This document discusses different types of injections and injection techniques. It describes intradermal injections which are administered just under the skin, subcutaneous injections which are used for slow, sustained absorption of medications like insulin into fatty tissues, intramuscular injections which deliver medications into muscles for rapid systemic action, and intravenous injections which deliver fluids directly into blood vessels. It provides details on sites, needle sizes, and proper techniques for each type of injection to ensure safety and effectiveness.

1. TYPES OF INJECTIONS

3. INJECTION TECHNIQUE
GIVING AN INJECTION SAFELY IS CONSIDERED TO BE A ROUTINE ACTIVITY. HOWEVER, IT
KNOWLEDGE OF ANATOMY AND PHYSIOLOGY, PHARMACOLOGY, PSYCHOLOGY,
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
WASTE THAT IS DANGEROUS FOR THE COMMUNITY.

4. 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

5. INTRADERMAL INJECTION
SUBCUTANEOUS INJECTION
INTRAMUSCULAR INJECTION
INTRAVENOUS INJECTION
INJECTION TECHNIQUE

7. 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.

8. 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.

9. 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 (+)

10. SUBCUTANEOUS INJECTION
• Subcutaneous tissue lies between the epidermis and the muscle.
• Subcutaneous route is used for slow, sustained absorption of medication.
• Used commonly for insulin injections
• Heparin

11. 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

12. 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.

13. 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.

14. 5 SITES ACCEPTABLE FOR IM INJECTION
• Deltoid 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)

15. 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.

17. 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)

18. peripheral venous catheter
A device used to draw blood and give treatments,
including intravenous fluids, drugs, or blood
transfusions.
A thin, flexible tube is inserted into a vein, usually
in the back of the hand, the lower part of the arm,
or the foot. A needle is inserted into a port to draw
blood or give fluids.

19. USE
• The catheter is introduced into the vein by a needle (similar to blood drawing), which is subsequently
removed while the small plastic cannularemains in place. The catheter is then fixed by taping it to the
patient's skin or using an adhesive dressing.
• A peripheral venous catheter is the most commonly used vascular access in medicine. It is given to
most emergency department and surgical patients, and before some radiological imaging techniques
using radiocontrast, for example. In the United States, in the 1990s, more than 25 million patients had
a peripheral venous line each year.[1]
• A peripheral venous catheter is usually placed in a vein on the hand or arm. It should be distinguished
from a central venous catheter which is inserted in a central vein (usually in the internal jugular vein of
the neck or the subclavian vein of the chest), or an arterial catheter which can be placed in a peripheral
or central artery. In children, a topical anaesthetic gel (such as lidocaine) may be applied to the
insertion site to facilitate placement

20. COMPLICATIONS
• Infection, phlebitis, extravasation, infiltration, air
embolism, hemorrhage (bleeding) and formation of a hematoma (bruise) may
occur. Because of the risk of insertion-site infection the CDC advises in their
guideline that the catheter needs to be replaced every 96 hours.[2]However, the
need to replace these catheters routinely is debated.[3] Expert management has
been shown to reduce the complications of peripheral lines.[1][4]
• Sizes
• Sizes of peripheral venous catheters can be given by Birmingham
gauge or French gauge. Gauge and diameter are inversely proportional

21. INFUSION SYSTEM
• An infusion system is a device, and any associated disposables, used to deliver
fluids or drugs in solution to the patient. The common routes are: intravenous,
subcutaneous, epidural or enteral.
• The simplest devices, gravity controllers, employ a clamping action to vary the
flow of liquid under the force of gravity. More complex systems use a positive
pumping action for infusion. The simplest of these is an elastomeric pump which
has a balloon reservoir which contracts delivering the infusion at a constant rate