1. Subcutaneous Intramuscular Injections
Administer and Monitor Medication in the Work Environment
Topic 8 Subcutaneous

2. Administering injections
Subcutaneous – into the fatty sc layer of tissue under the dermis
not as richly supplied with blood vessels as muscle ... slower absorption
Normally takes at least 30 mins for absorption – can provide the sustained effect needed with certain drugs

3. Administering injections
Subcutaneous - sites include: abdomen, arms (posterior surface), thighs (anterior surface), and hips
only small doses 0.5 – 1ml can be given – pain receptors sensitive to irritating solutions
Body weight of the individual indicates the depth of sc layer

4. SUBCUTANEOUS INJECTIONS

5. SPEED OF ABSORPTION

6. Administering injections
Subcutaneous
What equipment do you need?

7. Equipment – SC Injection
What needle should I use for SCI injections?
25G or 27G
Orange or grey hub

8. Procedure Subcutaneous
Perform the standard protocol for beginning the procedure
Attach the drawing up needle to the syringe
If using a vial – swab top of vial with an alcohol wipe
If using an ampoule – gently tap to dislodge and med. above the neck

9. Procedure Subcutaneous
snap open the ampoule – may use a gauze square to protect your fingers from broken glass; may need to use a file to help snap the ampoule
Draw up the correct amount of medication
Remove the needle from the syringe & dispose into sharps container

10. Procedure Subcutaneous
attach the administration needle to the syringe & expel air & any surplus medication
Transport all equipment to the client using a kidney dish or suitable tray
Access the injection site & when appropriate, clean it with alcohol

11. Procedure Subcutaneous Allow site to dry for about 10 sec
For insulin injections, the site is not swabbed with alcohol if it is clean
pinch a fold of skin upwards, insert 2/3 of the needle at a 45 – 900 angle holding the syringe like a dart
Inject the medication slowly & smoothly

12. Procedure Subcutaneous withdraw the needle smoothly
Place an alcohol swab or gauze over the site for a few seconds but do not massage as this may speed up the absorption or may cause bleeding into the tissues especially if administering heparin
Complete the standard protocol for ending the procedure

13. Things to consider…
Anything that interferes with the local blood flow to tissues affects the rate of drug absorption e.g. exercise, hot/cold compresses to the area ... do not give sc injection
Do not inject into an infected area, scar, near a bony prominence or into underlying muscle or nerves

14. Things to consider…
Avoid using any site within 5cm of the umbilicus – proximity to large blood vessels
Educate clients who need regular sc injections to rotate sites within the one area (for diabetics, this ↓s variability of insulin absorption) – injections should be given at least 2.5cm away from previous site & each site should not be used again for 1 month

15. Things to consider…
Insulin pens – small prefilled cartridges loaded into a device that looks like a pen – some are disposable, others reloadable.
a very fine needle is on the tip of the pen – many are coated with silicone = less painful injections
Users turn a dial to select the required dose & then press the plunger on the end to inject the insulin

16. Things to consider… Continuous sc medications
often used as an alternative to repeated IV, IM or SC boluses
Mainly used for analgesia & insulin
Less expensive, less risks & can be used in client’s home
Associated with better pain control & less sleep disturbance when compared with IV admin.