PREPARING THE INJECTION
Take the vial, Clean the rubber stopper with an alcohol swab. Remove the caps from the syringe. You will see the plunger. Then remove the orange cap, making sure to retain the cap since you will need to cap the needle before you dispose of the needle and syringe. Now the needle is exposed. Make sure the plunger of the syringe is completely pushed down. This is necessary in order to make sure you have no air in the syringe. With the plunger pushed in completely all the air will be out of the syringe. Additionally, this will create the vacuum needed to draw the medication as well as allow you to accurately measure the medication amount as you draw the medication into the syringe.
Take the vial in hand and hold upside down. With the other hand, push the needle through the rubber stopper into the lower part of the bottle. Then pull the plunger. The medication will be drawn into the syringe. The usual dose is approximately ½ ml. (it will read 50 on the syringe). After drawing the medication into the syringe, recap and needle with the orange cap and set aside. You will now prepare the area for injection.
***PLEASE SEE YOUR PRESCRIPTION FOR YOUR ACTUAL DOSAGE REQUIREMENTS
If you still have difficult understanding how to draw a syringe, a trained member of the medical staff will instruct you on preparing your particular dose of medication. Please note that the first time is the hardest. Once you have done it, it will be simple the next time.
Sites for routine subcutaneous injections. (Avoid umbilicus area.)
Wipe with alcohol in a circular motion to cleanse. Allow to dry.
Pinch skin between finger and thumb. Spread taut if client has substantial cutaneous tissue.
Insert needle at 45° or 90° angle depending on body size of client: 90° if obese; 45° if average weight. If client is very thin, gather skin at area of needle insertion and administer at 90° angle.
Insert needle at 45° or 90° angle into tissue for subcutaneous injection.
Release the subcutaneous tissue, and aspirate prior to injecting medication (except insulin or heparin).
Inject medication slowly, remove needle quickly, and gently massage site with alcohol swab. Do not massage after the administration of heparin.
Wipe site with alcohol in a circular motion to cleanse. Allow to dry.
Spread skin taut, and insert needle at 90° angle with quick, dartlike action.
Insert needle at 90° angle for intramuscular injections.
Aspirate, and observe for blood. (If blood appears, remove and discard needle).
Inject medication slowly, remove needle quickly, and gently apply pressure to site with dry, sterile 2 x 2 gauze. Do not massage injection site.
Deltoid (Upper Arm)
Use if volume is 0.5 - 1 cc, but not more than 3 cc. Use a 23 gauge, 1 inch needle.
Locate site by measuring 2 - 3 fingerbreadths below the acromion process on the lateral midline of the arm.
The deltoid muscle of the upper arm, used for intramuscular injections.
The upper arm can be used for both intramuscular (IM) and subcutaneous (Sub Q) injections.
Administer in nondominant arm when possible.
Dorsogluteal (Upper Outer Quadrant)
Locate site by palpating the posterior iliac spine where the spine and pelvis meet. Imagine a line from the posterior iliac spine to the greater trochanter. Administer medication above imaginary line at midpoint.
The dorsogluteal site for intramuscular injections.
Locate greater trochanter to identify dorsogluteal site.
Locate posterosuperior spine of iliac crest.
Draw imaginary line between trochanter and iliac spine.
- Inject medication directly into dorsogluteal site at 90° angle.
Locate site by placing the hand with heel on the greater trochanter and thumb toward umbilicus. Point to the anterior iliac spine with the index finger (forming a "V"). Injection of medication is given within the "V" area.
The ventrogluteal site for intramuscular injections.
Identify greater trochanter, and place palm at site.
Place palm on greater trochanter, and point to anterior iliac spine.
Inject medication at 90° angle within "V" area.
Anterolateral Thigh (Vastus Lateralis)
Locate by identifying the greater trochanter and lateral femoral condyle. Injection site is the middle third and anterior lateral aspect of the thigh.
The vastus lateralis site of the right thigh, used for intramuscular injections.
- The vastus lateralis muscle of the upper thigh.
- Identify greater trochanter and lateral femoral condyle.
- Select site using middle third and anterior lateral aspect of thigh.
- Inject medication at 90° angle directly into muscle.
- Discard needle after medication is drawn up, and use new needle for injection to minimize tissue staining or irritation.
- Use this method when administering injection in ventrogluteal or dorsogluteal sites.
- Displace skin to one side (laterally) before inserting needle.
- Z-track is used to prevent backflow of medication into subcutaneous tissue.
- Insert needle at 90° angle, aspirate, and administer if no blood is present.
- Withdraw needle before releasing skin.
- Use a tuberculin or 1 cc syringe and 25-27 gauge, 3/8 - 5/8 inch needle. Amount to be injected is usually 0.01 - 0.1 cc.
- Choose site: dorsal forearm, upper back or upper chest.
- Body sites commonly used for intradermal injections.
- Wipe site with alcohol in a circular motion to cleanse. Allow to dry.
- Insert needle, with bevel facing upward, at angle of 10 - 15°.
- Advance needle until entire bevel is under skin.
- Slowly inject medication to form small bleb.
- Inject solution to form wheal on skin.
- Withdraw needle quickly, and pat site gently with sterile 2 x 2 gauze pad. Do not massage area.