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Intradermal injection animation demonstration

Demonstration of injection techniques used to administer local anaesthetic, for allergy skin testing, and for tuberculin skin testing.

1) Equipment needed

  • Non-sterile gloves

  • Apron

  • Cotton wool or gauze

  • Small sticking plaster (ideal)[65]

  • Disposable tray

  • Sharps bin

  • Medicine for injection

  • Fluid for reconstitution or dilution

  • Filter needle to draw up medication

  • Appropriate needle size for the injection (usually 25 gauge or 27 gauge).

2) Contraindications

  • You should not administer injections through infected or broken skin

  • Take careful note of any previous allergic reactions, hypersensitivity, or other adverse effects by both asking the patient and checking their notes. If the patient is allergic to the medication, do not inject the medication.

Cautions

  • You should always adhere to manufacturer’s guidelines for the route of administration, dilution, dosage, and infusions

  • Clean skin with soap and water before giving an injection.[66] Skin cleaning guidance may vary; follow local guidance.

3) Indications

Some oral medicines undergo extensive first pass metabolism by the liver or are not well absorbed from the gastrointestinal tract, so alternative routes of administration are preferable. In other situations patients may be nil by mouth, or too unwell to take oral medications. For each medicine required, consider the routes of administration available and which is the most appropriate for the clinical setting. The following key issues have been described as important to consider when choosing the most appropriate route:[67]

  • Safety

  • Efficacy

  • Patient preference

  • Pharmacoeconomics.

4) Complications

Complications that may occur as a result of injection include:

  • Bleeding, bruising, or haematoma formation

  • Local infection and formation of an abscess

  • Fainting

  • Allergic reaction

  • Formation of a sterile abscess

  • Paraesthesia/nerve damage

  • Pain (local anaesthetics initially).

5) Aftercare

  • Monitor the patient for the desired responses after medications have been administered. Also be vigilant for potential adverse effects from the injection

  • Observe the injection sites for haematoma formation, bleeding, infection, and hypersensitivity reactions

  • Ensure that you correctly document all medications administered.