INTRADERMAL INJECTION( ID)

INDICATIONS

 To perform sensitivity test

 To give vaccine( BCG at birth)
 To perform tuberculin skin test
 To perform skin allergy before administration of any drug

CONTRA- INDICATIONS

 Any kind of infections near the site

 Known allergy/ hypersensitivity to the drug
 Erythema or swelling at the injection site

SITES OF ID

 Inner side of fore arm

 Subscapular region of the back
 Deltoid region for vaccination for neonates

ARTICLES REQUIRED
ARTICLES PURPOSE
Medication card
Prescribed medicine and diluents for
skin test
Tuberculin syringe(1ml) with 26-30 To administer low dose 0.01ml
G needle
70% isopropyl alcohol swab To clean the skin, to remove microbial flora and create a sterile
field.
Sterile gloves To maintain aseptic technique
Kidney tray and paperbag To collect waste
Pen/ marker To mark the wheel
Sterile injection tray To keep the loaded syringe

STEPS OF INTRADERMAL PROCEDURE WITH RATIONALE

STEPS RATIONALE
Check the doctor’s order for To prevent medication error
medication administration
Confirm the patient’s identity and To seek consent from the patient
explain the procedure
Ask the patient for any known history To check any contraindications
of any allergy to some drugs
Follow the 10 rights of medication To prevent medication error
administration including the expiry
date of the medication
Calculate the desired amount of dose To administer the right dose
Wash hands and wear the gloves To prevent cross infection/c ontamination
Withdraw the prescribed amount of To check body’s response to the drug administered
medication into the syringe. Only
small amounts of medication ie,
0.1ml is injected ID
Hold the syringe upright and tap To remove air in the syringe
lightly and expel air.
Select the appropriate site of Dorsal surface of the left forearm is easy to access
injection. The preferred site is on the and easy to assess the area
dorsal surface of the left forearm,
about 4 inches below the elbow.
Make the patient comfortable to sit For comfort of the patient
or lying
Apply swab at the center of the site To create sterile field
and rotate outward in a circular
motion about 2 inches. Cleanse the
injection site with alcohol swab and
allow drying thoroughly.
Remove needle cap from the needle For appropriate grip
and place syringe between the thumb
and fore finger of the dominant hand
With the bevel side up , insert the Bevel up will help to form wheal of the injected
needle slowly under the skin medicine
Insert the needle into the dermis 5-15 degree prevent the deeper injection of the
layer at 05-15 degree angle. Slowly needle
inject the medication
A firm, wheal or bleb about 6-10mm Indicates correct administration of ID injection
in diameter should appear on the
skin’s surface at the injection site. A
wheal or bubble indicates that the
medication is in the dermis
Withdraw the needle while applying Do not press the dry swab. Massaging and pressing
the dry swab gently over the injection will leads to wheal deformation
site . do not massage the site.
Dispose the syringe and needle in To prevent cross infection
sharp container
Draw a circle around the perimeter of To mark the area for next observation comparison
the injection site with pen. Write
down the date, time and name of the
medication.
Remove the gloves and wash hands To prevent infection
Dispose of the contaminated articles
Record the procedure in the
procedure in the patient medication
card. Evaluate patient response to
medication.
Observe the patient for 15-30 To manage any serious side effects if occurs
minutes for any allergic reaction

*In case of Mantaux test, wait for 48-72 hours to determine whether the patient has been
exposed to tuberculosis.