Overview
This lecture demonstrates the correct procedures and techniques for intradermal, subcutaneous, and intramuscular injections, emphasizing safety, site selection, and proper angle of insertion.
Intradermal Injections
- Commonly performed on the forearm for tests like TB.
- Clean the selected site with an antiseptic, center to outward.
- Use a small gauge needle with the bevel facing up.
- Hold syringe high; inject at a 5°–15° angle to form a bleb/wheal.
- Do not massage the injection site afterward.
Subcutaneous Injections
- Performed in areas with fatty tissue: abdomen, back of arms, or lateral thigh.
- Clean site in a circular motion and let dry.
- Use a 90° insertion angle if ≥1 inch of fat; use 45° if less fat.
- Pinch the skin, insert needle, let go to inject, and remove at same angle.
- Immediately dispose of needle in a sharps container.
- Do not massage the site post-injection.
Intramuscular Injections
- Vastus lateralis site located using anatomical landmarks (greater trochanter, iliac crest, groin).
- Clean site in concentric circles, let dry.
- Pull skin taut, hold syringe like a dart, and inject at a 90° angle.
- Anchor the syringe if necessary and inject medication slowly.
- Withdraw needle at the same angle and dispose of it immediately.
Z-Track Intramuscular Injection Method
- Displace upper tissue layers laterally by about 1 inch using the side of the nondominant hand.
- Follow standard cleaning and 90° injection procedure.
- After withdrawal, allow tissue to return and seal track, reducing leakage.
- Use needle safety feature if available, then dispose in sharps container.
Key Terms & Definitions
- Intradermal injection — injection placed between upper skin layers, often for allergy or TB tests.
- Bleb/Wheal — small bubble under the skin indicating correct intradermal placement.
- Subcutaneous injection — injection into fatty tissue below the skin for slow absorption.
- Intramuscular injection (IM) — injection directly into muscle for faster absorption.
- Z-track method — technique for IM injections to prevent medication from leaking into other tissues.
Action Items / Next Steps
- Practice injection techniques following the outlined steps.
- Review anatomical landmarks for injection site selection.
- Follow sharps disposal protocols after each injection.