Proper injection technique is crucial for effective and safe medication delivery. The specific technique varies depending on the injection type (e.g., intramuscular (IM), subcutaneous (SQ)), the patient's age and size, and the medication being administered. However, several core principles apply across most injection types.
Steps for a Safe Injection
-
Preparation: This includes hand hygiene, gathering necessary supplies (syringe, needle, medication, alcohol swabs, etc.), and verifying the medication's identity and dosage. Aseptic technique is paramount to prevent infection. See reference: Injection Techniques Clinical Skills Guidance Proper needle selection is also critical; the length and gauge should be appropriate for the patient and injection site. [See references: ACIP Vaccine Administration Guidelines for Immunization | CDC, How to Administer Intramuscular and Subcutaneous Vaccine Injections](https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/administration.html, https://www.immunize.org/news/updates/website/how-to-administer-intramuscular-and-subcutaneous-vaccine-injections-6/)
-
Site Selection: The injection site must be appropriate for the injection type and the patient. Common sites include the deltoid muscle (upper arm) for IM injections, and the abdomen or thigh for SQ injections. Consider patient factors like age, body mass, and medical conditions when choosing a site. [See references: Fundamentals: Immunization Technique for Intramuscular (IM ..., How to Administer IM (intramuscular) injections: MedlinePlus Medical ...](https://www.publichealthontario.ca/-/media/Documents/nCoV/Vaccines/2021/07/immunization-technique-intramuscular-injections-deltoid.pdf?rev=a436c0d6496249ae9707f0c0a03d0d41&sc_lang=en, https://medlineplus.gov/ency/patientinstructions/000935.htm)
-
Injection:
- Skin Preparation: Cleanse the injection site with an antiseptic swab. See reference: Injection Techniques Clinical Skills Guidance
- Needle Insertion: For IM injections, the needle is typically inserted at a 90-degree angle. For SQ injections, a 45-degree angle is often used. Stretch the skin taut at the injection site. [See references: Intramuscular Injection Technique - Intramuscular and ..., Nursing guidelines : Intramuscular Injections](https://www.nottingham.ac.uk/nursing/practice/clinicalskills/resources/procedures/imscinjection/imtech.php, https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Intramuscular_Injections/)
- Aspiration (Optional): Aspiration (pulling back on the plunger before injecting) was once standard practice to check for inadvertent blood vessel entry, but current guidelines often advise against it for routine IM vaccinations. See reference: The Injection Technique Factor: What You Don't Know or Teach Can ...
- Medication Administration: Slowly inject the medication.
- Needle Removal: Remove the needle smoothly and apply gentle pressure to the injection site. See reference: Giving an IM (intramuscular) injection: MedlinePlus Medical ...
-
Post-Injection: Dispose of the needle and syringe safely. Monitor the injection site for any adverse reactions.
Specific Considerations
- Intramuscular (IM) Injections: These injections deliver medication directly into a muscle. Proper technique is essential to ensure the medication is absorbed effectively. Needle length and angle are critical factors.
- Subcutaneous (SQ) Injections: These injections deposit medication just below the skin's surface. A shallower angle is used to prevent accidental intramuscular injection.
- Patient-Specific Factors: The ideal injection technique can vary depending on the patient’s age, weight, and overall health. Infants and children may require modified techniques and smaller needles.
