HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 11-6
Pediatrics: Subcutaneous Injection __RN
PURPOSE:
To inject a prescribed medication into subcutaneous
tissue between the fat and the muscle.
CONSIDERATIONS:
1. This route is commonly used for insulin, heparin,
some narcotics, some chemotherapy, hormone
replacement, allergy desensitization, and some
vaccines.
2. Common subcutaneous sites are outer aspects of
arms and thighs.
3. Rotate injection sites to avoid trauma to same site.
4. Since infants and children move unexpectedly, have
an extra needle available in case of contamination.
5. Encourage the child to help with the procedure by
putting on the bandaid.
6. A filter needle must be used to draw up medication
from an ampule and then replaced with appropriate
size needle for injection.
7. Use at least two (2) patient identifiers prior to
administering medications.
EQUIPMENT:
Medication
Alcohol swabs/wipes
Gauze
Syringes with 24 to 30-gauge needles
19-gauge filter needle (optional)
Gloves
Impervious trash bag
Puncture-proof container
PROCEDURE:
1. Adhere to Universal Precautions.
2. Check doctor's order for dosage, frequency, and
route of administration.
3. Explain procedure to caregiver and patient, in age
appropriate manner.
4. Draw up medication. Recheck medication dosage.
5. Select injection site.
6. Clean site with alcohol swabs, clean center, and
move outward in circular motion.
7. Pinch up skin gently to elevate subcutaneous tissue.
8. Insert needle at 45-degree angle for child with little
subcutaneous tissue, 90-degree angle for child with
more subcutaneous tissue.
9. Once needle is inserted, skin can be released.
10. Pull back on plunger to aspirate, if there is no blood
aspirated, medication may be injected slowly. If
there is blood aspirated, remove needle and choose
another injection site. For insulin and heparin
injections, it is not recommended to aspirate to
check for blood.
11. Withdraw needle. Hold gauze over site and press
for a few seconds.
12. Discard soiled supplies in appropriate containers.
AFTER CARE:
1. Encourage caregiver to comfort the child.
2. Utilize play opportunities to help the child master
his/her feelings about injections.
4. Document in patient's record:
a. Medication administered, dose, time, route, and
site.
b. Patient's response to procedure, side effects,
and management.
c. Instructions given to caregiver.
d. Communication with the physician.
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