Introduction

Subcutaneous injection is a common medical procedure used to administer medication or fluids into the subcutaneous layer of the skin. It involves delivering the medication into the fatty tissue just beneath the skin, using a small needle. This method allows for slow absorption and sustained release of medication.

Subcutaneous injection Definition

A subcutaneous injection is the introduction of a medication or fluid into the subcutaneous layer of the skin, using a small needle and syringe.

Subcutaneous Injection Purpose

The purpose of a subcutaneous injection is to deliver medication or fluids directly into the fatty tissue beneath the skin. This route is commonly used for medications that require slow and sustained absorption, such as insulin, heparin, vaccines, and certain types of pain medications.

Subcutaneous injection Indication

Subcutaneous injections are indicated in various situations, including:

• Administration of medications that require slow absorption and long duration of action.
• Delivery of medications that are poorly absorbed through the digestive system.
• Administration of vaccines, such as the flu shot or certain travel vaccines.
• Giving medications or fluids to patients who are unable to take oral medication.
• Contraindication: Subcutaneous injections should not be performed in the following cases:
• When a patient has a known allergy or hypersensitivity to the medication being administered.
• In areas with skin infections, wounds, or lesions.
• When the medication is contraindicated for subcutaneous administration due to potential adverse effects.

Subcutaneous Injection Advantages and Disadvantages

Advantages of subcutaneous injections include:

• Easy and relatively painless procedure.
• Slower absorption allows for sustained release of medication.
• Suitable for medications that cannot be taken orally.
• Can be self-administered by the patient in some cases.

Disadvantages of subcutaneous injections include:

• Limited volume of medication that can be injected.
• Slower onset of action compared to other routes like intravenous injection.
• Potential for local skin reactions or infections at the injection site.
• Equipment: The equipment required for a subcutaneous injection includes:
• Medication is prescribed in the appropriate dosage.
• A syringe with a small-gauge needle (typically 25-30 gauge) suitable for subcutaneous injections.
• Alcohol swabs or other antiseptic solution for skin preparation.
• Sharps container for safe disposal of used needles.

Subcutaneous Injection Site

What is the correct angle for a subcutaneous injection? What are 3 sites for subcutaneous injections? What are the rules of subcutaneous injection?

The correct angle for subcutaneous injection is 45° of a syringe on the patient’s skin, and  Common subcutaneous injection sites are given one by one:

• Abdomen: Avoid the area around the navel and maintain a distance from any scars or wounds.
• The outer aspect of the upper arm: Use the area between the shoulder and elbow.
• Thigh: Use the outer area, about 4 inches above the knee and 4 inches below the hip.

subcutaneous injection site images

Subcutaneous Injection Procedure

How do you give a subcutaneous injection step by step?

• Wash your hands and gather the necessary equipment.
• Verify the medication order and check the expiration date and dosage.
• Explain the procedure to the patient, addressing any concerns.
• Choose an appropriate injection site, typically the abdomen, outer aspect of the upper arm, or thigh.
• Cleanse the chosen site with an alcohol swab and allow it to air dry.
• Using your non-dominant hand, pinch the skin around the injection site to create a small fold or mound.
• Hold the syringe like a pencil and insert the needle into the subcutaneous tissue at a 45- to 90-degree angle, depending on the patient’s body habitus.
• Inject the medication slowly and steadily, ensuring it is fully delivered.
• Withdraw the needle and release the pinched skin fold.
• Apply gentle pressure with a sterile gauze or cotton ball to the injection site, if necessary.
• Dispose of the used needle in a sharps container.
• Document the procedure, including the medication administered, dosage, injection site, and any patient responses.

Subcutaneous injection Contraindication

Subcutaneous injections should be avoided in the following cases:

• Known allergy or hypersensitivity to the medication being administered.
• Skin infections, wounds, or lesions at the intended injection site.
• Medications contraindicated for subcutaneous administration due to potential adverse effects.

Subcutaneous Injection Procedure Nursing Responsibilities

As a nurse, your responsibilities during subcutaneous injections include:

• Assessing the patient’s suitability for subcutaneous injections, considering contraindications and patient preferences.
• Ensuring accurate medication preparation and dosage calculations.
• Educate the patient about the procedure, potential side effects, and self-administration techniques if applicable.
• Selecting appropriate injection sites and rotating them to prevent tissue damage or lipodystrophy.
• Administering the injection using an aseptic technique and proper needle disposal.
• Monitoring the patient for any adverse reactions or complications.
• Documenting the procedure accurately in the patient’s medical record.

Conclusion

Subcutaneous injections are a commonly used method to administer medications or fluids into the fatty tissue beneath the skin. They offer advantages such as ease of administration, sustained release of medication, and suitability for certain medications and patient populations. However, they have limitations, including a limited volume of medication that can be injected and a slower onset of action. Nurses play a crucial role in performing subcutaneous injections safely and effectively, considering patient preferences, and providing appropriate education and support.

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Frequently asked questions (FAQs) about the subcutaneous injection procedure

What is a subcutaneous injection?

A subcutaneous injection is a method of administering medication or vaccines by injecting them just beneath the skin into the fatty tissue layer. It is typically done with a small, short needle.

When is a subcutaneous injection used?

Subcutaneous injections are often used to deliver medications like insulin, certain vaccines, blood thinners, and other drugs that can be absorbed through the subcutaneous tissue.

How do I prepare for a subcutaneous injection?

Wash your hands with soap and water. Gather the necessary supplies, including the medication, a syringe, and a clean, alcohol-soaked swab. Choose an injection site, rotate sites as directed, and ensure it’s clean.

What are common injection sites for subcutaneous injections?

Common injection sites include the abdomen (at least two inches away from the navel), the front of the thighs, and the upper, outer area of the arms. Your healthcare provider will recommend the most suitable site for your medication.

How do I draw the medication into the syringe?

If the medication comes in a vial, draw air into the syringe, inject it into the vial, invert it, and withdraw the correct dose. For pre-filled syringes, follow the manufacturer’s instructions.

How should I clean the injection site?

Use an alcohol-soaked swab or cotton ball to clean the chosen site in a circular motion. Allow it to air dry before injecting.

How do I administer the injection?

Pinch the cleaned skin between your thumb and forefinger, hold the syringe like a pencil, and insert the needle at a 90-degree angle (or as directed by your healthcare provider). Inject the medication slowly and steadily.

How do I minimize pain or discomfort during the injection?

Relax your muscles, breathe deeply, and use a quick, smooth motion when inserting the needle. Minimizing anxiety can also help reduce discomfort.

What should I do after the injection?

Withdraw the needle, release the pinched skin, and apply gentle pressure with a clean cotton ball or swab. Do not rub the injection site. Dispose of the needle in a sharps container.

Can I reuse needles or share them with others?

No, needles should never be reused, and sharing needles is extremely dangerous. Use a new, sterile needle for each injection.

What if I experience an adverse reaction or discomfort after the injection?

If you experience severe pain, swelling, redness, or signs of an allergic reaction, contact your healthcare provider immediately.

How should I dispose of used syringes and needles?

Used syringes and needles should be placed in a designated sharps container to prevent accidental needle sticks. Do not dispose of them in regular trash.

Always follow your healthcare provider’s specific instructions for subcutaneous injections, and if you have any concerns or questions, don’t hesitate to ask them for guidance.