1. Introduction to Injections Administer and Monitor Medication in the Work Environment Topic 8 Intradermal

2. Intradermal Injection   Administered usually into the forearm. Other sites include the upper chest, the upper arm, and shoulder blades. - - given into the dermal layer of the skin, just under the epidermis. - - Injected at about a 10 – 15 0 angle.

3. Intradermal Injection - - Only a very small dose can be given < 0.5ml, usually 0.01 – 0.1ml. - - Used for TB & allergy testing. - - As there is a reduced blood supply, drug absorption can occur slowly.

4. Subcutaneous Injection   Administration sites include: abdomen, anterior thigh, and the fat pad over the deltoid muscle in the upper arm - - given under the skin into the loose fat & connective tissue - - Absorption of drug is via the capillaries... slower acting than IM or IV - - slow, steady absorption

5. Injection Routes   Subcutaneous - - should never be given into scar tissue, a lesion or over a bony prominence - - As subcutaneous tissues contain pain receptors, only a small volume < 2ml should be given - - Unsuitable for any drug that may be irritating to the tissues

6. Injection Routes   Intramuscular - given into the muscle tissue below the fatty subcutaneous layer - - Rich blood supply... readily absorbed into the bloodstream - - Suitable for drugs that are soluble, non irritant to soft tissue & require quick absorption

7. Injection Routes   Intramuscular - - Up to 4ml can be injected without causing undue discomfort - - Solution can be more viscous than that given by SC route – permits thicker, oil based compounds

8. Administering injections   Intradermal - - these medications are very potent requiring very slow absorption - - Only very small amounts can be administered 0.01 – 0.1ml - - The needle is inserted at an angle of 10 – 15 0 to the skin - a small bleb should appear on the surface of the skin

9. Administering injections   Intradermal - - if a bleb doesn’t appear, most likely the medication has entered the sc tissue & any results from the skin testing will be invalid - - The inner forearm & upper back are the most common sites used

10. Administering injections   Intradermal What equipment do you need?

11. Procedure   Intradermal injection - perform the standard protocol for beginning the procedure - - Select injection site & clean skin with an alcohol swab; allow to dry - - Expel any air from the syringe - - Pull the skin taught & insert the needle into the skin approximately 3mm at a 10 – 15 0 angle, bevel face upwards

12. Procedure   Intradermal - - do not aspirate but inject slowly – it should produce a small bleb under the skin - - Withdraw the needle smoothly & wipe the injection site - - Do not massage – may disperse medication into sc layer - - Complete the standard protocol for the completion of a procedure

13. Things to consider…   Client must be observed closely as they may have a severe anaphylactic reaction if a test allergen is being injected   The site chosen should be free of lesions & only lightly pigmented – enables clear inspection & assessment of any changes from the injection