The LSUHSC New Orleans Emergency Medicine Interest Group Presents The Student Procedure Manual

Subcutaneous Injection

by Greg Jeansonne

Indications

• Patient requires medication (i.e. insulin or heparin)

Prerequisites

• Check patient allergy/contra-indications to medication
  
• Equipment Reguired
  
• Medication
  
• Syringe (smallest possible)
  
• 2 needles (18ga for loading syringe 25ga - 27ga for injection, 3/8" - 5/8")
  
• Antiseptic wipes
  
• Bandage

Procedure

1. Draw-up medication into syringe (max. volume = 1ml).
   
2. Eject air & excess medication.
   
3. Change to sharp injection needle.
   
4. Select site:
   • Common sites: lateral arm, abdomen, flank, & thigh. Avoid: bony prominences, large vessels/nerves, & inflamed/defon-ned skin areas.
5. Clean injection site with antiseptic wipe.
   
6. Pinch skin around injection site between 1st & 2nd digits.
   
7. Insert needle @ 45-90' (450 is typical).
   
8. Release skin pinch.
   
9. Inject medication slowly.
   
10. Withdraw needle quickly.
    
11. Massage area with antiseptic wipe.

Complications

• Possible tissue breakdown with repetitive injections (rotate sites)
  
• Local infection/irritation, soreness, bruising.

Follow-up

• Check for signs of tissue breakdown with chronic injection pts.