Subcutaneous Intramuscular Injections Administer and Monitor Medication in the Work Environment Topic 8 Subcutaneous
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
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
SUBCUTANEOUS INJECTIONS
SPEED OF ABSORPTION
Administering injections Subcutaneous What equipment do you need?
Equipment – SC Injection What needle should I use for SCI injections? 25G or 27G Orange or grey hub
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
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
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
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
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
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
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
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
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.