ADMINISTERING INTRADERMAL

(ID)
INJECTION/INTRACUTANEOUS
INJECTION
10 RIGHTS OF DRUG
ADMINISTRATION
• 1 Right Drug/Medication
• 2. Right Dose
• 3. Right Time
• 4. Right Route- Intravenous, Intramuscular. Subcutaneous, Parenteral, Per
orem, Topical
• 5. Right Patient
• 6. Right patient education
• 7. Right Documentation
• 8. Right to refuse
• 9. Right Assessment
• 10. Right Evaluation
 The injection of a small amount of
medication/fluid into the dermal layer of
the skin just beneath the epidermis.

• Indicated for diagnosing allergies and

tuberculin testing.
• Used to administer vaccination and local
anesthetics.
• Inner aspect of the forearm

• Subscapular region of the back

• Right deltoid (for BCG vaccine only).

• Sterile 1-ml syringe
• Needle (25 to 27 gauge)
• Antiseptic or alcohol swabs
• Medication ampule or vial
• Medication card
• Disposable gloves (agency protocol)
 PROCEDURE RATIONALE

Follow the general procedure for giving injection: To identify whether any medication is to be given to an
individual client on your shift.
a. Assess the medication record used in your facility. Prevents errors in drug administration.

b. Check the medications listed against the physician’s order using the Right in Drug Ensure accuracy and prevents medication error.
Administration.
c. Review information regarding the medication. Knowledge on the drug/medicine to be used/ordered can help health
care provider to be more competent.

d. Assess the size and general built of the client. To choose the correct size of needle for the injection.

e. Assess the status of the client. Determine the need for assistance to turn or restrain the client during
the procedure.
f. Wash hands and prepare materials needed For infection control.
g. Withdraw the correct dosage of medicine using the techniques described for Facilitates proper aspiration of the ordered medicine.
drawing up from a vial or an ampule or for mixing medication in a syringe.

h. Recheck your dosage calculation. To prevent medication error.

i. Identify and explain the procedure to the client. Provide privacy. To establish correct identify and reduce level of anxiety.

j. Assist client into a comfortable position. Divert client’s attention by talking about an Relaxation minimized discomfort and diverting client’s attention
interesting subject. reduces anxiety.

k. Wear clean gloves on your non-dominant hand and select the appropriate site of Protect yourself from potential blood spill.
injection.

l. Clean the site with alcohol swab/alcoholised cotton ball using a circular motion and Circular motion and mechanical action of swab removes secretions
moving from the middle of the site outward. Allow skin to air-dry. containing microorganism.

m. While holding a clean dry cotton ball between fingers of non-dominant hand, pull Dry cotton ball remains accessible during procedure. Prevents
cap from the needle, touching only the inside of the cap. contamination of needle.
Using your non-dominant hand make the skin taut in an appropriate manner in
the injection site chosen.
Hold the 1 ml/tuberculin syringe with gauge 25-27 needle at a 10-15o angle,
with bevel of needle facing up.
Insert the needle just until the bevel is no longer visible. Do not aspirate.
Inject the medication slowly while watching for a small wheal/bleb to appear.
Withdraw the needle while applying gentle pressure using the dry cotton ball.
Do not massage the site.
Encircle the wheal/bleb with a skin-marking pen if the site must be assessed
for reaction or sensitivity.
Discard the uncapped needle and syringe in a safe receptacle.
Remove gloves and wash hands.
Document procedure done.
Assess the sire at the appropriate time of interval (after 30 minutes)
An injection is less painful if the skin is taut when pierced and
allows the needle to enter the skin more easily.
Intradermal tissues will be penetrated when the needle is held
as near parallel to the skin as possible.
Facilitate proper introduction of the medicine.
Small wheal/bleb indicates the medication was deposited in the
dermis.
Supporting tissue around injection site minimizes discomfort.
Massage can disperse medication into the tissue and altering
test result.
Encircling part of the wheal/bleb serves as basis of reading.
Decreases risk of accidental needle prick.
Prevents transmission of microorganisms.
Maintains continuity of care.
Determines reaction or sensitivity to the drug.
• ADMINISTERING SUBCUTANEOUS
(SC/SQ) HYPODERMIC INJECTION
• The administration of drug/medication
into the subcutaneous tissue.

