Video Guide: Subcutaneous Injections

STEPS IN ADMINISTERING SUBCUTANEOUS INJECTION

1. Assemble equipment and check physician’s order.
2. Explain procedure to patient.
3. Perform hand hygiene.
4. If necessary, withdraw medication from ampule or vial.
5. Identify patient carefully. Close curtain to provide privacy. Don disposable gloves (optional).
6. Have patient assume a position appropriate for the most commonly used sites.
-Outer aspect of upper arm- Patient’s arm should be relaxed and at side of body.
-Anterior thighs- Patient may sit or lie with leg relaxed.
-Abdomen-Patient may lie in a semirecumbent position.

7. Locate site of choice (outer aspect of upper arm, abdomen, anterior aspect of thigh, upper back, upper ventral or dorsogluteal area). Ensure that area is not tender and is free of lumps or nodules.

8. Clean area around injection site with an alcohol swab. Use a firm circular motion while moving outward from the injection site. Allow antiseptic to dry. Leave alcohol swab in a clean area for reuse when withdrawing the needle.

9. Remove needle cap with nondominant hand, pulling it straight off.
10.Grasp and bunch area surrounding injection site or spread skin at site.
11. Hold syringe in dominant hand between thumb and forefinger. Inject needle quickly at an angle of 45 to 90 degrees, depending on amount and turgor of tissue and length of needle.

12. After needle is in place, release tissue. If you have a large skin fold pinched up, ensure that the needle stays in place as the skin is released. Immediately move your nondominant hand to steady the lower end of the syringe. Slide your dominant hand to the tip of the barrel.

13. Aspirate, if recommended, by pulling back gently on syringe plunger to determine whether needle is in the blood vessel. If blood appears, the needle should be withdrawn, the medication syringe and needle discarded, and a new syringe with medication prepared. Do not aspirate when giving insulin or heparin.

14. If no blood appears, inject solution slowly.
15. Withdraw needle quickly at the same angle at which it was inserted.
16. Massage area gently with alcohol swab. (Do not massage a subcutaneous heparin or insulin injection site.) Apply a small bandage if needed.
17. Do not recap used needle. Discard needle and syringe in appropriate receptacle.
18. Assist patient to a position comfort.
19. Remove gloves, if worm, and dispose of them properly. Perform hand hygiene.
20. Chart administration of medication, including the site of administration. This charting can be done on CMAR.
21. Evaluate patient response to medication within an appropriate time frame.