Subcutaneous injections

Subcutaneous injection

A subcutaneous injection delivers the medicine into the layer of fat, between the skin and the muscle tissue. Absorption is slower than with IM, since vascularization of fatty tissues is limited. It is performed at a 45° to 80° angle. Needles are typically 25-30G and ½-⅝ inch long.

1 - SETTING UP

• Clean your work area and assemble supply:

  • Medication in the vial
  • The syringes and two needles: one for drawing (18G), and one for injecting (25-30G; ½-⅝ inch), or an insulin U-100 syringe with attached needle (up to 30G)
  • Alcohol swab
  • Sharps container for disposal

• Check the medication: expiry date, visible particles, discoloration…

• Check the syringe package: do not use it if it is opened or damaged.

• Wash your hands thoroughly.

2 - PREPARING THE DOSE

• Clean the rubber stopper with the alcohol swab, and leave it untouched to dry.

• Attach the 18G needle to the syringe, and remove the cover. (Skip if using Insulin U-100 syringe)

• Draw air in the syringe, as much as the amount of medication you will inject.

• Insert the needle through the center of the rubber stop into the bottle (vial is up, needle down), and inject the air into the bottle. This will create pressure that will help with drawing.

• Turn the vial upside down, keeping the needing in the vial. Make sure the liquid covers the tip of the needle.

• Slowly pull the plunger to fill the syringe with the medication, to a bit more than what you will inject.

• Check for air bubbles, and tap with your fingers to have them go up the syringe. Slowly push the plunger to remove them, and reach the exact amount of medication you need to inject.

• Pull the syringe and needle out of the vial, remove the 18G needle and replace it with the chosen injection needle. Remove the cap. (No change of needle if using Insulin U-100 syringe)

3 - SELECT AND PREPARE INJECTION SITE

4 - GIVE THE INJECTION

• Clean the injection site with an alcohol swab; let it dry.
• Hold the syringe with the hand you’ll use to give the injection, and with the other hand, pinch a fold of skin.
• Insert the needle into the pinched zone, at a 45° angle, with on firm and quick motion. The shorter the needle is, the more you can vary between 45° and 90°. Leave away the hand holding the skin fold.
• Proceed to injection by steadily pushing the plunger. Wait for 10 seconds after everything has been pushed in.
• You may experience burning/pressure as you push in the medicine, especially with larger amounts.
• Remove the needle and syringe from the skin and dispose of them in the sharps container.

TIPS TO REDUCE PAIN

• Never reuse needles
• Wait for the alcoolic solution you used to clean the injection spot to dry completely.
• Using a drawing needle and an injection needle keep the second one perfectly sharp for injection, and can reduce pain.
• Inject medicine at room temperature
• Don’t hesitate when pushing the needle through the skin: be firm, steady and quick.
• Avoid movement once inserted (moving back and forth, wiggling…)