This document provides information on injection technique. It begins by explaining that giving injections safely requires knowledge in various areas like anatomy, pharmacology, and communication skills. It then defines what an injection is and identifies the main parts of a syringe. The document proceeds to discuss skin anatomy and different injection sites. It provides details on intradermal, subcutaneous, and intramuscular injection techniques, including needle and syringe selection, administration steps, and recommended sites for each. Proper hand washing and infection control are emphasized throughout.

1. NJECTION TECHNIQUE
PAOLO M. ZABAT, RN

2. INJECTION TECHNIQUE
Giving an injection safely is considered to be a
routine activity. However, it requires knowledge
of anatomy and physiology, pharmacology,
psychology, communication skills and practical
expertise.
A safe injection is one that does not harm the
recipient, does not expose the provider to any
avoidable risks and does not result in waste
that is dangerous for the community.

3. INJECTION
It is an infusion method of putting fluid into
the body, usually with a syringe and a
hollow needle which is pierced through the
skin to a sufficient depth for the material to be
administered into the body.
Syringe – a device made of a hollow tube and
a needle that is used to force fluids into or take
fluids out of the body

4. PARTS OF THE SYRINGE
Plunger
Barrel
Tip
Hub
Shaft
Bevel
Keep
sterile
Measure dose
here
Avoid touching

5. SKIN

6. RULES IN NEEDLE SYRINGE
SELECTION
 When looking at a needle package, the first number is the gauge
or diameter of the needle (ex: 18, 20) and the second number is
the length (ex: 1, 11/2)
 As the gauge number becomes larger, the size of the needle
becomes smaller.
 The length of the needle is directed by the size of the patient,
the selected insertion site and the tissue you are trying to reach.
(Ex: An IM injection in an emaciated person would require a
shorter needle than the same injection in an obese patient.)
 The size of the syringe is directed by the amount of medication
to be given. If the amount is less than 1ml, use a 1ml syringe. If
the amount of the medication is equal to the size of the syringe,
you may go up to the next size to prevent awkward movements
when deploying the plunger.

7. GAUGE OF THE NEEDLE SYRINGE
The larger the gauge, the smaller the size

8. INJECTION TECHNIQUE
INTRADERMAL INJECTION
SUBCUTANEOUS INJECTION
INTRAMUSCULAR INJECTION

9. INJECTION TECHNIQUE

10. INTRADERMAL INJECTION
 It is the introduction via needle of tiny amounts of fluid
into layers of skin.
 It provides a local, rather than systemic effect.
 Syringe used is 1ml tuberculin syringe because of a
very small amount of drug needed.
 Needle used is a short (1/4 to 5/8 inch), fine gauge
(g25-27).
Indications:
 For diagnostic purposes (allergies and sensitivities to
drugs)
 For administering tuberculin testing

11. INTRADERMAL INJECTION
 Intradermal literally means “between
the skin layers” and injection is
administered just under the
epidermis .
 Syringe is positioned at15˚ angle.
 Small volumes, usually 0.01 to
0.05ml, are injected because of the
small tissue space.

12. INTRADERMAL INJECTION
 Most commonly used site: Inner surface of the
forearm
 Subscapular region of the back can be used as well
as the deltoid region.

13. INTRADERMAL INJECTION
REMEMBER:
 Mixture of drug and water for skin testing: 0.9cc of
distilled water/sterile water and 0.1cc of the drug.
 Inject the solution intradermally and just enough to
form a wheal.
 Encircle the site correctly and write the time when to
check the injection site to determine reaction to the
drug.
 Check the site after 30 minutes for signs of reaction.
 If negative, document it as ANST (-); if positive,
ANST (+)

14. INTRADERMAL INJECTION
REMEMBER:
 A positive result may be manifested by any of the
following:
 Reddening of the site accompanied with marked
elevation
 Increase in circumference of the wheal
 Presence of itchiness on the site

15. PROCEDURE: ID
 Prepare all the equipment needed: 1cc syringe,
disposable needle (aspirating needle), sterile water,
drug to be tested, wet and dry cotton balls and
ballpen.
 Wash hands and observe appropriate infection
control measures.
 Introduce yourself and verify the client’s identity.
 Explain to the client what you are going to do, why it
is necessary and how the client can cooperate.
 Prepare needed materials aseptically.
 Check the label of the drug three times.

16. PROCEDURE: ID
 Prepare the medication to be used for skin testing
(e.g ampule or vial)
 Aspirate 0.9cc of distilled water/sterile water and
0.1cc of the drug using the tuberculin syringe with the
aspirating needle.
 Mix the drug and the distilled water in the syringe.
 Replace the aspirating needle with g25 needle.
 Expel excess air.
 Place the syringe on the tray together with the wet
and dry cotton balls.

