Subdermal injections.,indications ,sites.

intradermal injection

1. Intradermal injections Prepared by Jeena Vijayan P V Nursing tutor

2. Definition It is defined when the medication is injected to dermis, where blood supply is reduced and drug absorbs slowly

3. Purpose To perform sensitivity test To serve as a diagnostic tool for certain diseases and allergies/testing for antibody formation (PPD for tuberculosis) To administer vaccination Bacille Calmette Guerin (BCG))

4. Sites Usually palmar (inner) side of forearm or subscapular region of the back Deltoid region for BCG vaccination in neonates The site should be easily obtainable and relatively free from being rubbed by clothing.

5. Articles 1. Tuberculins syringe (1 ml) with pre- attached 26-30 gauge needle 2. Alcohol swab 3. Dry cotton swabs/gauze piece 4. Medication for skin test 5. Clean gloves 6. Patient's documentation chart 7. Kidney tray 8. Paper bag 9. Hand sanitizer 10. Pen/marker

6. Steps Preprocedural Steps Check the physician's order for medication administration and identify the patient. Explain procedure to the patient Ask the patient/parent if the patient has a known history of allergy to the medication

7. Wash hands and don gloves. Prepare medication from ampoule/vial as prescribed. Ask for assistance with children

8. Intraprocedural Steps Select appropriate injection site. Inspect skin surface over site for braises, inflammation, and edema Select site three to four finger width below antecubital space. Place arm in a relaxed position with palm up Prepare injection site with alcohol and air dry it With nondominant hand, stretch skin over the site with forefinger thumb.

9. Place needle almost flat against patient's skin (15") and insert the needle slowly into the skin so that point of needle can be seen through the skin. Inject medication slowly (0.01-0.1 mL). Notice at the injecting site, a bleb approximately 6 mm resembling mosquito bite appears on skin surface. Withdraw needle while applying sterile cotton/gauze gently over site.

10. Do not massage site. Assist patient to comfortable position. Draw circle around perimeter of injection site with pen. Write date and time and name of administration of medication.

11. Postprocedural Steps Discard used and replace the unused articles. Do not recap the needle Remove disposable gloves and wash hands. Record area of injection, name amount and type of testing substance and date and time on medication record Stay with patient to observe the allergic reactions for 10-15 minutes Report for any undesirable effects from medication.