Subcutaneous injection is an effective method of drug delivery that is used quite frequently in nursing.Objective is to deposit medication into the subcutaneous tissue layers safely, avoiding injury to the patient, while ensuring proper drug absorption after injection.
Sites of Subcutaneous Injection
Subcutaneous Injection Syringe Angles
“Rules of thumb”, for the nurse using this method.
- First, a well-lighted area should be used to assess the site of injection.
- Second, when giving repeated doses on a regular basis, the use of a site rotation chart should be instituted and kept on the Medication
Administration Record (MAR).
- Third, avoiding exposing the needle in the patient’s line of vision decreases level of anxiety.
Additionally, keep in mind the anatomy of the patients receiving the medication:
Obesity requires the use of a longer needle, and elderly people have less subcutaneous tissue stores and less skin elasticity.
Example of Subcutaneous Injection
Insulin is routinely delivered by the subcutaneous injection route.
• Reference should be made to the section on insulin for added information.
• Efficient teaching to diabetic patients is beneficial because most of these patients will be self-administering these medications at home.
Heparin is another medication that is commonly administered by subcutaneous injection.
Some special considerations for heparin, owing to its anticoagulant effects, are
- Site of choice is the abdomen, because the layer of subcutaneous tissue here does not lie over any major muscles, leading to decreased chance of hematoma formation and movement.
- Syringe of Choice is 1/2-inch, 25- to 27-gauge.
- Changing the needle once the medication is drawn up to prevent heparin from remaining in needle, which could lead to inadvertent delivering of the medication into the intradermal tissue.
- Controversial views on aspirating prior to injection (review agency policy on this issue).
- Do not Massage after heparin injection. Massaging the site after injection can increase incidence of bruising.
- Rotation of sites around abdomen to decrease irritation to tissue.
