Indications for Intradermal Injection
Intradermal injections are primarily indicated for: Allergy testing
Tuberculosis screening
Local anesthesia in small procedures
Vaccination (though less common)
Preparing for the Procedure
Preparation is crucial for ensuring the safety and effectiveness of the injection. The following steps should be followed: Gather all necessary equipment including a 1 mL syringe with a fine-gauge needle (26-27 gauge).
Confirm the patient's identity and verify any allergies.
Explain the procedure to the patient to ensure their understanding and cooperation.
Perform hand hygiene and don appropriate
personal protective equipment (PPE).
Procedure for Intradermal Injection
1. Choose the Injection Site: The most common sites are the inner forearm and the upper back. Ensure the area is free from tattoos, scars, or any skin conditions.
2. Clean the Site: Use an alcohol swab to clean the injection area. Allow it to air dry completely.
3. Prepare the Syringe: Draw the prescribed amount of medication into the syringe, ensuring there are no air bubbles.
4. Insert the Needle: Hold the skin taut and insert the needle at a 5 to 15-degree angle with the bevel facing up. The needle should be inserted just enough to cover the bevel.
5. Inject the Medication: Slowly inject the medication, creating a small wheal or bleb under the skin.
6. Remove the Needle: Withdraw the needle at the same angle it was inserted. Do not rub the injection site.
7. Dispose of Materials: Safely dispose of the needle and syringe in a sharps container, and other materials in appropriate waste bins.Post-Procedure Care
Post-procedure care includes: Observing the patient for any immediate adverse reactions.
Educating the patient on what to expect and how to care for the injection site.
Providing instructions on follow-up visits if necessary, such as reading the results of a TB test.
Complications and How to Manage Them
While complications are rare, they can occur. Common complications include: Infection: Ensure the site is cleaned properly and use sterile equipment.
Allergic Reaction: Monitor the patient for signs of anaphylaxis and have emergency equipment ready.
Bleeding or Bruising: Apply gentle pressure to the site if minor bleeding occurs.
Documentation and Follow-Up
Proper documentation is essential for maintaining accurate medical records. Document the following: Type and dose of medication administered
Site of injection
Date and time of procedure
Any immediate patient responses or complications
Follow-up may be necessary, particularly for TB tests, which need to be read 48-72 hours post-injection.
Conclusion
Intradermal injections are a vital skill in nursing, used primarily for diagnostic purposes. Proper technique, patient education, and meticulous documentation are essential for successful outcomes. As with any medical procedure, awareness of potential complications and how to manage them is crucial for patient safety.
