when you administer an intradermal injection or give any agent remember to prepare medication for only one patient at a time use aseptic technique and avoid distractions and interruptions first review the patient's medication order then you will compare the medication label against the medication administration record or ma are twice during your preparation to assure it is the ordered medication you will verify the medication a third time at the patient's bedside be sure to check the medication expiration date when you retrieve it from the automated medication dispensing unit take the medication to the patient at the correct time according to your agency's policy give non time-critical scheduled medications within one to two hours of the scheduled dose as you proceed apply the six rights of medication administration when preparing an injection away from the patient's bedside be sure to label the syringe properly after performing hand hygiene and ensuring privacy introduce yourself to the patient then identify him using to identify errs ask him if he has any allergies just ask you a few questions here can you tell me your name and your birthday tere Portman 1229 51 at the bedside compare the drug label with the ma R for the third time mr. Portman I'm gonna be doing a PPD test on you discuss the purpose of each medication its action and possible adverse effects give the patient a chance to ask questions tell him the injection may cause a slight burning or stinging sensation instruct the patient to report any itching or shortness of breath raise the bed to a comfortable working height if needed drape a sheet or gown over portions of the body that need not be exposed choose an injection site free of lesions and discoloration select a site three to four finger widths below the antecubital space and one hand width above the wrist if you can't use the patient's forearm inspect his upper back if necessary use a site that would be appropriate for a subcutaneous injection position the patient's arm so that his elbow and forearm are supported on a flat surface apply clean gloves use an antiseptic swab to clean the site beginning at the center and circling outward about 2 inches or 5 centimeters remove the cap and hold the syringe between the thumb and forefinger of your dominant hand with the bevel of the needle pointing up stretch the skin taut at the injection site by pulling gently with the thumb and forefinger of your non-dominant hand hold the needle very close to the patient's skin insert it slowly at a 5 to 15 degree angle until you feel resistance advance the needle through the epidermis to a depth of about 1/8 of an inch or 3 millimeters you'll see the slight bulge of the needle tip beneath the skin as you slowly inject the medication you should feel resistance if you don't it's likely the needle is too deep withdraw it and begin the procedure again as you inject the Medicaid a quarter-inch bleb that resembles a mosquito bite will appear on the patient's skin after withdrawing the needle gently wipe the site with an alcohol swab or gauze pad do not massage the area activate the safety mechanisms and dispose of the needle and syringe in a sharps container are you comfortable yeah help the patient into a comfortable position remove your gloves and perform hand hygiene stay with the patient a few minutes to watch for an allergic reaction then document the medication administration in the M AR include the location of the injection as part of your follow-up care return in fifteen to thirty minutes to see if the patient has any acute pain burning numbness or tingling at the injection site