Intradermal Injection is the injection of a tiny amount of fluid into the layer of the skin. It’s usually done to test for drug sensitivity before administering larger amounts by other methods.

The procedure usually painful, ensuring that needle inserted into the epidermis and not in subcutaneously would reduce patient discomfort.

  1. Gather all the equipment needed and check the physician order
  2. Explain the procedure to patient,the purpose,site for injection and how he/she has to cooperate.
  3. Wash hands and don disposable gloves
  4. Prepare medication from ampule or vial
  5. Position the patient and select the inner aspect of the forearm, upper chest or upper back beneath scapulae
  6. Cleanse the site with alcohol swab in circular motion moving outward. Allow skin to dry. Keep cotton in the clean tray for reuse when taking out the needle.
  7. Remove needle cap with the non-dominant hand by pulling it straight off.
  8. Use non -dominant hand to spread skin taut over injection site
  9. Place needle almost flat against patient’s skin. Insert 1/8- inch bevel up  so that needle can be seen through the skin.
  10. Slowly inject the drug(0.01ml-0.1ml) watching for a bleb/blister to develop(appearance of bleb/wheal indicates that needle is in intradermal tissue).If not present withdraw needle slightly and inject medication.
  11. Withdraw needle quickly in the same angle as it was inserted
  12. Do not massage the area
  13. Do not recap the needle. Discard syringe and needle in to appropriate receptacle
  14. Remove glove and wash hands
  15. Record the medication administration-the medication administered,amount,dose,site and patients response
  16. Draw circle using blue/black pen around injection site. Write date and time of administration of medication.
  17. Check the reaction within a specified interval of time, usually it depends from the hospital protocols.
  18. Inform the physician for medication reaction.

Important points to remember

  1. The redness wheal formation within 10-15 minutes is usually a sign of positive test reaction
  2. Patient should watch for at least 30 minutes for sign of allergy reaction.
  3. The following must be available for emergency treatment of penicillin anaphylaxis or generalized reactions.
    • Epinephrine Hcl 1:10 00 for immediate IM
    • I.V. antihistaminics
    •  50/0 Dextrose in Water 1 liter and venosel.

Each Hospital has a policy on how the patient reaction will be evaluated and recorded. Always review the  hospital policies to be sure of the process..

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