Administering an injectable drug accurately and safely is also possible in the privacy of your home. Practicing an injection safely protects the patient, the person giving the injection and the environment. There are two types of injections that can be done at home: subcutaneous injections, such as those for administering insulin, and intramuscular injections. Follow the steps below to learn how to give an injection: in this way you can give it yourself, or give it to a family member or close friend.
Steps
Method 1 of 4: Prepare the Administration of an Injection
Step 1. Determine the type of injection to give
Read the detailed instructions accompanying the drug and carefully check all the information provided by your doctor, nurse or pharmacist. If you have any questions or concerns about how or where to inject, talk to your doctor, nurse or pharmacist. Before proceeding, ask for advice even if you are not sure if you have taken the right syringe or needle of the correct length or gauge.
- Some drugs are ready to use, while for others it is necessary to aspirate with the needle from a vial or vial.
- Be very specific in getting what you need for the injection. Some people are given more than one injection at home.
- It can be easy to confuse the syringes and needles required for a specific injection with those intended for another type of drug to be injected.
Step 2. Familiarize yourself with the product packaging
Not all injectable drug packs are the same: some require dissolving prior to administration, while others are packaged with everything you need, including syringes and needles. Carefully read all the documentation that comes with the drug and follow all the preparatory steps for that specific drug.
- The product documentation will give you clear, step-by-step instructions on everything that needs to be done to prepare the drug for administration.
- The documentation will also tell you the recommended size of syringe, needle and needle gauge if these are not included in the package.
- Let's take, for example, a drug packaged in single-dose vials. A pack frequently used by manufacturers of injectable drugs consists of a vial that contains a single dose of the product, called a single-dose vial.
- The label on the product vial will say "single dose vial".
- This means that each vial contains only one dose. Keep in mind that, after preparing the required dose, there may still be some liquid left in the vial.
- The residual drug must be thrown away. Don't keep it for another dose.
Step 3. Prepare a dose from a multidose vial
Other drugs are packaged in a multidose vial: this way you can draw more than a single dose from the same vial.
- The label on the vial will say "multidose vial".
- If you are using a drug contained in a multidose vial, write the date of first opening with a permanent marker.
- Between applications, place the medicine in the refrigerator. Don't freeze it.
- In the preparation process of the medicines contained in multidose vials, small quantities of preservatives may have been included: these minimize the development of any contaminants, but allow to protect the purity of the drug only up to 30 days after opening the vial.
- The vial should be discarded 30 days after first opening, unless your doctor advises otherwise.
Step 4. Get everything you need
You will need the drug package or vial, the syringe included in the package, if available, or a purchased needle-syringe kit or a syringe and needle that you will combine at the time of administration. Other things you will need are an alcohol swab, a small gauze or cotton swab, a band-aid, a sharps disposal container.
- Remove the outer seal from the vial and disinfect the rubber stopper with an alcohol swab. Allow the area you scrubbed with the alcohol swab to air dry. Blowing on the vial or rubbed skin can cause infection.
- With the gauze or cotton ball, apply pressure to the injection site to reduce the bleeding, then cover it with a plaster.
- The sharps container is an important safety measure to protect the patient, the injector and the community from biohazard materials. It is a thick, plastic container designed to hold used needles, syringes and lancets. Once full, the container will be transferred to a place where biohazard materials are destroyed.
Step 5. Review the medication
Make sure you have the right drug, in the right concentration, and that the expiration date has not already passed. Also make sure that the vial has been stored properly, according to the manufacturer's instructions: some products are stable if kept at room temperature before use, others may require refrigeration.
- Check the package for visible damage such as cracks or dents on the vial containing the drug.
- Check the area around the top of the vial. Check for cracks or dents around the seal on the top of the medication container. A dent may mean that the sterility of the package is no longer guaranteed.
- Check the liquid inside. Look for any substance, even the smallest, that is unusual or that floats inside the container. Most injectable drugs are transparent.
- Some types of insulin appear cloudy. If you notice anything other than the clear liquid inside the container of a drug other than insulin, throw it away.
Step 6. Wash your hands
Wash them thoroughly with soap and water.
