Overview
This lecture demonstrates the correct techniques for administering intradermal, subcutaneous, and intramuscular injections, including site selection, needle angles, and safety protocols.
Intradermal Injections
- Commonly performed on the forearm.
- Clean the site with an antiseptic swab from center outward.
- Use a small gauge needle with the bevel up.
- Hold the syringe high, not like a dart, and inject at a 5-15° angle.
- Pull skin taut, insert needle until bevel is under skin, and inject to form a bleb (wheal).
- Withdraw needle at the same angle; do not massage the site.
Subcutaneous Injections
- Suitable sites: abdomen, back of arms, lateral thighs (areas with pinchable fat).
- Clean site with antiseptic swab in a circular motion.
- Use a 90° angle if at least 1 inch of fat is present; use 45° if less fat.
- Pinch tissue, insert needle, inject medication, release pinch, remove at same angle.
- Discard needle in sharps container immediately; do not massage the site.
Intramuscular Injections
- Example site: vastus lateralis (thigh).
- Identify site using anatomical landmarks (greater trochanter and iliac crest).
- Clean site in concentric circles; pull skin taut.
- Hold needle like a dart and inject at a 90° angle into the muscle.
- Inject medication slowly and steadily.
- Withdraw needle at same angle and immediately discard in sharps box.
- Stabilize needle with fingers if needed to avoid movement.
Z-Track Method for IM Injections
- Displace upper tissue layers laterally before injection.
- Inject at 90°, inject medication, withdraw needle, and then release displaced tissue.
- Prevents medication from seeping into other tissues and reduces leakage.
- Use needle safety devices as needed and dispose of in sharps box immediately.
Key Terms & Definitions
- Intradermal injection — Injection into the first layer of skin, often on the forearm, for tests like TB.
- Subcutaneous injection — Medication injected into fatty tissue under the skin for slow absorption.
- Intramuscular injection — Injection into muscle tissue for faster absorption.
- Bleb (wheal) — Small, raised area formed when fluid is injected intradermally.
- Z-track method — Technique for IM injections that displaces skin/tissue to prevent medication leakage.
- Sharps box — Container for safe disposal of needles.
Action Items / Next Steps
- Review and practice injection techniques, focusing on angles and site selection.
- Dispose of all needles in a sharps container promptly.
- Avoid massaging injection sites after administration.
- (If applicable) Reference cards or course materials for step-by-step guidance.