Difference between revisions of "Give a Subcutaneous Injection"
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# Prepare a clean, ordered work area. When performing a subcutaneous injection, the less you have to come in to contact with un-sterilized materials, the better. Having all your tools laid out ahead of time in a clean, easily-accessible work area makes the process of injection quicker, easier, and more sanitary. Lay your towel on a clean surface within easy reach of your intended work site. Lay your tools on the towel. | # Prepare a clean, ordered work area. When performing a subcutaneous injection, the less you have to come in to contact with un-sterilized materials, the better. Having all your tools laid out ahead of time in a clean, easily-accessible work area makes the process of injection quicker, easier, and more sanitary. Lay your towel on a clean surface within easy reach of your intended work site. Lay your tools on the towel. | ||
#* Arrange your supplies on the towel in the order you will need them. Note: You can make a small tear in the edge of your alcohol wipe packages (one that doesn't puncture the inner pocket containing the alcohol wipe) to make them easier to quickly open when you need them. | #* Arrange your supplies on the towel in the order you will need them. Note: You can make a small tear in the edge of your alcohol wipe packages (one that doesn't puncture the inner pocket containing the alcohol wipe) to make them easier to quickly open when you need them. | ||
| − | # Choose an injection site. Subcutaneous injections are meant to be given into the layer of fat below the skin. Certain areas of the body allow this fatty layer to be accessed more easily than others. Your medication may come with instructions about which specific injection site to use - check with your local health care professional or the medication's manufacturer if you are uncertain of where to administer your medication. Below is a common list of sites for subcutaneous injections:<ref>http://www.cc.nih.gov/ccc/patient_education/pepubs/subq.pdf</ref> | + | # Choose an injection site. Subcutaneous injections are meant to be given into the layer of fat below the skin. Certain areas of the body allow this fatty layer to be accessed more easily than others. Your medication may come with instructions about which specific injection site to use - check with your local health care professional or the medication's manufacturer if you are uncertain of where to administer your medication. Below is a common list of sites for subcutaneous injections:<ref name="rf1">http://www.cc.nih.gov/ccc/patient_education/pepubs/subq.pdf</ref> |
#* The fatty part of the tricep on the side and back of the arm between the elbow and shoulder | #* The fatty part of the tricep on the side and back of the arm between the elbow and shoulder | ||
#* The fatty part of the leg on the outside front portion of the thigh between the hips/groin and knee | #* The fatty part of the leg on the outside front portion of the thigh between the hips/groin and knee | ||
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#* If, at this point, you discover the skin at the injection site you've chosen is irritated, bruised, discolored, or distressed in any other way, pick a different site. | #* If, at this point, you discover the skin at the injection site you've chosen is irritated, bruised, discolored, or distressed in any other way, pick a different site. | ||
# [[Wash Your Hands|Wash your hands]] with soap and water. Because subcutaneous injections pierce the skin, it's important for the person administering the injection to wash his or her hands. Washing kills any bacteria present on the hands, which, if accidentally transferred to the small wound caused by injection, can cause infection. After washing, dry thoroughly. | # [[Wash Your Hands|Wash your hands]] with soap and water. Because subcutaneous injections pierce the skin, it's important for the person administering the injection to wash his or her hands. Washing kills any bacteria present on the hands, which, if accidentally transferred to the small wound caused by injection, can cause infection. After washing, dry thoroughly. | ||
| − | #* Be sure to wash methodically, ensuring all the surfaces of your hands receive soap and water. Studies have shown that the vast majority of adults don't wash their hands well enough to kill all bacteria.<ref>http://www.cbsnews.com/news/95-percent-of-people-wash-their-hands-improperly-are-you-one-of-them/</ref> | + | #* Be sure to wash methodically, ensuring all the surfaces of your hands receive soap and water. Studies have shown that the vast majority of adults don't wash their hands well enough to kill all bacteria.<ref name="rf2">http://www.cbsnews.com/news/95-percent-of-people-wash-their-hands-improperly-are-you-one-of-them/</ref> |
=== Drawing a Dose of Medication === | === Drawing a Dose of Medication === | ||
