Intradermal, Subcutaneous, and Intramuscular Injections: Clinical Nursing Skills | @LevelUpRN​

Summary

In this educational video by Level Up RN, Ellis demonstrates various injection techniques for clinical nursing skills. The video covers intradermal, subcutaneous, and intramuscular injections, detailing the proper site selection, needle angle, and injection methods. Key points include using a small gauge needle for intradermal injections to achieve a bleb, selecting subcutaneous sites with adequate fat, and using either a direct or Z-track method for intramuscular injections. Ellis emphasizes the importance of aseptic technique and proper needle disposal, providing a valuable resource for nursing students.

Takeaways

• 💉 Intradermal injections are typically done on the forearm, and it's crucial to position the needle with the bevel up to form a proper bleb or wheal.
• 🧼 Clean the injection site with an antiseptic swab, starting in the center and moving outward, before administering the injection.
• 💪 Intradermal injections should be administered at a 5- to 15-degree angle, with the needle bevel fully inserted under the skin before injecting the medication.
• 🚫 Do not massage the site after administering an intradermal injection to avoid dispersing the medication into other tissue layers.
• 🏥 Subcutaneous injections can be given in areas with a surplus of subcutaneous tissue, such as the abdomen, backs of the arms, and thighs.
• 📏 For patients with sufficient pinchable fat, inject at a 90-degree angle; for those with less subcutaneous tissue, inject at a 45-degree angle to avoid hitting muscle.
• 🛑 Like with intradermal injections, do not massage the subcutaneous injection site afterward.
• 🏹 Intramuscular injections should be done at a 90-degree angle with the skin pulled taut and the needle held like a dart to ensure stability.
• 📐 The Z-track method for intramuscular injections displaces tissue to prevent medication from leaking into other tissue layers, creating a Z-shaped wound track.
• 🔒 Always use proper sharps disposal techniques immediately after injections and employ any safety mechanisms present on the needle to prevent injury.

Q & A

What are the three types of injections demonstrated in the video?

The three types of injections demonstrated in the video are intradermal, subcutaneous, and intramuscular injections.

Where is the intradermal injection typically administered?

Intradermal injections are almost always done on the forearm.

What is the purpose of the bleb formation during an intradermal injection?

The bleb, also known as a wheal or bubble, is a visual confirmation that the medication is being injected into the first layer of tissue and not deeper.

Why is the bevel of the needle positioned upwards during an intradermal injection?

The bevel is positioned upwards to ensure the medication is injected into the dermis layer of the skin, facilitating the formation of the bleb.

What is the recommended angle for injecting an intradermal injection?

The recommended angle for injecting an intradermal injection is between 5 to 15 degrees.

Which body areas are suitable for subcutaneous injections?

Suitable body areas for subcutaneous injections include the abdomen (tummy), the back of the arms, and the lateral aspects of the thighs.

Why is it important not to massage the injection site after a subcutaneous injection?

Massaging the injection site after a subcutaneous injection could disperse the medication into different layers of tissue, which is not the intended site of action for subcutaneous medications.

How does the angle of insertion differ between subcutaneous injections with adequate and insufficient subcutaneous fat?

If there is at least one inch of pinchable fat, a 90-degree angle is used. If there is insufficient subcutaneous fat, a lower angle, such as 45 degrees, is used to avoid hitting the muscle.

What is the 'Z-track method' used for in intramuscular injections?

The 'Z-track method' is used to displace the upper layers of tissue, which helps to minimize the seepage of medication into other tissues or out of the wound track after the needle is withdrawn.

Why is it crucial to inject and withdraw the needle at the same angle during intramuscular injections?

Injecting and withdrawing the needle at the same angle ensures that the wound track is minimized, reducing the likelihood of medication leakage or tissue damage.

What is the significance of using safety needles during intramuscular injections?

Safety needles are designed to automatically retract after use, reducing the risk of needlestick injuries and ensuring that the needle is safely contained for disposal.