7.5: Subcutaneous Route
- Page ID
- 89724
\( \newcommand{\vecs}[1]{\overset { \scriptstyle \rightharpoonup} {\mathbf{#1}} } \)
\( \newcommand{\vecd}[1]{\overset{-\!-\!\rightharpoonup}{\vphantom{a}\smash {#1}}} \)
\( \newcommand{\id}{\mathrm{id}}\) \( \newcommand{\Span}{\mathrm{span}}\)
( \newcommand{\kernel}{\mathrm{null}\,}\) \( \newcommand{\range}{\mathrm{range}\,}\)
\( \newcommand{\RealPart}{\mathrm{Re}}\) \( \newcommand{\ImaginaryPart}{\mathrm{Im}}\)
\( \newcommand{\Argument}{\mathrm{Arg}}\) \( \newcommand{\norm}[1]{\| #1 \|}\)
\( \newcommand{\inner}[2]{\langle #1, #2 \rangle}\)
\( \newcommand{\Span}{\mathrm{span}}\)
\( \newcommand{\id}{\mathrm{id}}\)
\( \newcommand{\Span}{\mathrm{span}}\)
\( \newcommand{\kernel}{\mathrm{null}\,}\)
\( \newcommand{\range}{\mathrm{range}\,}\)
\( \newcommand{\RealPart}{\mathrm{Re}}\)
\( \newcommand{\ImaginaryPart}{\mathrm{Im}}\)
\( \newcommand{\Argument}{\mathrm{Arg}}\)
\( \newcommand{\norm}[1]{\| #1 \|}\)
\( \newcommand{\inner}[2]{\langle #1, #2 \rangle}\)
\( \newcommand{\Span}{\mathrm{span}}\) \( \newcommand{\AA}{\unicode[.8,0]{x212B}}\)
\( \newcommand{\vectorA}[1]{\vec{#1}} % arrow\)
\( \newcommand{\vectorAt}[1]{\vec{\text{#1}}} % arrow\)
\( \newcommand{\vectorB}[1]{\overset { \scriptstyle \rightharpoonup} {\mathbf{#1}} } \)
\( \newcommand{\vectorC}[1]{\textbf{#1}} \)
\( \newcommand{\vectorD}[1]{\overrightarrow{#1}} \)
\( \newcommand{\vectorDt}[1]{\overrightarrow{\text{#1}}} \)
\( \newcommand{\vectE}[1]{\overset{-\!-\!\rightharpoonup}{\vphantom{a}\smash{\mathbf {#1}}}} \)
\( \newcommand{\vecs}[1]{\overset { \scriptstyle \rightharpoonup} {\mathbf{#1}} } \)
\( \newcommand{\vecd}[1]{\overset{-\!-\!\rightharpoonup}{\vphantom{a}\smash {#1}}} \)
\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)Subcutaneous drugs are injected into the fatty layer under the dermis. The subcutaneous layer has fewer blood vessels than the muscular tissue, so drugs are absorbed more slowly than with the intramuscular route. Subcutaneous injections use a 1–3 mL syringe, a 5/8-inch needle, and a 23–25-gauge needle. Subcutaneous injections are administered at a 45-degree angle. The maximum volume is 0.5 to 1.5mL, but only 0.5mL is injected for children. Sites for subcutaneous administration include the anterior thigh, abdomen, upper outer arm, flank region, and subscapular area of the back. For children, inject into the anterior thigh only. It is important to note that if a patient has routine subcutaneous injections, the injection sites should be rotated to avoid injuring the skin and forming scar tissue.
Follow these steps to administer an intradermal injection safely.
Supplies needed:
- Provider’s order
- Drug reference material
- Patient’s health record
- Alcohol wipes
- Medication ordered
- 1 mL or 3 mL syringe with 5/8-inch 23–25-gauge safety needle
- Gauze
- Bandage
- Medication tray
- Sharps container
- Marker
- Gloves
- Review the provider’s order and review drug reference material.
- Wash hands and don gloves.
- Select the right medication and check it against the provider’s order.
- Check the expiration date.
- Calculate the dose to be given.
- Assemble the supplies needed.
- Check the medication against the provider’s order.
- Open the syringe and needle; attach the needle to the syringe if packaged separately.
- Use the marker to label the syringe with the drug name.
- Remove the cap from the vial and clean it with an alcohol wipe.
- Using the syringe, pull the plunger down to the amount of drug to be administered.
- Insert the needle into the vial and inject the air.
- Invert the vial and syringe and pull the plunger down to fill it with liquid from the vial.
- Use the plunger to remove any large bubbles.
- Use the plunger to fill the syringe with the correct dose.
- Remove the needle from the vial and use the scoop method to recap the needle.
- Check the provider’s order against the vial and the syringe.
- Place the syringe on the medicine tray and clean the area.
- Remove gloves and wash hands.
- Greet the patient and identify yourself. Verify the patient’s identity by asking for their name and date of birth. Check the patient’s identification bracelet if required.
- Ask the patient if they have any drug allergies.
- Provide patient education. Explain the drug ordered, the indication for the drug, side effects, adverse effects, and the provider who ordered the drug.
- Perform any assessments before administering the drug.
- Allow the patient to ask questions.
- Wash hands and don gloves.
- Instruct the patient to extend their forearm or expose the area to be injected.
- Assess the injection site for intact, healthy skin. Palpate the skin for any lumps or bumps under the skin.
- Clean the site with an alcohol wipe and allow it to dry.
- Remove the cap from the syringe.
- Place the gauze between your nondominant hand's index and middle finger. Use your index finger and thumb to pinch the skin.
- Hold the syringe between your dominant hand's thumb and index finger.
- Quickly and smoothly insert the needle into the site at a 45- or 90-degree angle, depending on the needle size. Insert the entire needle. Ensure that the needle tip is not pointed toward your non-dominant hand.
- Release the pinched skin.
- Push the plunger to inject the drug. Inject slowly and smoothly until the syringe is empty. Inject 1mL over 10 seconds.
- Pull the needle from the skin at the same entry angle.
- Activate the needle’s safety device with one hand while the other covers the site with gauze. Gently apply pressure at the site to stop any bleeding.
- Apply the bandage.
- Dispose of the syringe in the sharps container.
- Observe the patient for any reactions.
- Clean the area, remove gloves, and wash hands.
- Document the procedure in the patient’s health record. Include the injection site, patient response, assessments, and teaching.
(Centers for Disease Control and Prevention, 2023).