Apply gloves and cleanse the injection site with antiseptic swab in a circular motion. Allow to air dry. With the thumb and index finger of the nondominant hand, spread the skin taut. Insert the needle, with the bevel facing upward, at an angle of 10–15°. Advance the needle until the entire bevel is under the skin; do not aspirate. Slowly inject the medication to form a small wheal or bleb. Withdraw the needle quickly, and pat the site gently with a sterile 2 × 2 gauze pad. Do not massage the area. Instruct the patient not to rub or scratch the area. Draw a circle around the perimeter of the injection site. Read in 48 to 72 hours. Subcutaneous-- medication delivered beneath the skin o Delivered to the deepest layers of the skin o Insulin, heparin, vitamins, some vaccines, and other medications are given in this area because the sites are easily accessible and provide rapid absorption.
o Body sites that are ideal for subcutaneous injections include the following: Outer aspect of the upper arms, in the area above the triceps muscle Middle two-thirds of the anterior thigh area Subscapular areas of the upper back Upper dorsogluteal and ventrogluteal areas Abdominal areas, above the iliac crest and below the diaphragm, 1.5 to 2 inches out from the umbilicus. o Small in volume ranging from 0.5 to 1mL o Needle size depending on the patients quantity of body fat o The length is usually half the size of a pinched/bunched skinfold that can be grasped between the thumb and forefinger. o It is important to rotate injection sites in an orderly and documented manner to promote absorption, minimize tissue damage, and alleviate discomfort. For insulin, however, rotation should be within an anatomic area to promote reliable absorption and maintain consistent blood glucose levels. o When performing subcutaneous injections, it is usually not necessary to aspirate prior to the injection. o Note that tuberculin syringes and insulin syringes are not interchangeable, so the nurse should not substitute one for the other. o Administration Guidelines Verify the order and prepare the medication in a 1- to 3-mL syringe using a 23- to 25-gauge, 1 ⁄ 2 - to 5 ⁄ 8 -inch needle. For heparin, the recommended needle is 3 ⁄ 8 inch and 25–26 gauge. Choose the site, avoiding areas of bony prominence, major nerves, and blood vessels. For heparin and other parenteral anticoagulants, check with agency policy for the preferred injection sites. Check the previous rotation sites and select a new area for injection. Apply gloves and cleanse the injection site with antiseptic swab in a circular motion.
Allow to air dry. Bunch the skin between the thumb and index finger of the nondominant hand. Insert the needle at a 45° or 90° angle depending on body size: 90° if obese; 45° if average weight. If the patient is very thin, gather the skin at the area of needle insertion and administer at a 90° angle. Inject the medication slowly.