Is the skin test injection intradermal or subcutaneous?

1. Intradermal injection (ID)

Intradermal injection is a method of injecting a small amount of medicinal solution between the epidermis and the dermis.

(First, the purpose

1. Used in various drug allergy tests to observe local reactions.

2. Vaccination.

3. Pioneering steps in local anesthesia.

(2) Parts

1. Skin test Take the lower medial segment of the forearm. Because the skin is thinner and lighter in color, it is easy to inject and identify.

2. Vaccinations are often injected into the lower edge of the deltoid muscle, such as BCG and pertussis vaccines.

(3) Items

Put a sterile 1ml syringe and a 4.5-5 gauge needle in the injection tray, and prepare the liquid according to the doctor's instructions.

(4) Operation method

1. Bring supplies to the bedside, check, and explain to the patient for cooperation. Before doing the skin test, you should ask in detail whether you have a history of allergies. If you have a history of allergies to the liquid that needs to be injected, you can't do a skin test. You should contact your doctor and change other drugs before doing the test.

2. With a 1ml syringe and needle, extract the liquid and exhaust the air.

3. Select the palm of the forearm (or the lower edge of the deltoid muscle), use a 70% alcohol swab to sterilize the skin and let it dry. Tighten the skin with the left hand, hold the syringe with the right hand, make the needle bevel upward, and pierce the skin at 5 to 15 degrees to the skin ( Figure 10-5).

4. After the bevel of the needle enters the skin, level the syringe and inject 0.1ml of the medicinal solution. The dosage should be accurate, so that a circular raised skin mound will be formed locally, the skin will become white, and the pores will become larger.

5. After the injection, quickly pull out the needle, do not massage, clean up the materials, and observe the reaction on time.

6. For a control test, use another syringe and needle to inject 0.1 ml of isotonic saline into the same part of the other forearm for 20 minutes, and then observe the reaction.

(5) Matters needing attention

Do not use iodine tincture for skin disinfection, do not insert the needle too deep, and do not press the needle when pulling out, so as not to affect the observation of the results.

2. Subcutaneous injection method (H)

Subcutaneous injection is a method of injecting a small amount of medicinal solution into the subcutaneous tissue.

(First, the purpose

1. It should be used when the drug effect needs to be achieved quickly, and oral administration cannot or should not be performed. For example, oral insulin is easily destroyed by digestive enzymes in the gastrointestinal tract and loses its effect, while subcutaneous injection is rapidly absorbed.

2. Local anesthesia or preoperative medication.

3. Vaccination.

(2) Parts

The lower edge of the deltoid muscle of the upper arm, the outer side of the upper arm, the abdomen, the back and the outer side of the thigh (Figure 10-6).

Figure 10-6 Subcutaneous injection site

(3) Items

Use sterile 1-2m syringes and 5.5-6 gauge needles in the injection tray, and prepare liquid medicines according to the doctor's instructions.

(4) Operation method

1. Bring supplies to the bedside, check, and explain to the patient for cooperation. Select the injection site, disinfect the skin with 2% iodine tincture and 70% alcohol, and let it dry.

2. Inhale the medicinal liquid into the syringe, exhaust the air, tighten the skin with the left hand, hold the syringe with the right hand, fix the needle plug with the index finger, the needle is inclined upward and the skin is at an angle of 30 to 40 degrees, and those who are too thin can pinch the injection site (Figure 10-7). ), quickly pierce two-thirds of the needle, release the fixed needle plug with the left hand, and no blood is returned by aspiration, then the liquid can be injected.

3. After the injection, use a sterile cotton swab to gently press the acupuncture point, quickly pull out the needle, and clean up the materials.

(5) Matters needing attention

1. The needle penetration angle should not be greater than 45 degrees, so as not to penetrate the muscle layer.

2. Try to avoid subcutaneous injection of drugs that are irritating to the skin.

3. Those who inject frequently should change the site and take turns injecting.

4. To inject less than 1ml of liquid medicine, a 1ml syringe must be used to ensure the accurate dose of the injected liquid medicine.

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