Subcutaneous Injection at Home
Your health professional has prescribed special medicine for your child, which must be given by injection.
Supplies you will need
Drawing up the medication
- Prescribed medication
- Alcohol swab or 70% alcohol and cotton ball
- Syringe and needle
- Container for disposal
- Wash your hands with soap and water. Count to 15 while washing. Rinse and dry with clean paper or cloth towel.
- Check the medication bottle before using it. Look at the label and check that you have the correction medication and concentration. Make sure that the expiration date has not passed and that the top of the bottle is not damaged. Make sure the medication has not changed color or consistency. Follow the bottle instructions for mixing the medication prior to use.
- Clean the top of the bottle with an alcohol swab or a cotton ball dipped in alcohol. Allow it to dry
- Remove the needle cover from the syringe by pulling it straight off. Lay the cover on a flat surface.
- Draw air into the syringe by pulling back on the plunger to the amount of medication to be given. (Picture A)
- Insert the needle into the rubber stopper of the bottle and push air into the bottle by pushing the plunger. (Picture B)
Picture A: Draw air into the syringe.
Picture B: Insert needle into the bottle. Inject air into the bottle (not the medicine) by pushing the plunger.
Picture C: Fill the syringe with medication by pulling the plunger.
- Leaving the syringe in the bottle, slowly pull the plunger down past the dose of medication you need to give. (Picture C) If there are no air bubbles, push the plunger up to the line to the exact dose of medication you need to give. The top of the rubber plunger should be on the desired amount (not bottom of plunger). If there are air bubbles in your syringe, flick or tap the syringe with your finger. When the air bubble goes to the top of the syringe, push the plunger tip up to push the air out of the syringe into the medication vial. Make sure the needle tip is in the medication fluid, and then pull the plunger back to the exact dose for injection. Repeat the step as needed to remove air from the syringe.
- Remove the syringe from the bottle once the exact dose is in the syringe without air bubbles.
- Put the cap back on the needle loosely to keep the needle clean until you are ready to give the injection. Do not touch the needle.
Several things can be done to make the injection less painful, please discuss these options with the physician:
- Apply ice to the site for 3-5 minutes prior to the injection
- Use distraction techniques during the injection, have the child squeeze something, have the child sing a song, hum, count or recite colors. Keep the child involved in talking, singing or watching TV.
- Discuss using a topical ointment or spray with your physician to numb the site prior to an injection.
- Shot Blockers®, a plastic device used to make shots less painful, may be available in some physician’s offices. Refer to CHKD Way to Grow Shot Blockers® if you are given a ShotBlocker to use at home.
The medication prescribed should be injected into subcutaneous tissue. This is the tissue between the fat layer just under the skin and over the top of the muscles. Subcutaneous tissue is all over your body, but the most common areas for subcutaneous injections are:
- the upper outer area of the arm
- the front and outer sides of the thighs
- the abdomen, except for a 2 inch area around the navel
- the upper outer area of the buttocks
- the upper hip
The grids shown on the body maps on the right are the best places for subcutaneous injections because these are away from joints, nerves and large blood vessels. Discuss the best sites for injection with the nurse or physician.
Site rotation is a system of changing injection sites in a pattern that will help you choose different sites each time you inject. This helps prevent problems that could come from giving injections in the same area. Giving injections in the same place each day may cause your skin to become sunken (atrophy) or lumpy (hypertrophy).
Choose a pattern that is easy for you to remember - one that best suits the number of injections you need and your body size. Most people should inject in one area until all the sites in that area are used. You should move to a different site within the area for each injection. The injections should be about 1 to 2 inches apart. When all the previous sites are used, move to a new area of the body and choose a new site in that area for each injection.
Keep a record of when and where you give each injection. You can mark the date or place an "X" on the body maps as you use a site.
How to give a subcutaneous injection
- Choose injection site.
- Clean the skin with alcohol on a cotton ball or pad using a circular motion and allow it to dry.
- Remove the needle cover by pulling it straight off. Hold the syringe like a pencil with the bevel up. The bevel is the slanted edge of the needle. Do not put your thumb on the plunger yet.
- Pinch the skin between your thumb and index finger. Raise skin ½ to 1 inch.
- With one quick darting motion, insert the needle straight into the skin (90-degree angle) or at a 45-degree angle. The faster the needle goes in, the less it will hurt. You will be instructed on the angle to use for your child. Insulin is always given at a 90-degree angle.
- Inject the medication by pushing the plunger down.
- Release the skin pinch and remove the needle from the skin quickly.
- With a clean cotton ball or tissue, gently apply pressure to the injection site if bleeding occurs. Apply a band aid as needed for bleeding or comfort.
How to discard the syringe:
- Do not recap the syringe. You may hurt yourself.
- Drop the used syringe in a disposal container, such as a hard plastic or metal container with a lid. You may use a coffee can with a slit in the plastic lid. Choose a container that you cannot see through.
- When the container is full, tape the top closed. Discard the container in the trash. You may want to call your local trash collection service for other disposal suggestions. DO NOT bring the container with the used syringes to the hospital or to your physician’s office.
- If you are using a sharps container from a medical company or from a pharmacy, DO NOT return it to the hospital or your physician’s office.
If you have any questions, contact your physician’s office.
This information is of a general nature and is not intended to serve as a substitute for the advice of a physician or other qualified Health Care Provider. ©2002. (Diagrams on page 1 and 3 are from Wong and Whaley's Clinical Manual of Pediatric Nursing, Ed 5, Community and Home Care Instructions, ©2000).
This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.