- Also wash your nails, the spaces between your fingers and your wrist.
- This way you will avoid contamination and reduce the risk of infections.
- Before giving an injection, it is recommended to wear gloves that have the CE marking: they will represent an additional barrier against bacteria and infections.
Step 7. Check the syringe and needle carefully
Make sure both packages are unopened and sterile, and that they show no obvious damage or signs of deterioration. After opening, check that the syringe does not have cracks on the cylindrical body or that any of its components do not have stains. The same goes for the rubber tip of the plunger. Any damage or deterioration indicates that the syringe should not be used.
- Examine the needle and look for any damage. Make sure the needle hasn't been bent or broken. Do not use products that appear damaged, including those whose packaging appears damaged: it could indicate that the needle is no longer to be considered sterile.
- Some packaged syringes and needles show the expiration date, but not all manufacturers indicate it on the package. If you are concerned that a product is too old to use, make a note of any batch number and contact the manufacturer.
- Discard damaged or deteriorated syringes, or those that have expired, by throwing them into a sharps container.
Step 8. Make sure you have a syringe of the right size and type
Make sure you are using a suitable syringe for the injection you are making. Avoid alternating between different syringe types, as you could run into serious dosing errors. Use only the type of syringe recommended for the drug you are going to administer.
- Choose a syringe with a slightly larger capacity than the amount of medication you need to administer.
- Follow the manufacturer's recommendations for needle length and gauge.
- The caliber, or gauge, is that number that describes the diameter of the needle. The larger the number, the tighter the needle will be. Some drugs are denser than others and you will therefore need a needle of a smaller or larger gauge depending on the case.
- For safety reasons, most syringes and needles are currently manufactured in one piece. So, when you select the syringe size, you actually choose the needle length and gauge as well. Make sure you have the right tools to inject. This information is detailed in the product instructions, or is available by asking your pharmacist, doctor or nurse.
- Separate syringes and needles are, however, still available. If that's what you have, put the two components together. Make sure that the syringe is the right size and that the needle is sterile, new and of the right length and gauge for the type of injection to be given: an intramuscular and subcutaneous injection require different needles.
Step 9. Fill the syringe
Follow the instructions on the package, if available, or proceed by filling the syringe from the drug vial.
- Sterilize the top of the vial with alcohol and let it dry for a few minutes.
- Get ready to fill the syringe. Determine exactly how much liquid you need to withdraw and administer for your dose. The syringe should contain exactly the amount prescribed for the dose. This information is available on your prescription or on the instructions provided by your doctor or pharmacy.
- Pull the plunger back to fill the syringe with a volume of air equal to the exact amount of fluid to be aspirated.
- Hold the vial upside down, insert the needle into the rubber seal and push the plunger to inject the air from the syringe into the vial.
- Pull out the plunger to draw up the liquid in the exact amount needed.
- Sometimes air bubbles form in the syringe. Gently tap the syringe while the needle is still in the medication vial. This will move the air to the top of the syringe.
- Squeeze the air back into the vial and draw in the medication again as needed to get the desired amount.
Step 10. Make the patient feel comfortable
Consider first applying ice to the area where you are going to inject to reduce pain, especially if the patient is a child. Have him sit in a comfortable position with the area where you are going to prick well exposed.
- Make sure you can easily reach the area where you need to inject.
- The patient should remain as still and relaxed as possible.
- If you scrub the area with alcohol, wait a few minutes for the skin to dry before inserting the needle.
Method 2 of 4: Make a Subcutaneous Injection
Step 1. Determine where to inject based on your doctor's instructions
A subcutaneous injection must be carried out in the fatty layer of the skin: these are injections necessary for specific drugs and, usually, for small quantities. The fatty layer where the injection is made is located between the skin and the muscle.
- An excellent place to perform this type of injection is the abdomen. Select a point below the waist and above the hipbone, displaced by about 5 cm from the navel. Avoid the navel area.
- Subcutaneous injections can also be performed in the thigh area, halfway between the knee and the hip, by moving slightly to the side: the important thing is to be able to lift, by pinching, 3 to 5 cm of skin.
