This document outlines the procedure for administering subcutaneous injections, detailing the preparation, identification of the patient, injection techniques, and post-procedure care. It emphasizes the importance of aseptic technique, proper disposal of materials, and precautions regarding multi-use versus single-use devices. Additionally, it provides guidelines for evaluating patient responses and ensuring safety during the procedure.

1. NABH BASE
NURSING CARE PROCEDURE
SUBCUTANEOUS INJECTION
DR.ANJALTCHI MUTHUKUMARAN
Vice principal cum Nursing Supt
ELMCH, era university

2. ABBREVIATION
 OD
 BD/b.i.d
 TDS/t.i.d
 IM
 IV
 ID ,
 SC , H.S
 IVP, stat, hs,
 Syrup.

3. DEFINITION OF SUBCUTANEOUS INJECTION

4. ROUTE OF INJECTION SITE

5. TYPE OF INJECTION

6. RIGHT OF THE INJECTION ADMINISTRATION

7. ARTICLES FOR PROCEDURE

8. PROCEDURE

9. MIXING OF TWO MEDICINE IN VIAL

10. HOW TO WITHDRAW THE MEDICINE FROM VIAL

11. HOW TO GIVE INJECTION

12. DEGREE/POSITION TO GIVE INJECTION

13. INJECTION TECHNIQUES

14. SITE FOR SUBCUTANEOUS INJECTION

15. CHILDREN IMAGES FOR SC

16. PROCEDURE
 Assemble equipment and check physician’s order.
 Explain procedure to patient.
 Perform hand hygiene.
 If necessary, withdraw medication from ampule or
vial.
 Identify patient carefully. Close curtain to provide
privacy. Don disposable gloves (optional).
 Have patient assume a position appropriate for the
most commonly used sites.
 Outer aspect of upper arm- Patient’s arm should be
relaxed and at side of body.
 Anterior thighs- Patient may sit or lie with leg relaxed.

17. CONTINUED
 Abdomen-Patient may lie in a semirecumbent position.
 Locate site of choice (outer aspect of upper arm,
abdomen, anterior aspect of thigh, upper back, upper
ventral or dorsogluteal area). Ensure that area is not
tender and is free of lumps or nodules.
 Clean area around injection site with an alcohol swab.
Use a firm circular motion while moving outward from the
injection site. Allow antiseptic to dry. Leave alcohol swab
in a clean area for reuse when withdrawing the needle.
 Remove needle cap with nondominant hand, pulling it
straight off.

18. CONTINUED
 Grasp and bunch area surrounding injection site or
spread skin at site.
 Hold syringe in dominant hand between thumb and
forefinger. Inject needle quickly at an angle of 45 to
90 degrees, depending on amount and turgor of
tissue and length of needle.
 After needle is in place, release tissue. If you have a
large skin fold pinched up, ensure that the needle
stays in place as the skin is released. Immediately
move your nondominant hand to steady the lower
end of the syringe. Slide your dominant hand to the
tip of the barrel.

19. CONTINUED
 Aspirate, if recommended, by pulling back gently on
syringe plunger to determine whether needle is in the
blood vessel. If blood appears, the needle should be
withdrawn, the medication syringe and needle
discarded, and a new syringe with medication
prepared. Do not aspirate when giving insulin or
heparin.
 If no blood appears, inject solution slowly.
 Withdraw needle quickly at the same angle at which it
was inserted.
 Massage area gently with alcohol swab. (Do not
massage a subcutaneous heparin or insulin injection
site.) Apply a small bandage if needed.

20. CONTINUED
 Do not recap used needle. Discard needle and
syringe in appropriate receptacle.
 Assist patient to a position comfort.
 Remove gloves, if worm, and dispose of them
properly. Perform hand hygiene.
 Chart administration of medication, including the site
of administration. This charting can be done on
CMAR.
 Evaluate patient response to medication within an
appropriate time frame.

22. PRECAUTIONS

23. ADVANTAGES

24. DISADVANTAGES

25. NURSES RESPONSIBILITY

26. SAFETY PRACTICES
 Prepare injections using aseptic technique in a clean
area.
 Disinfect the rubber septum on a medication vial with
alcohol before piercing.
 Do not use needles or syringes for more than one patient
(this includes manufactured prefilled syringes and other
devices such as insulin pens).
 Medication containers (single and multidose vials,
ampules, and bags) are entered with a new needle and
new syringe, even when withdrawing additional doses for
the same patient.
 Use single-dose vials for parenteral medications when
possible.

27. SINGLE-USE (DISPOSABLE) DEVICES
 What is a single-use device?
 According to the Food and Drug Administration’s
(FDA’s) guidance entitled Labeling
Recommendations for Single-Use Devices
Reprocessed by Third Parties and Hospital sexternal
icon, “a single-use device, also referred to as a
disposable device, [is] intended for use on one
patient during a single procedure. It is not intended to
be reprocessed (cleaned, disinfected/sterilized) and
used on another patient.
 The labeling may or may not identify the device as
single-use or disposable and does not include
instructions for reprocessing.”

28. CONTINUED
 Use single-dose vials for parenteral medications
when possible.
 Do not use single-dose (single-use) medication
vials, ampules, and bags or bottles of
intravenous solution for more than one patient.
 Do not combine the leftover contents of single-
use vials for later use.
 The following apply if multidose vials are used:
 Dedicate multidose vials to a single patient
whenever possible.

29. CONTINUED
 If multidose vials will be used for more than one
patient, they should be restricted to a
centralized medication area and should not
enter the immediate patient treatment area
(e.g., dental operatory) to prevent inadvertent
contamination.
 If a multidose vial enters the immediate patient
treatment area, it should be dedicated for
single-patient use and discarded immediately
after use.

30. CONTINUED
 Date multidose vials when first opened and
discard within 28 days, unless the manufacturer
specifies a different date.
 Do not use fluid infusion or administration
sets (e.g., IV bags, tubings, connections) for
more than one patient.

31. REFERENCES
 CDC. Basic Expectations for Safe Care Training
Module 6 – Safe Injection Practices. Available
at: https://www.cdc.gov/oralhealth/infectioncontr
ol/safe-care-modules.htm. Accessed May 8,
2018.
 CDC. Summary of Infection Prevention
Practices in Dental Settings: Basic Expectations
for Safe Care. Available
at: https://www.cdc.gov/oralhealth/infectioncontr
ol/pdf/safe-care2.pdf pdf icon[PDF – 834 KB].
Accessed March 31, 2016.