ADMINISTERING MEDICATIONS –INJECTIONS IN HEALTHCARE PRACTICES
- Prof. Usha Dabas
- Jun 13
- 4 min read
An injection is a way of administering a medication in a sterile fluid/ liquid form into the body tissues beneath the skin, usually using a sharp needle. Injections are among the most common health care procedures, with a large amount administered in developed and developing countries each year. Although majority of injections are administered for treatment purpose or to cure a condition, many are administered for the purpose of immunization and other purposes, such as during phlebotomy procedures, IV administration, for blood transfusions, recreational and healthcare. Injections are characteristically sterile solutions, emulsions or suspensions and prepared by dissolving, emulsifying or suspending an active ingredient and other substances in water for injection.
The three main routes of injection are- intradermal (ID), subcutaneous (SC) and intramuscular (IM). Each type targets a different skin layer such as dermis, adipose tissue or fat layer, underneath the skin or delivered into the muscle.
Intradermal injections (ID)- Intradermal injections (ID) are the injections administered into the dermis, just below the epidermis (outer most layer). Intradermal route is used for sensitivity tests, like Tuberculin, allergy tests, and for local anesthesia. The ID injection route has the longest absorption time of all parenteral routes. Intradermal (ID) vaccine administration technique is product-specific and should be administered as per product information. The inner forearm is the preferred site for ID injections. ID injections should be administered at a 5° to 15° angle.
Subcutaneous injections (SC)- Subcutaneous injections (SC) Injections are also referred to as ‘subcut’, ‘sub-Q’, or ‘SQ’ injections. Subcutaneous (SC) injections are administered into the adipose tissue layer just below the epidermis and dermis. This tissue has few blood vessels, so drugs administered by this route have a slow, sustained rate of absorption. Subcutaneous injections are highly effective in administering vaccines and medications such as insulin, heparin and morphine. Insulin injection is one of the most common SC injections and can be considered a high-risk medication, and special care must be taken to ensure the correct amount of medication and type of insulin is administered. Heparin SC Injections also considered a high-alert medication injections administered with due care. Sites for SC injections include the areas such as the outer aspect of the upper arm, the abdomen- around the belly button, anterior aspects of the thighs etc. SC injections for vaccine recipients 12 months of age and older are usually given into subcutaneous tissue of the upper triceps area of the arm. SC injections should be administered at a 45° angle.
Intramuscular injections (IM)- Intramuscular injections are very commonly administrated in form of a vaccine, like the Covid shot, flu shot or tetanus, vitamin B 12 etc. Intramuscular injections of vaccine are administered into the anterolateral thigh muscle (vastus lateralis) in newborns, preterm infants and infants less than 12 months of age. The anterolateral thigh or the deltoid muscle can be used for toddlers and older children. The deltoid muscle of the arm is the preferred injection site in adolescents and adults. An intramuscular injection allows the medication to be absorbed into the bloodstream quickly.
Clinical judgment should be used while selecting needle length for these injections as consideration should be given to vaccine recipient's weight, gender and age. IM injections should be administered at a 90° angle. The skin should be stretched flat (between thumb and forefinger) at the time of administration. A larger gauge needle (e.g., 22 gauge) may be required when administering viscous or larger volume products such as immune globulin. Muscles are vascular meaning they have a good supply of blood vessels. Hence, the medications administered into the muscles are absorbed quickly. Longer needles are sometimes necessary to reach a muscle, so IM injections may be more uncomfortable to the patients than subcutaneous injections.
Depot injections- Depot injections are slow-release or sustained-release form of medications. The injection uses a liquid that releases the medication slowly, over the period of time, so it lasts a lot longer. Depot injections can be used for various types of drugs, including birth control injections like Depo-Provera and some antipsychotics.
Prior to administering any kind of injections, a qualified administrator must be knowledgeable about the following aspects:
Knowledge and information of related anatomy and physiology
Proper, safe procedure for ID/SC/IM/Depot Injections
Performing infection control and asepsis during injection procedures
Medication orders
Patient's informed consent & documentation
Identifying the acceptable locations for all injections
Locating structures in surrounding area that, if pierced, can cause injury
Appropriate techniques of ID/SC/IM/Depot Injections
IM, SC, ID, Depot Injection equipment and supplies
Drug doses for various medications
Dos and Don’ts of IM, SC, ID, Depot Injection procedures
Various Vaccinations for children and adults-Pros and Cons, precautions
Complications in IM, SC, ID, Depot Injection and problem solving
References:
Injection Techniques/ IM injection and vaccinations-Advanced program-training/ certificate/ workshop at Springfield College helps prepare you get skills needed for a challenging career in a physician’s office, hospital or medical clinic. Students learn details and techniques of SC, ID, IM injections, various vaccines for children and adults, safe and effective Injection techniques, patient communication and preparations in healthcare.
For details of-Injection Techniques/ IM injection &vaccinations-Advanced program and best training- CONTACT:
# 19-1- Bartley Bull Parkway
(Across Shoppers World Brampton, Above Food Basics)
Brampton, ON, L6W 3T7
Tel: 905-216-1600; 416-456-6689
E-Mail: admin@springfieldcollege.ca
Very nice information and knowledge.
Informative blog on Administering Medications and injections In Healthcare Practices.