The Procedure
Administering a subcutaneous injection:
AIM: Your aim is to administer the drug just beneath the skin. This will allow slow (yet complete) absorption of the drug. Drugs commonly administered in this way, include heparin (low molecular weight heparin) and insulin.
1. Collect your equipment in a tray. Make sure that the sterile packaging is all 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. Gain clear access to your desired injection site (usually the upper arm, upper leg/thigh or the lower abdomen.)
6. Clean the skin with a single sweep of the alcohol swab. Allow the skin to dry or else the injection will sting more. 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).
7. 'Pinch' the skin, between the thumb and forefinger of your non-dominant hand, and keep a hold of this fold of skin.
8. Insert the needle into the base of this skin fold 'lump' that you have created. Enter at an angle of 20-30o.
9. Release the fold of skin from between your fingers.
10. Suck the plunger of the syringe backwards in order to ensure that the needle has not entered a blood vessel (if it has, you will aspirate blood - just pull back if this happens and apply pressure to the area.)
11. If you are ok to proceed, then slowly inject the drug.
12. Once done, withdraw the needle in one swift motion.
13. Wipe the area clean with the cotton wool or gauze.
14. Stay and check that the patient suffers no immediate (allergic/anaphylactic) reaction to the administered drug.
15. Dispose of your sharps into the sharps bin immediately.
16. Document the drug administration in the notes and/or drug chart.
17. Thank the patient and re-cover any removed clothing.