# Remove the tamper resistance tab from the vial of medication. Set this on the towel. If this tab has already been removed, as in the case of multidose vials, wipe the vial's rubber diaphragm with a clean alcohol wipe. | # Remove the tamper resistance tab from the vial of medication. Set this on the towel. If this tab has already been removed, as in the case of multidose vials, wipe the vial's rubber diaphragm with a clean alcohol wipe. | ||
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#* You may need to tap the sides of your syringe to force air bubbles to the top, then expel the air bubbles by gently pressing the plunger, forcing the air bubbles back into the medication vial. | #* You may need to tap the sides of your syringe to force air bubbles to the top, then expel the air bubbles by gently pressing the plunger, forcing the air bubbles back into the medication vial. | ||
# Repeat the previous step as needed. Repeat the process of drawing medication into your syringe and expelling air bubbles until you have the desired dose in your syringe with no air bubbles. | # Repeat the previous step as needed. Repeat the process of drawing medication into your syringe and expelling air bubbles until you have the desired dose in your syringe with no air bubbles. | ||
| − | #* It's ''very'' important for there to be no air bubbles in the syringe when the medication is administered. Forcing an air bubble under the skin can cause a serious medical condition known as an ''embolism'', which, though rare, can be fatal if the air bubble blocks blood flow to the heart, brain, or lungs.<ref>http://www.healthline.com/health/air-embolism</ref> | + | #* It's ''very'' important for there to be no air bubbles in the syringe when the medication is administered. Forcing an air bubble under the skin can cause a serious medical condition known as an ''embolism'', which, though rare, can be fatal if the air bubble blocks blood flow to the heart, brain, or lungs.<ref name="rf3">http://www.healthline.com/health/air-embolism</ref> |
# Remove the vial from your syringe. Place the vial back on your towel. Do not set your syringe down at this point, as doing so can contaminate your needle which can lead to infection. | # Remove the vial from your syringe. Place the vial back on your towel. Do not set your syringe down at this point, as doing so can contaminate your needle which can lead to infection. | ||
=== Giving a Subcutaneous Injection === | === Giving a Subcutaneous Injection === | ||
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# Gently "pinch" the injection site. Using your non-dominant hand, gather about {{convert|1+1/2|to|2|in|cm|1|1}} of skin between your thumb and index finger creating a slight mound of skin, taking care not to bruise or damage the surrounding area. By bunching up the skin, you create a thicker area of fat for you to inject into, ensuring the entire dose is administered into the fat and not into the underlying muscle. | # Gently "pinch" the injection site. Using your non-dominant hand, gather about {{convert|1+1/2|to|2|in|cm|1|1}} of skin between your thumb and index finger creating a slight mound of skin, taking care not to bruise or damage the surrounding area. By bunching up the skin, you create a thicker area of fat for you to inject into, ensuring the entire dose is administered into the fat and not into the underlying muscle. | ||
#* When gathering your skin, do not gather any muscle tissue. You should be able to feel the different between the soft upper fat layer and firmer, lower muscle tissue. Subcutaneous medications are not intended for injection into muscle and, if administered into muscle, may result in bleeding into the muscle tissue. This is especially true if the medication has blood thinning properties. | #* When gathering your skin, do not gather any muscle tissue. You should be able to feel the different between the soft upper fat layer and firmer, lower muscle tissue. Subcutaneous medications are not intended for injection into muscle and, if administered into muscle, may result in bleeding into the muscle tissue. This is especially true if the medication has blood thinning properties. | ||
| − | # Insert the syringe into the skin. With a slight snapping motion of your wrist, plunge the needle all the way into the skin. Usually, the needle should be inserted into the skin at 90 degrees (straight up and down, relative to the skin) to ensure that the medication is injected into the fatty tissue.<ref | + | # Insert the syringe into the skin. With a slight snapping motion of your wrist, plunge the needle all the way into the skin. Usually, the needle should be inserted into the skin at 90 degrees (straight up and down, relative to the skin) to ensure that the medication is injected into the fatty tissue.<ref name="rf1" /> However, for exceptionally thin or muscular people with little subcutaneous fat, you may need to insert the needle at a 45 degree angle (diagonally) to avoid injecting into muscle tissue. |
#* Act quickly and firmly, but without jamming or stabbing the needle into the patient with excessive force. Hesitation may cause the needle to bounce off the skin or pierce the skin slowly, causing increased pain. | #* Act quickly and firmly, but without jamming or stabbing the needle into the patient with excessive force. Hesitation may cause the needle to bounce off the skin or pierce the skin slowly, causing increased pain. | ||
# Release the skin. Ease your grip on the patient's skin, allowing it to fall back to its natural position. Keep the needle submerged in the skin. <br><br> | # Release the skin. Ease your grip on the patient's skin, allowing it to fall back to its natural position. Keep the needle submerged in the skin. <br><br> | ||
