Intradermal Injection Procedure

Preparation

• Prepare medication for only one patient at a time.
• Use aseptic technique.
• Avoid distractions and interruptions.

Patient Verification

• Review the patient's medication order.
• Compare medication label against the Medication Administration Record (MAR) twice during preparation.
• Verify the medication a third time at the patient's bedside.
• Check medication expiration date when retrieving it.

Timing

• Administer medication at the correct time according to agency policy.
• Non-time-critical medications should be given within 1-2 hours of the scheduled dose.

Six Rights of Medication Administration

• Apply the six rights when preparing the injection away from the bedside.
• Label the syringe properly.

Patient Interaction

• Perform hand hygiene and ensure privacy.
• Introduce yourself to the patient and identify them using two identifiers.
• Ask if the patient has any allergies.
• Discuss medication purpose, action, and side effects.
• Allow patient to ask questions.
• Inform the patient of possible sensations (e.g., burning or stinging).
• Instruct the patient to report itching or shortness of breath.

Injection Site Selection

• Raise the bed to a comfortable height if needed.
• Drape a sheet or gown to cover unnecessary exposure.
• Choose a site free of lesions and discoloration.
• Select a site 3-4 finger widths below the antecubital space and 1 hand width above the wrist.
• Use the upper back if forearm is unsuitable.

Injection Procedure

• Position the arm so the elbow and forearm are supported.
• Apply clean gloves.
• Clean the site with an antiseptic swab, circling outward about 2 inches (5 cm).
• Remove the needle cap.
• Hold syringe with dominant hand, needle bevel up.
• Stretch skin taut with non-dominant hand.
• Insert needle slowly at a 5-15 degree angle until resistance is felt.
• Advance needle to a depth of about 1/8 inch (3 mm).

Medication Injection

• Look for a slight bulge under the skin.
• Inject slowly; feel for resistance.
• If no resistance, needle may be too deep; withdraw and retry.
• A quarter-inch bleb resembling a mosquito bite should appear.
• Withdraw the needle and gently wipe the site; do not massage.
• Dispose of needle and syringe in a sharps container.

Post-Injection Care

• Ensure patient's comfort.
• Perform hand hygiene.
• Stay with the patient to monitor for allergic reactions.
• Document medication administration in MAR, including injection site.
• Follow-up in 15-30 minutes for acute pain, burning, numbness, or tingling.