Administering Intradermal Medication

Administering Intradermal Medication

Equipment
■ 1-mL syringe (tuberculin) with intradermal needle (25- to 28-gauge, 1/4 - to 5/8 -inch with short bevel).
■ Alcohol prep pad or CHG-alcohol product.
■ 2 in. 2 in. gauze pad; pen (ink or felt).

Assessment
■ Assess for previous reaction to skin testing and for all types of allergies.
■ Assess the skin at intradermal sites for bruising, swelling, tenderness, and other abnormalities.
■ Be Safe! Do not give intradermal skin tests if skin abnormalities are present. Also avoid giving them in areas where reading the results may be difficult, such as areas of heavy hair growth.

Post-Procedure Reassessment
■ Reassess 5 and 15 minutes after administration for allergic reactions.
■ Read the site within 48 to 72 hours of injection, depending on the test.
■ Observe that a wheal (about 6 to 8 mm in diameter) forms at the site and that it gradually disappears.
■ Observe for minimal bruising that may develop at the site of injection.

Key Points
■ Be Safe! Have appropriate antidotes for certain injections readily available before beginning the procedure.
■ Be Safe! Know the location of resuscitation equipment in case of a life-threatening adverse reaction.
■ Be Safe! Maintain sterile technique and standard precautions.
■ Be Smart! Be aware that an intradermal dose is small, usually about 0.01 to 0.1 mL.
■ Use a 1-mL syringe and a 25- to 28-gauge, 1/4- to 5/8-inch needle.
■ Choose a site on the ventral surface of the forearm, upper back, or upper chest.
■ Hold the syringe parallel to the skin at a 5° to 15° angle with the bevel up.
■ Stretch the skin taut to insert the needle.
■ Do not aspirate.
■ Inject slowly, and create a wheal or bleb.
■ Do not massage or bandage the site.

Documentation
■ Document medication, time, dose, and route given, lot numbers (check agency policy), and when the test is to be read.
■ Chart therapeutic and adverse drug effects, nursing interventions, and teaching.
■ Record scheduled medications on the MAR and PRN medications in the nursing notes.
■ For PRN medications, include reason given and response.

Injecting intradermal medication

Inject at a 5 to 15 angle