Administration of Subcutaneous Medications

"I Get To Use The Little Needle"

Before you begin you will need to collect the following items:

	Cotton balls/gauze pad
	disinfectant rubbing alcohol or alcohol swabs
	1 vial of medication
	1 vial of sterile diluent (water)
	1 3cc syringe with 21 gauge 1 ½ inch needle
	1 27 gauge ½ inch needle
	disposable container for medical waste

How to Prepare the Medication

Wash hands with soap and water and wipe the injection site with disinfectant or alcohol swabs to kill any surface bacteria. Let dry for at least one minute before administering the injection.

Remove the flip seals of the medication and diluent vials and wipe with the disinfectant or alcohol swabs.

First inject 1cc of air into the diluent vial to produce a small degree of pressure. To do this pull back on the plunger of the syringe introducing air into the barrel of the syringe (1cc) . While you hold the vial firmly on the work surface, push the needle into the rubber stopper. Inject the air into the bottle of liquid. Invert the vial and with the needle always held below the surface of the liquid in the vial, pull the plunger back slowly to the 1cc. Line or as directed by the doctor. You will need to gradually withdraw the needle as the liquid is drawn up.

Add 1cc or amount directed by your doctor of liquid into the vial of medication and swirl gently (do not shake) until the solution is clear, if the medication does not dissolve DO NOT USE IT. Once dissolved medication should be used immediately

For patients requiring a single injection from multiple vials up to 4 vials can be reconstituted with 1cc of liquid. This can be accomplished by reconstituting a single vial as described above. Then draw the entire contents of the first vial into the syringe and inject contents into the second vial. Gently swirl the second vial, as described above, once again checking to make sure that the solution is clear and free of all particles. This step can be repeated with 2 additional vials for a total of up to 4 vials reconstituted into 1cc of diluent.

Draw the reconstituted solution into the syringe. Draw back on the syringe leaving a ½ cc of air space, this ensures that all the medication is in the syringe. Remove the original needle and substitute with the ½ inch needle for injection.

Hold the syringe vertically with the needle pointing upwards and gently tap on the syringe to force any air bubbles to the top. Push upward on the plunger to force out all the air leaving only the solution in the syringe.

How To Administer The Medication

Administer the medication at the site already cleansed with disinfectant . Subcutaneous injections can be given under the skin in the abdomen or the upper thigh. For subcutaneous administration pinch a large area of skin near the navel ( staying at least 1 inch away from the umbilicus) or the upper thigh where there is loose skin and layers of fatty tissue and insert the needle at the base of the pinched skin at an angle of 45 degrees. Vary the injection site each day to prevent bruising.

Pull the plunger back gently and slowly. The plunger will be difficult to draw back if the needle is correctly positioned. If blood appears in the syringe then the needle penetrated a blood vessel . In this situation remove the syringe cover injection site with a Band-Aid. Discard original needle and replace with a new sterile needle. Repeat steps above for administration at a different site.

Once the needle is properly inserted depress the plunger slowly and steadily.

Pull the syringe out quickly and apply pressure to the injection site while massaging the area. This will relieve any discomfort and help dispense the solution of medication.

USE THE DISPOSABLE SYRINGE ONLY ONCE AND DISPOSE OF IT PROPERLY. DISCARD ANY UNUSED DISSOLVED DRUG.

Discarding Used Supplies

Using a sealable box or jar discard the used syringe, needle and the rest of the disposable supplies as instructed by your doctor.

NEVER LEAVE NEEDLES WHERE OTHERS CAN PICK THEM UP.