Intradermal injection

 Intradermal injection which means administering medication into the dermis
 skin testing is done through intradermal injection example ,tuberculosis screening and allergy tests.
these medications are potent so inject these into the dermis their blood supply is reduced and drug absorption occurs slowly.

sites for intradermal injection -

• inner aspect of the lower arm upper aspect of the anterior chest.
•  on the posterior -side upper aspect of the posterior chest and posterior side of the upper arm.

pre pocuder assingment -

• check accuracy and completeness of medication administration record with prescribers original medication order
• check patients name medication name and dosage route of administration and time of administration
• recopy any portion of medication administration record that is difficult to read
• review medication reference information about expected reaction when testing skin with specific allergen or medication an appropriate time to read site .
• assess patients history of allergies known type of allergens and normal allergic reaction.
• assess for contraindication to intradermal injections such as reduce local tissue perfusion.
• assess for history of severe adverse reactions or necrosis that happen after previous intradermal injection .
• assess patients knowledge of purpose and response to skin testing.
• check date of expiration for medication .

procuder-

• close room curtain to provide privacy.
• perform hand hygiene and apply clean gloves .
• keep sheet draped over body pots not requiring exposure to reduce transmission of infection
• select appropriate site note lesions or discolorations of skin if possible select site three to four finger widths below antecubital space and one hand width above wrist
• help patient too comfortable for she'll have her extend elbow and supported and forearm on flat surface
• for stabilizing injection site enabling easy accessibility
• clean site with antiseptic swab a place web at center of site and rotate outward in circular direction for about five centimeter this removes secretions containing microorganisms
• hold the gas between third and fourth fingers of non-dominant hand so it remains readily accessible when withdrawing needle .
• remove needle cap from needle by pulling it straight off preventing needle from touching sites of cap prevents contamination
• hold syringe between thumb and forefinger of dominant hand with bevel of needle pointing up
• administer injection
• with non-dominant hand stretched skin over site with four finger or thumb needle pierces tight skin more easily with needle almost against a patient's skin inserted slowly at five to 15 degree angle until resistance is felt advance needle through epidermis to approximately three millimeter below skin surface 
• you will see bulging of needle tip through skin this ensures that needle dippers and dermis you will obtain in accurate results if you do not inject needle at correct angle and depth inject medication slowly because slower injection minimizes discomfort at site then normally you feel resistance
•  if not needle is too deep remove and begin again.

clinical decision alert  -

It is not necessary to aspirate because dermis is relatively a vascular.
by injecting medication note that small bleb resembling mosquito bite appears on skin surface
blood indicates that you deposited medication in dermis
after withdrawing needle apply alcohol swab or gasps gently over site
 do not massage site applied and H if needed
help patient to comfortable position
gives patient a sense of well-being
discard uncap needle in needle disposal and drop the plunger and Barrel in leak-proof receptacle
this helps to prevent injury to patients and healthcare personnel
remove gloves and perform hand hygiene to reduce transmission of microorganisms.
stay with PATIENT for several minutes and observe for any allergic reactions. 

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