The Procedure
Administering an intradermal injection:
AIM: The aim of this injection is to inject a small amount of the drug locally, ie. not for systemic administration. This type of injection has several uses, including allergy tests and vaccinations.
1. Collect your equipment in a tray. Make sure that the sterile packaging is intact before opening, and that any drugs are correct and still within their expiry dates. Using the larger needle, draw up the required amount of the prescribed medication into your syringe (it can be easier to tip the container up-side down in order to do this.)
2. Re-check the patient's details and the drug chart to ensure that you have the correct drug and dose.
3. Introduce yourself to the patient and explain the procedure. Obtain consent.
4. Wash your hands and put on the gloves.
5. Select an appropriate injection site. This will ideally be more lightly pigmented areas of skin that are thinly keratinised with little or no hair. Commonly used areas include the forearm, upper arm, shoulder blades or the upper chest.
6. Clean the desired injection site with the alcohol swab, and allow the site to dry or else the injection will sting more.
7. Remove the larger 'drawing-up' needle from the syringe, and replace it with the smaller needle for the injection itself. Remember to use the specially designed edge of the sharps bin for needle removal - do not resheath the needle (minimise any needle-stick injury risks to yourself). Pull the skin at the injection site back and hold it taut.
8. Hold your needle parallel to the surface of the skin, with the bevel of your needle facing upwards.
9. Insert the needle a short distance (around 3-4mm) under the epidermis. Try to avoid penetrating the subcutaneous tissues. Unlike with other injections, do not aspirate once the needle has been inserted beneath the skin.
10. Inject the desired medication slowly under the skin, forming a subcutaneous 'bleb'.
11. Once done, swiftly withdraw the needle.
12. Wipe the area clean with the cotton wool or gauze, but do not apply pressure or massage the area, as this will disperse the medication.
13. Dispose of all of your sharps immediately and thank the patient.
14. Document in the notes what you have injected and why.
