Give a Subcutaneous Injection

This article is "in use", indicating that it is undergoing a major edit.
As a courtesy, please do not edit this article while this message is displayed. This notice was placed on 2008-11-14. If this was over two weeks ago, please contact the editor who added this notice to see if they are finished with the article before removing the tag. The editor will be listed in the article's edit history. If there is no response from them within 5-7 days, anyone may remove the tag.
Upon receiving a prescription for a medication requiring subcutaneous injections, your health care provider should provide detailed instructions on the correct way to give the injection. However, the stress experienced the day you receive the news makes it understandably difficult to remember the proper steps to follow. These instructions are intended to provide assistance to people who are not trained medical professionals who need to give subcutaneous injections to themself or a family member. These instructions are intended to be used only as a guideline. Any questions should be directed to your medical professional before you give any injections at home. Note: Two types of syringes are used in the instructions for demonstration only - a single use insulin syringe and a prefilled multidose syringe. Not pictured are the single dose prefilled syringes.

Steps

Wash your hands with soap and water and dry thoroughly.
Gather your supplies.
Check the medication label to ensure you have the correct medication and dosage.
Lay your towel on a clean surface within easy reach of your intended work site.
Injection supplies Arrange your supplies on the towel in the order you will need them. Note: Make a small tear in the edge of your alcohol wipe packages to make them easier to open as you need them.
Choose your site Choose your injection site and expose the area by moving your clothing away from the area to be injected. Note: This will make it easier when you are ready to give the injection. Caution: It is important to know what sites are recommended by the drug manufacturer as injuries may result if medications are given at the wrong site. Check with your local health care professional if you are uncertain.
Clean injection site Wipe the injection site gently with a fresh alcohol wipe and allow the site to air dry.
Clean stopper Remove the tamper resistance tab from the multidose vial and set it back on the towel. Note: If this has already been removed, wipe the rubber diaphragm with with a clean alcohol wipe. (Skip this step if you are using a prefilled medication syringe)
Pick up your syringe and hold it firmly in your dominant hand.
Grasp cap Grasp the cap over the needle with the thumb and forefinger of your other hand and pull the cap off the needle taking care not to allow the needle to touch your skin.
Lay the cap on your towel.
Skip to step 20 if you are using a prefilled medication syringe.
Add air to syringe Pull the plunger back on the syringe filling the syringe with air to the desired dosage.
Pick up the medication vial and hold it upside down being careful not to touch the rubber stopper.
Insert needle into vial Insert the need into the rubber stopper.
Depress the plunger injecting the air into the medication vial. Note: This will make it easier for you to draw the medication into the syringe by increasing the air pressure in the vial.
Fill syringe to desired dose Pull back on the plunger slowly and gently until you have reached your desired dosage. Note: You may have to tap the sides of your syringe to force air bubbles to the top and expel any air bubbles by gently pressing the plunger forcing the air bubbles back into the medication vial. Tap to remove air
Repeat step 17 until you have the desired dose in your syringe with no air bubbles.
Remove the vial from your syringe and place the vial back on your towel. Warning: Do not set your syringe down at this point as you will contaminate your needle which could lead to serious infection.
Position the syringe in your dominant hand as though you are holding a pencil or a dart.
Gather gently about 1 1/2 to 2 inches of skin between your thumb and first finger creating a slight mound of skin taking care not to bruise or damage the tissue. Warning: When gathering your skin, do not gather any muscle tissue. Subcutaneous medications are not intended for injection into muscle and may result in bleeding into the muscle tissue. This is especially true if the medication has blood thinning properties.
Insert needle Insert the syringe at a 90 degree angle (straight up and down) into the skin with a slight snapping motion of your wrist. Note: The needle should insert all the way to the hub. Hesitation may cause the needle to bounce off the skin or pierce the skin slowly causing increased pain. Caution: for thin or muscular people you may need to insert the needle at a 45 degree angle to avoid injecting into muscle tissue. 45 degree angle
Depress the plunger with steady even pressure until all of the medication has been injected.
Release skin Release the skin allowing it to fall back to its natural position.
Place cotton against syringe Place a piece of guaze or cotton ball next to the needle at the injection site.
Remove syringe Remove the needle from the skin in a smoothe motion. Caution: Do not rub or massage the injection site as it may cause bruising or bleeding under the skin.
Safety needle Safety your needle and discard or dispose of your syringe in a puncture resistant sharps container. Discard needle
Put all of your supplies away. You have successfully completed your subcutaneous injection.

Tips

An ice cube may be used to slightly numb the intended injection site.
Placing a piece of cotton or gauze at the injection site before removing the needle will prevent the skin from pulling and decrease the pain from the injection.
If you have access to the internet look up your medication on the manufacturers web site.
For questions about Lovenox call 1-800-633-1610
For more detailed information on subcutaneous injections go to Patient Information Publications at http://www.cc.nih.gov/ccc/patient_education/pepubs/

Warnings

Do not attempt to give any injections without proper instruction from your healthcare provider.
Read the label of your medication carefully to ensure you have the correct medication and strength.
Do not discard needles or syringes in regular trash, use only puncture resistant sharps disposal containers.
When using an ice cube to alleviate the pain of the injection, do not leave the ice cube in place too long as it can freeze cells damaging the tissues and decrease the absorption of the medication.