How to Perform Intradermal Injections

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Intradermal injections enter the top layers of the skin. The most common intradermal injections are TB skin tests and allergy shots. Intradermal injections are more challenging to administer than subcutaneous or intramuscular injections because you want to avoid injecting substances too deep into the skin.

Things You'll Need

  • Syringe
  • 27 to 30 gauge needle
  • Alcohol pad
  • 2 in. by 2 in. gauze pad

Performing an Intradermal Injection

  • Clean a two-inch diameter injection site with an alcohol pad and let dry completely. The preferred site for intradermal injections is the anterior (palm side) forearm halfway between the wrist and elbow. Do not touch the injection site once it has been cleaned.

  • Pull the skin taught from about one inch under the injection site. Insert the needle at a 10- to 15-degree angle with the bevel (angled hole) of the needle pointed up. The injection should be shallow enough to just cover the bevel and the needle should be easily visible under the skin.

  • Slowly inject the substance. Allergy shots will turn the skin white if the injection is done properly; a small bubble of skin will rise if a TB skin test is done properly. Any substance, in fact, will create a superficial reaction in the skin, making it evident that the injection was done properly.

  • Blot away any blood with a gauze pad but leave the injection site uncovered so you can watch the skin's reaction.

Tips & Warnings

  • An injection that is too deep will enter the fat under the skin and not be effective.
  • Always dispose of used needles in approved sharps containers immediately after use.
  • Never attempt to recap a used needle.

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References

  • "Mosby's EMT-Basic Textbook;" Walt Stoy PhD EMT-P CCEMT-P, Tom Platt MEd NREMT-P CCEMTP, Debra A. Lejeune MEd NREMT-P, Center for Emergency Medicine; 2006
  • " Mosby's EMT-Intermediate Textbook;" Bruce R. Shade EMT-P EMS-I AAS, Thomas E. Collins Jr. MD FACEP, Elizabeth Wertz RN BSN MPM FACMPE PHRN EMT-P, Shirley A. Jones MSEd MHA EMT-P; 2002
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