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How to minimize client's discomfort
- Use a sharp beveled needle in the smallest suitable length and gauge
- Position the client as comfortably as possible to reduce muscular tension
- Select the proper injection site, using anatomical landmarks
- Divert the client’s attention from the injection through conversation using open-ended questioning
- Insert the needle quickly and smoothly to minimize tissue pulling
- Hold the syringe steady while the needle remains in the tissue
- Inject the medication slowly and steadily
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subQ injections
- Best sites include: the outer posterior aspects of the upper arm, the abdomen from below the costal margins to the iliac crest, and the anterior aspect of the thighs.
- Equipment: 1-3mL syringe and needle (27-25 gauge, ⅜ to ⅝ inch)
- Assess for factors such as circulatory shock or reduced local tissue perfusion. Assess adequacy of client’s adipose tissue .
- Palpate sites for asses or tenderness and avoid these areas
- For average-size client, spread skin tightly across injection site or pinch skin with non-dominate hand.
- Inject needle quickly and firmly at 45- to 90-degree angle, Then release skin, if pinched.
- For obese clients, pinch skin at site and inject needle at 90-degree angle below the skin fold.
- Inject medication slowly.
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IM injections
- Equipment: 2-3mL syringe for adults, 0.5-1mL for infants and small children; needle length-Children: ⅝ to 1¼ inch; vastis lateralis and deltoid (adults) 1 to 1½ inch; ventrogluteal (adults) 1½ inch
- Assess for factors such as muscle atrophy, reduces blood flow, or circulatory shock.
- Note integrity and size of muscle, and palpate for tenderness or hardness, rotate sites. Use ventrogluteal site if possible
- Position non-dominate hand just below site, and pull skin approx. 2.5 to 3.5cm down or lateraly with ulnar side of hand to administer in a Z-track. Hold position until medication is injected. (Option - if client’s muscle mass is small, grasp body of muscle between thumb and fingers) With dominate hand, insert the needle quicly at 90-degree angle into muscle. After needle pierces skin, grasp lower end of syringe barrel with non-dominate hand to stablize syringe. Continue to hold skin tightly with non-dominat hand. Move dominate hand to end of plunger. Do not move the syringe. Inject medicine slowly, at a rate of 1mL/10sec. Wait 10 seconds then slowly and steadily withdraw needle and release skin.
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ID injections
- - Equipment: 1mL tuberculin syringe with pre-attached 26/27 gauge needle
- - Note lesions or discolorations of forearm.
- - Select site three to four fingers width before antecubital space and hand width above wrist. If you cannot use the forearm, inspect the upper back. If necessary, use sites for subQ injections
- - With non-dominate hand,stretch skin over site with forefinger or thumb.
- - With needle almost against the client’s skin, insert in slowly with bevel up at a 5- to 15-degree angle until resistance is felt. Then advance needle through epidermis to approximately 3mm (⅛ inch) below skin surface. You will see needle tip through skin.
- - Inject medication slowly. Normally, you feel resistance. If not, needle is too deep;remove and begin again.
- - Non-dominate hand can stabilize needed during the injection. While injecting the medication, notice that small bleb approx ¼ inch in diameter appears on the skin’s surface.
- - Instruct client this is a normal finding. Do not massage.
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