcutaneous, and intramuscular injections, including site selection, needle angles, and safety measures.
Intradermal Injections
- Usually performed on the forearm.
- Clean the site with an antiseptic swab, moving from the center outward.
- Use a small-gauge needle with the bevel up to create a bleb (wheal).
- Hold the syringe high and inject at a 5- to 15-degree angle just under the skin.
- Do not massage the site after the injection.
Subcutaneous Injections
- Common sites: abdomen, back of arms, lateral thighs (areas with subcutaneous fat).
- Clean the site in a circular motion and let it dry.
- If at least 1 inch of fat is present, inject at a 90-degree angle; otherwise, use a 45-degree angle.
- Pinch up the tissue before insertion, then release before injecting the medication.
- Withdraw the needle at the same angle and dispose of it in a sharps box.
- Do not massage the site post-injection.
Intramuscular Injections
- Vastus lateralis is a common site, located using anatomical landmarks.
- Clean the site in concentric circles.
- Pull skin taut and inject at a 90-degree angle using a dart-like grip.
- Anchor syringe for stability, inject slowly, and withdraw at the same angle.
- Dispose of needle immediately in sharps box.
Z-Track Method for IM Injections
- Displace upper tissue layers laterally by about 1 inch before injecting.
- Inject at a 90-degree angle, inject medication slowly, withdraw needle, then release tissue.
- Reduces medication leakage into other tissues or out of the wound track.
- Use needle safety features if available and dispose immediately.
Key Terms & Definitions
- Bleb/Wheal — A small bubble or elevation on the skin created by intradermal injection.
- Subcutaneous Tissue — Fatty layer below the skin, used for certain injections.
- Z-Track Method — Technique for IM injections that displaces tissue to prevent medication leakage.
Action Items / Next Steps
- Practice each injection method on mannequins or as allowed in clinical settings.
- Review Clinical Nursing Skills deck cards for detailed step-by-step guides.
- Dispose of all needles immediately in sharps containers after use.