Injections

Daytonite, BSN, RN · Oct 29, 2006

this is hard to explain, but when i'm giving an intradermal injection i try to slide the needle just under and flat with the skin. if you do this right, you can see the bump formed by the shaft of the needle through the skin. you really can't have much of a slant to the needle going in or you will end up in the sq layer. i try to think of it as putting a straight pin into a piece of fabric that i have lying on a table. you just want the needle to go through the fabric and not the table. so, what you end up doing is once you pierce that fabric you have to lower the needle so it's almost parallel with the table in order to continue pushing it through into the fabric. otherwise, you will get a scratch in the top of the table, or if it's a person, go deeper into the sq area. does that make sense to you?

here are some websites where intradermal and subcutaneous injections are addressed. some have drawings. hope you find them helpful.

http://teach.lanecc.edu/nursingskills/injmeds/intradermal.htm - instructions on how to give an intradermal injection. there is also a link to a video of giving an intradermal injection that you can click on to view.

http://teach.lanecc.edu/nursingskills/injmeds/subq.htm - instructions on how to give a subcutaneous injection. there is also a link to a video of giving a subcutaneous injection that you can click on to view.

http://cal.fmc.flinders.edu.au/gemp/clinicalskills/clinskil/default.htm - basic clinical skills. includes vital signs, bls, cardiovascular skills, respiratory skills, injection techniques, examinations of rectum, pelvis, breast and eye, iv cannulation, local anesthesia and suturing. from flinders school of medicine, bedford park, south australia. click on "injection techniques".

http://www.austincc.edu/adnlev1/rnsg1144/parenteral/sequence%20for%20sq%20injections.htm - sq injection technique step by step procedure from austin community college nursing program.

http://www2.ncn.com/~bln/skills/nur109/nur109_intradermal.htm - a short pictorial on how to give an intradermal injection. shows a nice photo of the wheal after injection.

http://flightline.highline.edu/drydberg/balckboard/injection%20equipment.htm - injection equipment and techniques: im injections. includes short discussion on needles, gauge, length and bevel, syringes and sizes (shows pictures of difference between regular and leur lock tips), what a carpuject and tubex cartridge looks like, how to draw up solutions from an ampule or a vial, im, subq, intradermal and z-track injection techniques as well as the im injection sites.

moongirl · Oct 29, 2006

didja ever as a kid fool around with a straight pin or needle and slide it just under your skin? thats what you exactly want to do for an intrad.

WDWpixieRN, RN · Oct 30, 2006

And i keep shaking, and frankly, i'm quite terrified of giving injections. My second attempt for an ID injection, yet again another failure, i ended up giving him a SQ injection. Any tips????

I totally got the eebie jeebies while watching the videos as I have always hated needles (not to the fainting point or anything) and wasn't sure I could stick other people....

So, I opened my lab kit at home, and spent the weekend poking oranges (I think that's rather old school?!?!)....and got the hang of flicking my wrist and just going for it! Interestingly, when I did my checkout, it worked the same way in the dummy!!

And then when I had clinicals the next day, and my instructor asked if I had passed injections, we headed directly to my pt's room for 2 subq's....did it just like I had been doing them all my life...it felt exactly the same!!

And knowing that there was a good reason to be doing the injection -- like helping to keep her healthy -- made it even easier.

YOU CAN DO THIS!! :smiley_ab

traumaQN · Oct 30, 2006

you can practice interdermals on hotdogs.. not oscar meyer, but the cheap kind.

sephinroth · Oct 31, 2006

Thanks for all the tips guys! I'm on sembreak, but this actually got me inspired to study more. Thanks for all the resources! I'll be practicing on tomatoes pretty soon, just got to buy some and also some syringes. Thanks again! :)

rnsrgr8t · Oct 31, 2006

You can also try getting an old fashioned bandaid (not the elastic kind) and stick it to a flat surface. You can practice injecting the pad like an intradermal injection and use water. You can get a good wheal if you do it right. The hotdog idea is great too. Good Luck! You can do it!

locolorenzo22, BSN, RN · Oct 31, 2006

Hey I did my injection demos last night and PASSED!!! NO MORE DEMOS FOR THE ENTIRE SEMESTER!! I was worried as I drew up the wrong dose for one demo, but the instructor let me start over as I was only one there and explained why I messed up. For some reason, "top of the stopper" made me think the dose was measured from the point, not the top border.....

Also, I didn't know you injected entire needle into site, thought just x inches,etc.....Much better now and am ready to go.....

Keep the faith, practice, and you'll be fine.

Thoc_123 · Nov 2, 2006

UGH! I just typed this nice long response about my experience and I somehow deleted it before it posted. So, I'm going to make this one short and sweet!

My study group was lucky enough to be able to practice our sterile technique & injections on a group of fire fighters/paramedics @ the local fire house. It was their idea and they actually allowed us to stick them numerous times. We practiced in the lab on hot dogs and a dummies, but it just isnt the same. It was great experience and now that I'm going into clinicals, I'm not the least bit nervous about injections. Of course, we also recommended a psych eval on each of those fire fighters, but.... :lol_hitti