• PURPOSE
• Used in the administration of
medications such as insulin and heparin,
because these drugs are absorbed slowly
to produce sustained effect.
• Outer aspect of the upper arms

• Anterior aspect of the thighs

• Lowers abdominal wall

• Scapular areas of the back

 PROCEDURE
Follow the general procedure for giving
injections (1.a-1.m of intradermal injection).
Hold syringe between thumb and forefinger of
dominant hand like a dart.
Pinch skin with cushion with the non-dominant
hand.
Inject needle quickly and firmly at a 45o angle.
Release the skin.
Grasp the lower end of the syringe with non-
dominant hand and position dominant hand to
the end of the plunger. Do not move the needle.
Pull back on the plunger to ascertain that the
needle is not in a vein. If there’s no backflow of
blood, slowly inject the medication. Aspiration
is contraindicated with some medications
like heparin.
RATIONALE
See rationale 1.a-1.m of intradermal
injection.
Quick, smooth injection is easier with
proper position of syringe.
Pinching skin elevates subcutaneous
tissue.
Quick, firm injection minimizes
discomfort.
Injection requires smooth manipulation
of syringe parts. Movement of needle
may cause discomfort.
Aspiration of blood indicates
intravenous placement of needle so
procedure may have to be repeated.
Quickly withdraw the needle while
applying pressure on the injected site
with the alcohol swab.
Gently massage the site. Massage is
contraindicated for some medication
like insulin.
Place back of client into a comfortable
position.
Do procedure #8-10 of intradermal
injection.
Supporting tissue around
injection site minimizes
discomfort.
Stimulates circulation and
improves drug distribution and
absorption.
Promotes comfort.
See rationale #8-10 of
intradermal injection.
• INTRAMUSCULAR (IM) INJECTION
• The administration of drug/medication
into the muscle tissue.

• PURPOSE
• Used to promote rapid drug absorption.
• Provides alternate route when drug is
irritating to subcutaneous tissue.
• Dorsogluteal site :
Place hand on iliac crest
and locate the posterosuperior
iliac spine. Draw an imaginary
line between the trochanter
and the iliac; the injection site
is the outer quadrant.
• Ventrogluteal site :
Place palm of left hand on
right greater trochanter so
• that index finger points toward
anterosuperior iliac spine;
spread thumb and middle of
the V.
NOTE: BE SURE NOT TO HIT THE
SCIATIC NERVE
IN DOING
INTRAMUSCULAR
INJECTION IN
VENTROGLUTEAL
AND
DORSOGLUTEAL
SITES
• Vastus lateralis :
Identify greater
trochanter; place
hand at lateral
femoral condyle;
injection site is
middle third of
anterior lateral
aspect.
• Deltoid :
Locate the lateral side of
the humerus from two to
• three fingerwidths below the
acromion process in adults or
one fingerwidth below the
acromion process in children.
 PROCEDURE
Follow the general procedure for giving
injections (1.a-1.m of intradermal injection).
Using the non-dominant hand, grasp skin, or
pinch a generous section of tissue firmly for thin
or emaciated client.
Inject needle quickly and firmly at a 90o angle.
Transfer non-dominant hand to the barrel of the
syringe to steady it and position dominant hand
to the end of the plunger.
Pull back the plunger (aspirate) to ascertain if
needle is in a vein. If no blood appears, slowly
inject the medication.
Quickly withdraw the needle while applying
pressure with the cotton ball then massage the
site gently.
Do procedure #8-10 of intradermal injection.
RATIONALE
See rationale 1.a-1.m of intradermal
injection.
Needle penetrates tight skin easier
than loose skin.
Quick injection minimizes discomfort.
Injection requires smooth manipulation
of syringe parts.
Aspiration of blood indicates
intravenous is injected, vein maybe
injured.
Stimulates circulation and improves
drug distribution and absorption.
See rationale #8-10 of ID injection.
• INTRAVENOUS DRUG
ADMINISTRATION
• IV Medication
administration
refers to the
process of giving
medication directly
into the patient's
vein.
• It is one of the fastest ways to deliver
medication

• It initiate a rapid systematic response to

medication
Verify medication card against the written doctor’s prescription
Observe the 10 R’s when preparing and administering medication
Explain procedure to reassure patient and S.O (the name of the medicine & action! interaction
of medication) before administration.
Do hand hygiene before and after the procedure. (use gloves especially for chemotherapy &
other vesicant drugs.)
Check the patency and other reaction signs of swelling, redness, phlebitis, etc. do not give the
drug.
Check for skin test result of the drug for IV push, drug- drug, drug IV fluid incompatibility,
dosage, computation).
Prepare the necessary materials for the procedure such as: right drug, right diluents needed, IV
injection tray, syringes and needles, alcohol, etc.
Disinfect injection port of the diluents, vial or ampule as appropriate.
Aspirate the right amount of Diluents for the drug (if the drug needs to be diluted).
Aspirate the right drug dose; disinfect the Y injection port of the IV administration set! catheter
IV port.
Close the ruler clamp of the IV tubing from the bottle and push IV drug aseptically and slowly
according to the manufacturer’s recommendation.
Using same syringe, aspirate 1-2cc of IVF to flush the medicine given
Regulate rate of IV fluid infusion as prescribed. (if needed)
Reassure patient and observe for signs & symptoms of adverse drug reaction.
Discards sharps and other waste according to Health Care Waste Management.
Thank you!