Subcutaneous injection

Jays george
Msc Nursing

1. Sub-cutaneous injection Mrs. Priyadarshini john Assot . Professor d.y.p.s.o.n MISS.JAYS GEORGE 1 ST YR MSC(N) D.Y.P.S.O.N

2. DEFINITION Administering Medication Into The Subcutaneous Tissue Is Called As Subcutaneous Injection

3. PURPOSE To Get Rapid And Systemic Effect Of The Drug. Some Medicines That Cannot Be administered Orally Due To Poor Absorption In GI Tract. When The Drug Is Toxic And Irritating To The Gastrointestinal Mucosa.

4. Injection sites Sites include ; The outer area of the upper arm. The abdomen from the rib margin to the iliac crest avoiding a 2 inch circle around the navel, this has the fastest rate of absorption among the sites. The front of the thigh , midway to the outer side ,4 inches below the top of the thigh to 4 inches above the knee, this has a slower rate of absorption than the upper arm.

5. The upper back. The upper area of the buttock, just behind the hip bone ,this has the slowest rate of absorption among sites

6. equipment's

7. articles

8. A Tray Containing ; Sterile Pre dish With Medication Card Sterile Syringe Prescribed Medication Spirit Swab Clean Gloves Kidney Tray

9. procedure Nursing action Assemble equipment and check physicians order Identify patient carefully Explain procedure to the patient , the drug that is to be administered , site and how he has to co operate . rationale Avoids medication error from occurring Ensures that right procedure is done on right patient. Encourage co operation and always reduce anxiety

10. Wash hands Withdraw medicine from an ampule / vial as prescribed. Assembles all the equipment including loaded medication in syringe near the patient’s bedside. Pull curtains Help patient assume position depending on site selected Reduces spread of micro- organisms Provide privacy Ensures free access to injection site.

11. Assess the area ,checks for lumps , nodules , tenderness, hardness , swelling , scaring , itching , burning sensation. Wear gloves Clean the area around the injection site with an alcohol swab use firm circular motion, while moving outward (5 diameter) allow the site for dry. Good observation helps in establishing the correct location , site and avoids damage to tissue. Reduces spread of micro organisms Friction help clean the skin

12. Remove the needle cap with non dominant hand, pulling straight off. Grasp and pinch the area surrounding the injection site or spread skin at site Hold the syringe in dominant hand between thumb and forefinger. Inject needle quickly at an angle of 45 – 90 degree depending on amount of tissue turgor of tissue and length of needle Less risk of an accidental needle prick. Provides for easy and less painful entry into subcutaneous tissue Subcutaneous tissue is abundant in well nourished , well hydrated people and sparse is emaciated dehydrated on very thin people .

13. After insertion release the tissue and immediately move your non dominant hand to steady lower end of syringe. Slide your dominant hand to top of the barrel. Aspirate if recommended ,by pulling back gently on the plunger to determine whether needle is in a blood vessel. If blood appears , withdraws needle and discard. Do not aspirate for heparin/ insulin. Injection solution into compressed tissue results in pressure against fibres and creates discomfort the non dominant hand secures the needles and allows for smooth aspiration. Discomfort and serious reactions may occur if a drug intended for s/c administration enters into the blood stream. Heparin is anticoagulant and can cause bruising on aspiration. Insulin needle is very small and aspiration will not give relevant information

14. Inject medication slowly, if no blood appears. Withdraw needle quickly at the same angle as it was inserted , while applying counter traction around the injection site with non dominant hand. Rapid injection of medication creates pressure in the tissues and results in discomfort. Slow withdrawal of the needle pulls tissue and causes discomfort. Applying counter traction around the site helps in preventing pulling of tissues when needle is withdrawn.

15. Do not massage a heparin /insulin injection site. Do not discard syringe and needle without recapping. Assist patient to a comfortable position. Massaging heparin can lead to bruising and after insulin will contribute to unpredictable absorption. Proper disposal prevents accidental needle stick injury.

16. Wash hands after removing gloves. Document medication administration with date , time dosage , route , site and nurses sign. Evaluate response of the patient to the medication.

17. Termination of the procedure Dismantle all the articles in an appropriate manner ; syringe in an antiseptic bowl. Glass syringes to be sent for autoclaving . Disposible syringes to be sent for crushing in an shredder. Steel needle are washed and sent for autoclaving. Wash the kidney tray and place it in the cupboard. Knife dish is washed and sent for autoclaving

18. complications Infection Pyrogenic reactions Allergic reactions