Subcutaneous injections involve injecting medication into the subcutaneous fat layer just below the dermis. Only small doses of water-soluble medications are given this way due to the tissue's sensitivity. Common sites for subcutaneous injections include the outer arm, back, abdomen, and thighs. The procedure involves preparing medications and supplies, positioning the patient, cleaning the injection site, quickly inserting the needle at a 45-90 degree angle, injecting the medication slowly, withdrawing the needle, and applying pressure. Potential complications include fat necrosis, erythema, abscess formation, cellulitis, and nodule formation.

1. SUBCUTANEOUS
INJECTION
Presented by: Ganga Tiwari
BSc. Nursing Fourth year, Teaching
Learning
TU,IOM,MNC, Kathmandu, Nepal

2. Different gauge of needle:

3. Subcutaneous injection:
 Subcutaneous injection involves
injecting medication into the adipose
tissue (sub cutaneous layer of fat)
below dermis and above the muscle
tissue.
 This tissue has few blood vessels, so
drug administered here have slow and
sustained absorption into the
capillaries.

4. Introduction contd…
 Only small dose (0.5 ml to 1 ml) of
water soluble medications is given
subcutaneously because tissue is
sensitive to irritating solution and large
volume of medication

5. Common sites:
 Outer aspect of upper arm.
 Posterior chest wall below the
scapula.
 Anterior abdominal wall.(2 inches
around the umbilicus)
 Anterior and lateral aspects of thigh.

6. Common sites:

7. Articles
 Medication cardex.
 Medication tray
 Kidney tray
 Spirit swab
 Sterile syringe and needle
 Prescribed medications in ampule or
vial
 Disposable gloves
 Medicine cutter/ opener
 Puncture proof container

8. Procedure
 Check medication instructions.
 Identify the patient carefully.
 Explain procedure to the patient the drug
that is to be administer, site and how to
co-operate.
 Wash hands
 Set up medication tray with necessary
articles.
 Assemble all articles including loaded
syringe near the patient bed side.

9. Contd..
 Maintain privacy.
 Help the patient to assume the position
depending upon the site selected.
 -anterior thigh: sitting or lying down with
muscle relaxed
 - Abdomen: patient should lie on semi
recumbent position.
 -Scapular: patient may be prone, lateral
or sitting position.
 -Outer aspect of upper arm: arm relaxed
at the side of the body

10. Contd..
 Assess the area. Check for lumps,
nodules, tenderness, hardness,
swelling, scaring, itching, burning
sensation and localized inflammation
in the area.
 Wear gloves
 Clean the area around the injection
site with spirit swab. Use firm circular
motion while moving outward (about 5
cm in diameter).allow antiseptic to dry.

11. Contd..
 Remove the needle cap with non-
dominant hand pulling it straight off.
 Grasp and pinch the area around the
injection site (obese and normal
person) or spread skin at site( thin
person).
 Hold the syringe in dominant hand
between thumb and fore finger. Inject
the needle quickly at an angle 45 to 90
degree.

12. Contd..
 After insertion, release the tissue
immediately moves your non-dominant
hand to steady the lower end of the
syringe. Slide your dominant hand to top
of the barrel.
 Aspirate by holding the barrel steady
with non-dominant hand. Withdraw the
needle if blood appears in the syringe,
discard and prepare new injection. Do
not aspirate heparin is anticoagulant and
causes bruising on aspiration.

13. Contd..
 Inject medication slowly if no blood
appears.
 Withdraw the needle quickly at the
same angle as it was inserted while
applying counter traction around the
injection site with non-dominant hand.
 After withdrawing the needle apply
gentle pressure.

14. Contd..
 Do not massage the heparin and
insulin injection site. Massaging
heparin site can lead to bruising.
Massaging insulin site can lead to
unpredictable absorption

15. Contd..
 Assist the patient to comfortable
position.
 Discard the syringe and the needle in
puncture proof container and discard
gloves and other soiled articles in an
appropriate container.
 Wash hands.
 Document the administration of
medication with date, time, route, sites
and nurse signature.

16. Complications
 Fat necrosis
 Erythema
 Abscess
 Cellulitis
 Formation of nodule.

17. Cellulitis

18. Complications of sub cut
injection

19. References
 Basvanthappa,B.T.(2004). Fundamentals of Nursing. New
Delhi :Jaypee Brothers.
 Perry, A.G. and Potter, P.A. (2007).Basic Nursing Essentials
For Practice .(sixth edition): Mosby
 Giri, M. and Sharma,P. (2013). Essential Fundamental Of
Nursing.(first edition).Kathmandu: Medhavi Publication.
 Pathak ,S.and Devkota ,R.(2011).A Textbook Of
Fundamentals of Nursing.(second
edition).Kathmandu:Vidyarthi Prakashan.
 Taylor,C.R. and Lillis,C.(2008). Fundamental Of
Nursing.(Volume1):Lipincott William and Willikins
 Health learning material center. Institute Of
Medicine,Tribhuvan University.Fundamental Of Nursing
(Second Edition ,reprint,2010).Kathmandu Dillibazar.
Heidel Press.

20. THANK YOU !!