Administering intradermal injections

Nursing, Feb 1996 by McConnell, Edwina A

DON'T

* Don't administer the injection if the patient's skin isn't completely dry because wet or damp skin can inactivate the antigen.

* Don't inject the solution until you've inserted the needle inch beyond the bevel; doing so could cause leakage.

* Don't withdraw the needle at an angle other than that at which you inserted it.

* Don't rub or massage the injection site because you could irritate the underlying tissue, which may affect test results.

DO

* Explain the procedure and reason for the injection to the patient, wash your hands, and put on gloves.

* Ask the patient to extend his arm with the ventral forearm exposed and facing upward. Select an injection site on the forearm (unless another site is required under your institution's policy or the physician's order).

* Clean the injection site with alcohol, making sure the site is free from hair or blemishes. Allow the skin to dry completely.

* Fill a small-barrel syringe-such as a tuberculin syringe with the prescribed solution, using a fine, 26 or 27-gauge-3/8inch needle.

* With your nondominant thumb placed about 1 inch (2.5 cm) away from the insertion site, stretch the skin downward toward the patient's hand.

* With your dominant hand, insert the needle at a 15-degree angle to the patient's arm, bevel up.

* Advance the needle about inch below the epidermis, stopping when the needle's bevel tip is under the skin. Make sure you can still see the outline of the needle just under the skin.

* Slowly inject the solution, observing for bleb formation. Withdraw the needle at the same angle at which you inserted it.

* If necessary, gently remove blood by dabbing the injection site with an alcohol swab.

* Circle injection sites with a felt-tip marker, putting a number above each site.

* Document the solution that corresponds to the number. Indicate the date and time of injection and the date and time the test results should be read.