“Intradermal Injection”

“Prepare the material”

(1cc syringe w/ needle gauge 25-27)
I will aspirate 0.9 ml of distilled water first and add 0.1 ml of medicine to be tested.
“Performs Hand Hygiene and other preventive measure( sterile gloving)”
To prevent the spread of microorganism and maintain the sterility.
“Explain procedure. Provide privacy.”
To reduce clients anxiety and gain there active cooperation.
“Select the injection site”
Commonly, we use the forearm as injection site but we need to identify the exact site first by placing 3-
4 fingers below antecubital space.
“Clean the injection site”
In circular motion we will clean the site using the cotton ball soaked in alcohol or antiseptic solution
starting frome the center then widening the circle outward. This is to make sure that the injection site
is sterile. Remember to allow area to dry thoroughly.
“Remove the needle cap and expel the air bubbles from the syringe”

“Grasp the syringe with non-dominant hand, close to the hub, holding it between thumb and
forefinger. Hold the needle almost parallel to the skin surface, with bevel of the needle up.”
It is because the possibility of the medication entering the subcutaneous tissue increases when using
an angle greater than 15°
“Hold skin tautly on ventral forearm by grasping the dorsal forearm of the client with non-dominant
hand.”
This will allow easier entry of the needle and less discomfort for the client.
“Insert the tip of the needle far enough to place the bevel through the epidermis into the dermis. The
bevel outline should be visible under the skin surface.”
This verifies that the medication entered the dermis.
“Stabilize the syringe and the needle. Inject the prepared skin testing solution carefully and slowly so
that it will produce a small wheal on the skin.”

“Withdraw the needle quickly; wipe the excess solution on the site with dry cotton ball or with dry
2x2 sterile gauze pad. DO NOT MASSAGE THE AREA!

Because massage can dispense the medication into tissue or out through the needle insertion site.
If administering the skin test. Encircle the wheal with blue or black ballpen. Indicate the time due for
reading or interpretation of result”
The result should be done by the physician after 30 minutes.
“Dispose the syringe and needle into the sharp container.”
Remember to do not recap to prevent needlestick injuries.
“Remove and discard gloves”
To avoid cross contamination.
“Record medication and site of injection, reaction and other pertinent data after the procedure.”
To keep all information recorded and documented.
 “Intramuscular Injection”

“Prepare the medication using appropriate syringe and needle”

The needle must be long enough to penetrate intramuscular tissue.
Perform hand hygiene and other preventive measure”
To prevent the spread of microorganism and maintain sterility.
“Explain the procedure to the client and provide privacy”
To reduce clients anxiety and gain their active cooperation.
“Select the site of IM Injection: And Place client comfortably in appropriate position.
(Deltoid = sitting; Ventrogluteal = back lying w/knee hip flexed; Dorsogluteal= side-lying;
Vastus lateralis= sitting or backlying)
: Appropriate to clients age and muscle condition. Then assess site for muscle atrophy, tenderness,
hardness, swelling, inflammation and skin lesions.
Use site that has not been used frequently. A properly selected site will prevent complications.

“Locate site for injection”

Deltoid, which is located by placing the 1 st finger over acromion process. The site is 4 finger breadths
below the acromion process. And no more than 1ml of solution is injected in this site.
“Cleanse the site”
Using circular motion, cleanse the site with antiseptic swab. Allow skin to dry. Discard the swab
appropriately. The mechanical action of swabbing removes skin secretion, which contains
microorganisms.
“Transfer and hold the swab between the 3rd and 4th finger of your non-dominant hand ready for
needle withdrawal.”
“Remove the needle cap/ cover w/o contaminating the needle.”
“Invert the syringe and expel excess air, leaving only 0.2ml of air, (air-lock or air bubble technique)”
Leaving small air bubble at the top so that all medicine will be expelled.
“Insert the needle by: stretching the skin for about 2.5 cm/1 inch at the site of displacing it to one side
a.k.a Z TRACK TECHNIQUE with the non-dominant hand.”
This will make it firmer and help facilitates needle insertion.
“ Hold the syringe in between the thumb and forefinger as if holding a pen, then pierce the skin quickly
and smoothly at 90° angle and insert it into the muscle.”
Using quick motion lessens clients discomfort.
“Hold the barrel of the syringe steady with your nondominant hand and aspirate by pulling back on
the plunger with your dominant hand. Aspirate for 5-10 seconds.”
If needle is in a small blood vessel it take time for the blood to appear. If blood appears in the syringe,
withdraw the needle, discard the syringe and prepare for new injection.
“ If blood does not appear inject the medication steadily and slowly ( approximately 10 secs per ml
while holding the syringe steady.”
Injecting the medication slowly promotes comfort and allows time for tissue to expand and begin
absorption of the medication.
“After injection, apply gentle pressure at the site with dry cotton ball. If bleeding occurs, apply
pressure with dry sterile gauze until it stops.”
This will permits the medication to disperse into the muscles tissue, thus decreasing the clients
discomfort.
“Dispose syringe and needle appropriately. Remove gloves and perform hand hygiene.”
To avoid cross contamination.
“Document all relevant information”