Seeking tips on how to give painless intradermal injections

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    I have a new job at allergist's office, and I will be the only nurse. I am afraid that I am not very good at the intradermal injections. I have not done very many of them before this job. I have done a few TB tests at a previous job. I have no problem getting the wheal, but I am afraid that I am hurting the patient, once I inject the allergen. I practiced at home, one injection on my daughter and one on my son. They were both fine with the wheals, however, once I injected the saline, they said that it burned. What am I doing wrong? Being on the receiving end of tb injections, I have had some that burned, one that actually was sq, and I have had a few that were absolutely painless. Please, if anyone can offer suggestions on giving a painless ID injection. I have given many SQ and IM's with no problems, but I can't get the hang of ID's. And, I have to do many of them for the allergy testing. I just don't want to hurt anyone. There are too many injections for one patient. I even tried the injection on myself, and it really burns once I inject the saline. I let the alcohol dry, too. I have done about 4 tests. Actually I think my first two tests were better injection techniques. At least, my pts. said that they didn't hurt too bad.
  2. 7 Comments so far...

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    Keep in mind that a lot depends on the pH ect. of what you are injecting. Some things burn no matter what you do. Make sure you're not pushing the plunger too fast.

    It takes some practice to inject and talk at the same time, but the best way I've found to minimize pain during any injection is distraction. The more they focus on the needle, the more it will hurt.
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    I just had a TB test at work and it was absolutely painless! I noticed that she went very slow and with a lot of traction when inserting the needle, then injected very slowly as well.
    GeauxNursing likes this.
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    What happened when you got the intradermal in the subcu tissue? Any adverse effects? Did you have any reaction or did they have to redo the test? Just peaked my curiousity!
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    I don't have any tips, but I wish the nurse who gave my allegy shots would find out. They hurt. I get one in each arm. When I was a lot younger I got them for a short time, but they never hurt at all. This time they do. I'm thinking of taking my serum and going elsewhere because normally I'm not a wimp. Tetanus shots don't bother me, but these do.
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    I used to give allergy shots to a patient who said I hurt less than the allergy office. I always changed the needles after drawing them up, she said she never saw them change the needles. Don't know if that or my technique that made the difference.
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    Changing the needle (as the poster above me mentioned) & rubbing the site fast and hard with an alcohol pad (to overload the nerve endings with stimuli) help reduce pain.
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    As a long term recipient of allergy shots, I think the burning comes from the serum. At low concentrations, it's not too bad, but once it starts to get more concentrated, the burning can get pretty intense. Sometimes I don't even feel the needle, but 2-3 seconds after, the burn would bring me to tears! Ice packs immediately after help a lot (nerve endings feel cold instead of pain) but it's not always practical to give away ice packs. Maybe a few ice cubes in a baggie would help numb the initial pain.

    But I definitely don't recommend going super slow. That hurts the MOST!


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