- The lower back is also a good place for a subcutaneous injection: this is the area above the buttocks, below the waist and halfway between the spine and the side.
- Another suitable point is the upper arm: the important thing is that there is enough skin to be able to lift, pinch, from 3 to 5 cm. The best point is midway between the elbow and the shoulder.
- Alternating between the various points can help prevent bruises and skin damage. You can also vary within the same area by injecting on different points of the skin.
Step 2. Proceed with the injection
Disinfect the skin around the injection site by rubbing it with an alcohol wipe. Let the alcohol dry before giving the injection. Just wait a minute or two at the most.
- Do not touch the disinfected area with your hands or any other material before making the injection.
- Check that you have the right drug, that you have chosen the right place to inject and that you have prepared the correct dose to administer.
- Grab the syringe with your dominant hand and remove the cap from the needle with the other hand. Pinch the skin with your non-dominant hand.
Step 3. Determine the entry angle
Depending on the amount of skin you can pinch, you can insert the needle at a 45 or 90 degree angle.
- Choose a 45 degree angle if you can only pinch 3 cm of skin.
- If, on the other hand, you can pinch about 5 cm of skin, insert the needle at a 90 degree angle.
- Grab the syringe firmly and make a quick movement of the wrist to prick the skin with the needle.
- With your dominant hand, insert the needle quickly and carefully at the sharp angle while pinching the skin with the other hand. Quickly insert the needle to prevent the patient from stiffening.
- For a subcutaneous injection it is not necessary to aspirate. However, it is not a problem to do this, unless you are giving blood thinners, such as enoxaparin.
- To aspirate, pull the plunger back slightly and check for blood in the syringe. If there is blood, remove the needle and look for a different place to inject. If there is no blood, continue with the injection.
Step 4. Inject the medication
Push the plunger in until all the liquid has been injected.
- Remove the needle. Press on the skin at the injection point and with a quick and precise movement remove the needle maintaining the same angle with which you had inserted it.
- The whole process should not take more than 5-10 seconds.
- Throw away all used tools in the appropriate container.
Step 5. Give an insulin injection
Insulin injections are subcutaneous injections but require different syringes to make sure each dose is accurate. It is also a drug that must be administered continuously. Noting where the injections were given is an important part of insulin delivery, which helps to vary the area of the sting.
- Recognize the differences in syringes. Using a normal syringe can cause serious dosing errors.
- Insulin syringes are graduated in units rather than cc or ml. It is essential to use a special insulin syringe to administer this drug.
- Check with your doctor or pharmacist to understand what type of insulin syringe to use with the drug and the dosage that has been prescribed.
Method 3 of 4: Give an Intramuscular Injection
Step 1. Determine where to inject
An intramuscular injection releases the drug directly into a muscle. Choose a place to inject that gives easy access to muscle tissue.
- There are four main areas suggested for an intramuscular injection: the thigh, hip, buttocks and upper arm.
- Alternating where to inject prevents bruising, cramps, scars and skin changes.
Step 2. Make an injection in the thigh
Vasto lateral is the name of the muscle you need to aim for in order to inject the drug.
- Visually divide the thigh into three sections. The middle section is the target of this injection.
- This is a perfect area if you need to give yourself an intramuscular injection as it is easy to see and reach.
Step 3. Take advantage of the ventrogluteal muscle
This muscle is placed in the hip. Use landmarks to find where you want to inject the drug.
- Find the exact spot by having the person lie on their side. Place the base of the thumb on the upper outer thigh where it joins the buttocks.
- Point your fingers towards the person's head and the thumb towards the groin.
- With the tips of the ring and little fingers you should feel a bone.
- Form a V by separating your index finger from the other fingers. The injection is made in the center of the V.
Step 4. Make an injection in the buttocks
The dorsogluteal muscle will be the area where the drug is injected. With practice it will become easier and easier to find the area to inject, but start by setting physical landmarks and dividing the area into quadrants to make sure you have identified the correct point.
- Draw an imaginary line, or actually draw it by rubbing it with the available alcohol, running from the top of the intergluteal sulcus to the side. Find the midpoint of that line and move up about 7cm.