17. PROCEDURE: ID
 Confirm again patient’s identity.
 Locate the appropriate site for skin testing.
 Cleanse the medial surface of the forearm by using
firm, circular motion from inner to outer portion.
 Allow the skin to dry before injecting the drug.
 Place hand in non-dominant hand of the patient.
 Remove needle cap and holds syringe at 15 degrees
angle from skin with bevel up.
 Stretch the skin and tell the patient that he/she will
feel a prick as needle is inserted.

18. PROCEDURE: ID
 Inject the solution intradermally and
just enough to form a wheal.
 Remove the needle quickly but
gently at the same angle used for
injection.
 Wipe with dry cotton ball but do not
press the injection site.
 Encircle the site correctly and write
the time when to check the injection
site to determine reaction to the
drug. Check the site after 30
minutes.

19. SUBCUTANEOUS INJECTION
 Subcutaneous tissue lies between the epidermis and
the muscle.
 Subcutaneous route is used for slow, sustained
absorption of medication.
 SC or SQ
Indications:
 Used commonly for insulin injections
 Heparin

20. SUBCUTANEOUS INJECTION
 Common sites used for SQ
route:
 Outer aspect of the upper
arm
 Abdomen(from below the
costal margin to the iliac
crests)
 Anterior aspects of the thigh
 Upper back
 Upper ventral or dorsogluteal
area

21. SUBCUTANEOUS INJECTION
REMEMBER:
 Hold syringe in the dominant
hand between the thumb and
forefinger.
 Inject the needle quickly at an
angle of 45 to 90 degree,
depending on the amount and
turgor of the tissue and the length
of the needle.

22. INTRAMUSCULAR INJECTION
 The intramuscular (IM) route injection delivers
medication into well perfused muscle, providing rapid
systemic action and absorbing relatively large doses.
 Gastric disturbances do not affect the medication.
 Clients does not need to be conscious to receive the
medication.
 Absorption occurs even more rapidly than with SQ
route because of greater vascularity of muscle tissue.
 Irritating drugs are commonly given IM because very
few nerve endings are in deep muscle tissues.

23. 5 SITES ACCEPTABLE FOR IM
INJECTION
muscle of the upper arm –
Preferred site for vaccinations in adults.
 Dorsogluteal – Performed by entering
through the gluteus maximus muscle. Care
should be given to avoid damage to the
sciatic nerve and vessels surrounding this
area.
 Ventrogluteal – Safer option which
accesses the gluteus medius muscle.
(Primary location for IM use as it avoids all
major nerves and blood vessels)
 Deltoid

24. 5 SITES ACCEPTABLE FOR IM
INJECTION
 Vastus Lateralis – A quadriceps muscle situated on
the outer side of the femur and is used as a primary
site for children. It does have risks associated to it due
to overuse but has been suggested safe for children
up to seven months old.
 Rectus Femoris – Anterior quadriceps muscle which
is rarely used by physicians/nurses but is easily
accessed for self- administration, or for infants.

25. SITES ACCEPTABLE FOR IM
INJECTION

27. INTRAMUSCULAR INJECTION
REMEMBER:
 3cc syringe can be used for IM
injection with g22 or 23 needle; 1-2
inches long
 Position the needle at 90˚ angle.
 Do not forget to aspirate the
plunger once injected to check for
blood. (To determine if a blood
vessel was hit)
 Inject
medication
slowly
(To
minimize pain)

28. INTRAMUSCULAR INJECTION
REMEMBER:
 Apply
pressure to site and
massage
after
(To
prevent
hematoma on the injection site and
prevent oozing of blood and for
proper absorption of the medicine)

29. PROCEDURE: IM
 Prepare needed materials aseptically.
 Check the label of the drug three times.
 Prepare the medication.
 Position the patient and locate the site correctly.
 Cleanse the site using circular motion from inner to
outer portion and allow it to dry.
 Place a swab between fingers of non-dominant hand.
 Pinch or spread tissue and insert needle quickly at 90
degrees angle in a dartlike position.

30. PROCEDURE: IM
 Pull back the plunger to check for blood.
 Inject the medication slowly if no blood appears.
 Withdraw needle quickly.
 Apply pressure and dry cotton ball to the site and
massage.
 Leave the client in a comfortable position.
 Dispose the syringe and other materials used
properly, wash hands and document the procedure.

31. Z TRACK INJECTION

32. Z TRACK INJECTION