Administration

General Principles

• An i njection s ite is the reaa o f a limbwhere a vaccination can be gveni. There are num erous injection sites i n e ach limb, f or example the m iddle a nterior surface of the f orearm, the m iddle third of the posterolateral surface of the arm, the upper third of the arm, theexternal anterolateral area of the thigh, and the vastuslateralis muscle.

•Immunizing a gents m ust be gi ven using t he a dministration r oute i ndicated i n t he a ppropriate chapter.

•Immunizing a gents s hould not be injected where there is inflammation, itching, rs,scanodules, sensitivity, induration, pain, or blood vessels.

•Whenever possible, avoid administering an immunizing agent in a limb that is likely to be affected by a lymphatic system problem, such as lymphedema or mastectomy with lymph node curettage.

agent’s antigen are used. If the agent is inadvertently administered subcutaneously, the result will be suboptimal immune response.

•A good intramuscular (IM) injection technique is important for the following reasons: –Injecting the agent into adipose tissue could adversely affect the immune response.

–Vaccines containing adjuvants administered subcutaneously or intradermally can cause irritation, induration, a change in skin colouring, inflammation, or the formation of granuloma at the site.

•Hepatitis B and rabies vaccines must be injected into the deltoid muscle in persons 1 year of ageor older. For c hildren u nder 1 year o f age, t he vastus lateralis muscle is u sed t o a dminister these

adipose tissue, instead of the muscle tissue. Any hepatitis B or rabies vaccines administered into the gluteal muscle should be considered not given and should be readministered in the deltoid muscle.

•If several injections are to be given at the same visit, consideration could be given to administering two injections at thesame site. This means that 2IM injections, or1 IM and 1 SC injection, or 2 SC injections could be given at the same site (deltoid muscle or vastus lateralis muscle). The distance between injections should be at least 2.5cm (1inch) so that local reactions can be distinguished for each product administered and immune interference prevented.

Intradermal (ID)Injections

Definition

The introduction into the derma of a minimal amount (between 0.01and 0.1 mL) of biological product; it is used for tuberculin skin test (TST) administration.

Site and needle size for ID injections

•Use a 1 mL TB syringe and 27-gauge needle of ½" length.

•The usual site for intradermal injections is the flexor surface of the forearm.

•Have client rest their arm on a firm surface, forearm turned up.

• Because of t he d ecreased a ntigenic m ass administered wit h I D injections, attention to technique is essential to ensure that the material is not injected subcutaneously.

2.Clean the site with an alcohol swab using a circular Allow the site to dry in order to prevent the user from feeling

outward motion from the centre, describing a circle burning sensation when the needle enters. approximately 5 cm in diameter.

3.Hold t he s kin i n t he s elected a rea be tween thumb and index finger.

Subcutaneous (SC) Injections

Definition

The introduction of an immunizing agent into the connective tissue layer beneath the skin.

2.Clean the s ite with a n a lcohol s

3.

4.Pinch t he s kin between t he thumb a n index fingers to raise the subcutaneous tissue.

5.Release the skin.

6.Inject the immunizing agent.

7.Withdraw t he ne edle a nd a pply sghtli

8.Dispose of s oiled e quipment i n container provided for that purpose.