Subcutaneous Intramuscular Injections

Administer and Monitor Medication in the Work Environment

Topic 8 Subcutaneous

Administering injections

• Subcutaneous – into the fatty sc layer of tissue under the dermis

- not as richly supplied with blood vessels as muscle ... slower absorption

- Normally takes at least 30 mins for absorption – can provide the sustained effect needed with certain drugs

Administering injections

• Subcutaneous - sites include: abdomen, arms (posterior surface), thighs (anterior surface), and hips

- only small doses 0.5 – 1ml can be given – pain receptors sensitive to irritating solutions

- Body weight of the individual indicates the depth of sc layer

SUBCUTANEOUS INJECTIONS

SPEED OF ABSORPTION

Administering injections• Subcutaneous

What equipment do you need?

Equipment – SC Injection

What needle should I use for SCI injections?

25G or 27G

Orange or grey hub

Procedure

• Subcutaneous

- Perform the standard protocol for beginning the procedure

- Attach the drawing up needle to the syringe

If using a vial – swab top of vial with an alcohol wipe

If using an ampoule – gently tap to dislodge and med. above the neck

Procedure• Subcutaneous- snap open the ampoule – may use a

gauze square to protect your fingers from broken glass; may need to use a file to help snap the ampoule

- Draw up the correct amount of medication- Remove the needle from the syringe &

dispose into sharps container

Procedure

• Subcutaneous

- attach the administration needle to the syringe & expel air & any surplus medication

- Transport all equipment to the client using a kidney dish or suitable tray

- Access the injection site & when appropriate, clean it with alcohol

Procedure

• Subcutaneous- Allow site to dry for about 10 secFor insulin injections, the site is not

swabbed with alcohol if it is clean- pinch a fold of skin upwards, insert 2/3 of

the needle at a 45 – 900 angle holding the syringe like a dart

- Inject the medication slowly & smoothly

Procedure

• Subcutaneous- withdraw the needle smoothly- Place an alcohol swab or gauze over the

site for a few seconds but do not massage as this may speed up the absorption or may cause bleeding into the tissues especially if administering heparin

- Complete the standard protocol for ending the procedure

Things to consider…

• Anything that interferes with the local blood flow to tissues affects the rate of drug absorption e.g. exercise, hot/cold compresses to the area ... do not give sc injection

• Do not inject into an infected area, scar, near a bony prominence or into underlying muscle or nerves

Things to consider…

• Avoid using any site within 5cm of the umbilicus – proximity to large blood vessels

• Educate clients who need regular sc injections to rotate sites within the one area (for diabetics, this ↓s variability of insulin absorption) – injections should be given at least 2.5cm away from previous site & each site should not be used again for 1 month

Things to consider…

• Insulin pens – small prefilled cartridges loaded into a device that looks like a pen – some are disposable, others reloadable.

- a very fine needle is on the tip of the pen – many are coated with silicone = less painful injections

- Users turn a dial to select the required dose & then press the plunger on the end to inject the insulin

Things to consider…

• Continuous sc medications- often used as an alternative to repeated

IV, IM or SC boluses- Mainly used for analgesia & insulin- Less expensive, less risks & can be used

in client’s home- Associated with better pain control & less

sleep disturbance when compared with IV admin.