Saturday, December 24, 2011

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Subcutaneous injection - Insulin / Heparin

Definition:
It is defined as the introduction of a fluid drug under pressure using a syringe equipped with a hollow needle into the loose connective tissue below the dermis i.e. into the hypodermis.
It has a low absorption there because of the low vascularisation but since it contains pain receptors, injection can be painful depending on the volume administered.
For structure of skin, consider this page : Skin structure

Sites:
1) outer sides of arm,
2) front of upper outer thigh,
3) above and below the spine of scapula,
4) abdomen extending from the costal margin to the iliac crest except 5 cm all around the umbilicus.


Angle of insertion of needle:
1) 90 degrees with a short needle,
2) 45 degrees with a longer needle.

Techniques:
1) Pinch skin slightly to make 3 cm fold,
2) Insert needle quickly and firmly,
3) Release skin,
4) Aspirate and make sure that needle is not in a vessel,
5) Remove needle by gentle pressure with antiseptic swab,
6) Massage lightly to diffuse drug.

Caution must be taken when injecting anticoagulant. The preferred site is the abdomen. The drug usually comes in ready to use syringe fitted with a needle. We should not remove any air trapped inside. The air is to make sure that all the medication has been delivered. Also do not release the skin after inserting the needle. Finally do not massage the medication!!



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