Intradermal & Subcutaneous Injection.pptx

It is a type of route of drug administration.

1. Intradermal Injection Presentation by : Chandani S. Modi F.Y.M.Sc.Nursing C.M.P.C.O.N.

2. INTRODUCTON:- Intradermal injections are only given for certain therapies, such as skin testing, tuberculin screening and allergy tests. It is preferred as the body’s reaction to substances is more easily visible since it is close to the surface. The intradermal sites should be free of lesions and relatively hairless.

3. DEFINITION:- It is defined as the shallow and superficial injection of a medication into the dermis, where blood supply is reduced and drug absorbs slowly. It is useful route for certain vaccination and for allergic testing.

4. PURPOSE:- To perform sensitivity test To administer vaccination To serve as a diagnostic tool for certain diseases and allergies/testing for antibody formation for example (PPD for Tuberculosis)

5. SITES:- Usually palmer (inner) side of forearm and subscapular region of back Deltoid region for BCG vaccination in neonates The site selected should be an easily obtainable area and relatively free from being rubbed by clothing

6. RIGHTS OF DRUG ADMINISTRATION Right Patient Right Drug Right Dose Right Route Right Time Right Documentation Right Client education

7. 8. Right to refuse 9. Right Assessment 10. Right Evaluation 11. Right Preparation 12. Right Storage 13. Right Expire date 14. Right Patient Chart 15. Right Order 16. Right handling

8. TO GIVE AN INTRADERMAL INJECTION: This method is used for skin tests to detect allergies. The skin is held taut, by grasping it under the forearm. With the bevel of the needle facing up, insert the needle at an angle of 10 to 15 to the skin.

9. The needle enters between the two layers of the skin- the bevel should be practically visible through the skin. Inject the medication slowly, to produce a wheel on the skin. A quantity of 0.01 to 0.1 ml of medication is injected intra- dermally . https://www.youtube.com/watch?v=f3w-MlDAdg0

10. In order to avoid errors in reading the tissue reaction, a control injection of normal saline is given on the other arm and a careful record is kept. Take out the needle quickly. Do not try to clean or massage the area.

11. Select an area where the skin is healthy, free of an irritation, swelling, edema, discoloration and where the clothing will not irritate the skin. Usually the intradermal injections are given at the inner aspect of the lower arm, upper aspect of the anterior chest and upper aspect of the posterior chest.

12. SPECIAL CONSIDERATION: This is a painful procedure and is used only with small amount of solution. Ensure that the needle is inserted into the dermis [ just below the outer layer of skin ] not subcutaneously as absorption would be reduced. If injection does not from a wheal or if bleeding is noted ,the injection was probably too deep and should be repeated .

13. COMPLICATIONS: Injection site reaction (pain, itching, redness, swelling and hard lump) Muscle pain Headache Feeling unwell Shivering

14. TUBERCULIN SYRINGE

15. INTRODUCTION: Tuberculin syringes are devices used to measure and deliver a specific amount of liquid through a needle. They are used for subcutaneous or intradermal injections of medicines, vaccines or other substances.

16. Tuberculin syringes are graduated, hold up to 1 mL /cc of liquid, are sterile and latex-free, and may have varying needle sizes, including attached short, fine-gauge needles or a Luer lock or slip needle hub.

17. USE: Tuberculin syringes are commonly used for tuberculosis testing or “ tb tests.” Tuberculin, a purified protein derivative, is a glycerol extract of the tubercle bacillus used for tuberculin (PPD) skin tests.

18. A standard dose of tuberculin is injected between the layers of the skin. This method, also called the Mantoux technique, is typically performed on the inner forearm and creates a bubble of liquid that is eventually absorbed by the body.

19. Persons exposed to tuberculosis bacteria or with past tuberculosis infections should exhibit an immune response to the injected bacterial proteins, a classic example of delayed-type hypersensitivity reaction (DTH) hypersensitivities.

20. Local inflammation is produced by T cells and myeloid cells attracted to the site of the reaction. After 48 to 72 hours, an area of induration more than five to ten millimeters in diameter is considered a positive result.

21. SUBCUTANEOUS INJECTION

22. INTRODUCTION: An injection is a method of putting liquid into the body with a hollow needle and a syringe, which is pierced through the skin long enough for the material to be forced into the body.

23. A subcutaneous injection is one into the fatty tissue just beneath the skin. These injections are shallower than those injected into the muscle tissue.

24. DEFINITION: A subcutaneous injection is administered into the subcutis , the layer of the skin directly below the dermis and epidermis collectively referred to as the cutis. Subcutaneous injections are highly effective in administering such medications Insulin, Heparin and Morphine.

25. PURPOSE: For rapid systematic effects of drug , e.g ; heparin, adrenaline and insulin Local effects, e.g ; anesthetics Administer drug when a small amount of fluid is to be injected The patient is unable to take the drug orally The drug is destroyed by intestinal secretions

26. SITES: The outer area of the upper arm Just above and below the waist, except the area right around the naval The upper area of buttock, just behind the hip bone The front of the thigh, midway to outside, 4 inches below the top of thigh to 4 inches above the knee

27. TO GIVE THE SUBCUTANEOUS INJECTION: Any site is acceptable if it meets the following criteria: The skin and underlying tissues are free of abnormalities Not over bony prominences Free of large blood vessels and nerves

28. The subcutaneous injections are usually given on the outer aspect of the upper arm, posterior chest wall below the scapula, anterior abdominal wall from below the breasts to the iliac crests and the anterior and lateral aspect of the thigh. https://www.youtube.com/watch?v=XoGpnJ2_t2A

29. https://www.youtube.com/watch?v=fJPzkzyuMZ8

30. COMPLICATIONS: Severe pain Redness Swelling Warmth or drainage

31. ASSIGNMENT Write down the Nursing responsibility for administration of Intradermal and Subcutaneous injection . Submission date: 03/04/21 Email id: [email protected]