- Draw another line that intersects the first one forming a cross.
- Find a rounded bone in the outer upper quadrant. The injection should be made in this quadrant, under the rounded bone.
Step 5. Give the injection in the upper arm
The deltoid muscle is located in the upper arm and is an ideal spot for an intramuscular injection, if there is properly developed muscle tissue. If, on the other hand, the person is thin or has little muscle in that area, opt for an alternative spot.
- Find the acromial process, which is the bone that crosses the upper arm.
- Draw an imaginary inverted triangle with the bone as the base and the tip at the level of the armpit.
- Inject in the center of the triangle, 3-5 cm below the acromial process.
Step 6. Disinfect the skin of the area by rubbing it with alcohol
Let it dry before injecting.
- Do not touch clean skin with your fingers or other materials before injecting.
- Hold the syringe firmly with your dominant hand and pull the needle cap off with the other.
- Apply some pressure to the skin where you are going to inject the medication, then gently press and pull the skin to tighten it.
Step 7. Insert the needle
With your wrist, push the needle through the skin while maintaining a 90 degree angle. You will have to push it pretty deep to make sure you release the drug into the muscle tissue. Select a needle of the right length to make the injection process easier.
- Suck in while pulling the plunger back slightly. In this operation, check if any blood is drawn into the syringe.
- If there is blood, gently remove the needle and look for a new place to inject. If not, complete the injection.
Step 8. Inject the medicine carefully
Press the plunger to inject all the liquid.
- Do not press too hard so as not to push the drug too fast inside the body. Push the plunger firmly but slowly to reduce pain.
- Remove the needle while maintaining the same angle of entry.
- Cover the area with a small piece of gauze or a cotton ball and band-aid. Check the injection area regularly. Make sure it is always clean and that the injection site does not continue to bleed.
Method 4 of 4: Pay Attention to Post-Injection Safety
Step 1. Check for any allergic reactions
See a doctor immediately if any signs or symptoms of an allergic reaction appear.
- Signs of an allergic reaction also include redness or itching, shortness of breath, difficulty swallowing, a sensation of having a closed throat or airways, and swelling of the mouth, lips or face.
- Call 911 if symptoms of an allergic reaction develop. If this is the case, you may have injected a drug into your body that could speed up a reaction.
Step 2. See a doctor if an infection develops
Even the best injection technique sometimes allows the access of contaminants.
- See your doctor right away if you experience flu symptoms, fever, headache, sore throat, joint or muscle, and gastrointestinal problems.
- Other symptoms warranting a prompt medical examination are chest tightness, nasal congestion or occlusion, a widespread rash, and mental disorders such as confusion and disorientation.
Step 3. Monitor the injection site
Check that there are no changes in the skin tissue at the injection site and just around it.
- Reactions at the injection site are very common for some drugs. Read the package insert before administering the drug to know any reactions in advance.
- Common reactions that may appear in the injection area are redness, swelling, itching, bruising and sometimes a thickening or hardening of the skin.
- Alternating injection sites can help minimize damage to the skin and surrounding tissue, especially when frequent injections are required.
- Persistent reaction problems should be checked by a doctor.
Step 4. Handle used tools safely
Sharps containers are a great tool for disposing of used needles, syringes, or lancets. You can buy them at your local pharmacy and they are also available online.
- Never throw lancets, syringes or needles in the regular garbage can.
- Check the regional and national guidelines. Your pharmacist can help you find a solution that's right for you. Many Regions have well-defined guidelines and suggestions for safely disposing of biohazardous waste resulting from home injections.
- Lancets, needles and syringes are biohazardous waste, since they have been contaminated with skin and blood resulting from direct contact with you or the person receiving the injection.
- Consider making arrangements with a company that provides returnable kits. Some companies offer a service that provides you with the containers you need to dispose of sharp materials and make arrangements that you can then mail the container to them once it is full. The company will then take responsibility for disposing of biohazardous waste.
- Ask your pharmacist about the safest ways to dispose of ampoules that contain unused medications. Often opened drug vials can be thrown into sharps containers.
