Subcutaneous Injection

Document created by kbass Employee on Dec 30, 2016Last modified by alawson on Mar 27, 2017
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Purpose


For several medicines, injection is the best way to get the medication into the body so it can work.

 

Subcutaneous tissue is the layer of fat between the outer layer of skin and the muscle. Injections are given subcutaneously because there is little blood flow to the fatty tissue so the medicine is absorbed slowly.

 

Supplies you will need


  • Syringe with a 27 gauge (5/8 of inch long) or 28 gauge (1/2 of inch long) needle
  • Medication to be given
  • Disinfectant (alcohol swab)
  • Proper needle disposal container to put the syringe in after use
  • Sterile 2x2 gauze pad

 

What to do


  1. Wash your hands.
  2. Check the label for the correct medication and expiration date.
  3. Remove the soft metal or plastic cap protecting the rubber stopper on the medicine bottle.
  4. Clean the rubber top with the alcohol swab.
  5. Take the syringe out of the package and be sure the needle is screwed on tightly.
  6. With the cap still on the needle, pull back the plunger to fill the syringe with air equal to the amount of medicine that you want to give.
  7. Remove the cap from the needle – do not touch the needle.
  8. Lay the needle cap on its side to keep it clean.
  9. Have the bottle of medicine sitting on the table.
  10. Push the needle straight into the bottle of medicine (90-degree angle).
  11. Push the air in the syringe into the bottle.
  12. Turn the bottle of medicine upside down with the needle still in it.
  13. Be sure the tip of the needle is completely covered with medicine.
  14. Pull back on the syringe with the correct dose of medicine.
  15. Keep the bottle upside down – flick the syringe to move the major air bubbles to the top of the syringe so you can push them back into the bottle.
  16. Remove the needle from the bottle.
  17. Slide needle into the cap (nurse will demonstrate)
  18. Check again to be sure you have the correct dose of medicine in the syringe

 

Now it is time to inject the patient


  1. Explain to the patient what your are going to do, even if you do not think they can hear you.
  2. Uncover the area to be injected (upper arm, upper leg, abdomen).
  3. Clean the skin (alcohol swab).
  4. Dry the area with 2x2 gauze.
  5. Take the cover off the needle
  6. Hold the needle like a pencil or a dart.
  7. Grasp the skin between thumb and index finger.
    • How to hold skin when injecting the patient
  8. Quickly thrust needle all the way into the skin (like a dart action).
  9. Do not press down on the plunger while putting the needle through the skin.
  10. After the needle is all the way into the skin grasp the syringe near its base to stabilize it.
  11. Aspirate by pulling back gently on the tip of the plunger and be sure no blood returns. (If blood does return, pull the needle out of the skin, change needles and use a different site for the injection.)
  12. If no blood returns push the plunger in at a slow rate to inject the medicine.
  13. Pull the needle out of the skin.
  14. With one hand - press the 2x2 gauze over the site – apply a little pressure.
  15. It is not unusual to see a drop of blood or a little clear fluid at the site.
  16. Do not recap the needle.
  17. Put the used syringe and needle into a proper disposal container.

(Use a coffee can or other container that the needle cannot poke through – a bleach bottle can also work.)

 

Special instructions


  • Always be sure to have the correct medication.
  • Hold the needle at about a 90 degree angle unless on a child or very thin person – then use a 45 degree angle.
  • Ask your nurse about suggested locations to give the subcutaneous injections.
  • Sites that can be used for subcutaneous injections are:
    • Outer side of upper arm
    • The abdomen (below the ribs and above the hip bones)
    • The front side of the thighs
    • The buttocks
      • Where to give subQ injection
  • Choose a site that is not red or infected.
  • Do not give into a scar or into a very bony area.
  • Stay at least 2 inches away from the umbilicus (naval).
  • Rotate where you give the injections. Move at least 2 inches away from where you gave the last injection.
  • Report any unusual reaction or redness to your nurse.

 

 

Adapted from: Harkreader, H., & Hogan, M.A. (2004). Fundamentals of nursing: Caring and clinical judgment. St. Louis: Saunders.

 

 

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