IM & SC Injection Technique

Question 1

What needles are used for drawing up the drug into the syringe?

Answer 1

Red needles that are not sharp

Reduces risk of sharps injury and have a filter to reduce likelihood of contamination with tiny pieces of glass/rubber

Question 2

What needles are used for IM injection?

Answer 2

Blue (children, deltoid)

Green (adults, buttock or vastus lateralis)

Question 3

What needles are used for SC injection?

Answer 3

Brown or orange

Question 4

How to prepare the patient for an injection?

Answer 4

• Promotecomfortandrelaxation
• Explainreasonforinjection
• Describetheprocedure/obtaininformedconsent
• Check forany allergies/historyofanaphylaxis
• Checkprescription/drug/patient identify
• Checkexpirydatesandrecordlotnumbers
• Avoidover­exposureofpatient
• Positioningofpatient

Question 5

Procedure for injections

Answer 5

Selectsite
Selectcorrectneedlelengthandsyringe
Washhandsandapplygloves
Prepare injectionsusingaseptictechnique
Checkpatientidentity
Skinpreparation(localpolicy)
Injectslowlyandremoveneedle
Documentprocedure
Reviewtheindividualas appropriate

Question 6

Where in the buttock do you inject?

Answer 6

Ventro or dorsogluetal

Always in superior lateral quadrant, and then in the superior lateral quadrant of that (double cross)

Question 7

Where in the thigh do you inject?

Answer 7

Divide thigh into 3 lengthways

Inject in lower border of upper 1/3

Question 8

Where do you inject in the deltoid?

Answer 8

5cms below greater tuberosity

Question 9

What technique ensures the injected fluid doesn’t leak out when you withdraw the needle?

Answer 9

Z track
•Pullskintaut
•Keepingskintautwithheel ofhandinsertneedleata90ºangle
•Aspirateplungerover5/­10secondsnotinganyblood
•If clearinject1mlevery10seconds
•Wait10secondsbeforeremovingneedle
•Keepskintautuntilneedleremoved

Question 10

How many mls is maximum recommended at each IM site?

Answer 10

Deltoid max 0.5-1ml

Vastus lateralis/gluteal max 2-4ml

Question 11

Where can you inject sub cutaneously? Which is fastest absorbed?

Answer 11

Arms, thighs, abdomen, buttocks

Abdo absorbed fastest

Question 12

SC injection technique

Answer 12

Liftskinfold (pinch)
Punctureskinat45degrees
Donotaspirate
Injectslowlyandremoveneedle
Releaseliftedskinfold

Question 13

Potential complications of injections

Answer 13

• Infection
• Incorrectlocationofinjectate
• Pain
• Anaphylaxis
• Longandshorttermnervedamage
• Intramuscularhaemorrhage
• Hittingabloodvessel
• Sterileabscess
• Lipodystrophy

Question 14

Needlestick management?

Answer 14

• Bleedwoundunderrunningwater (don’t squeeze finger)
• Washwithsoapandwater
• Attend OccupationalHealthdept– assessriskand
take appropriateaction
• Identifysourceofcontaminationeg patientdetails
• DocumentandReportincident