Injections can be given safely and accurately at home. Applying a safe injection method can protect the patient, the injecting person, and the environment. Injections are generally given at home there are two, namely subcutaneous injections which include insulin administration, and intramuscular injections. If you have to inject yourself or inject a close friend or family member, you should first learn how from the medical professional who prescribes the drug to be injected.
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Method 1 of 4: Preparing to Inject
Step 1. Decide what type of injection you will give
Your doctor should give detailed instructions about the type of injection you will give and the technique. When ready, review the detailed instructions that came with the medication as well as the instructions given by your doctor, nurse, or pharmacist. If you have questions or doubts about how and when the injection should be given, talk to your doctor, nurse, or pharmacist. Ask if you are unsure about the syringe, needle length, and needle thickness before proceeding.
- Some drugs come ready in injections for immediate use, while others have to be filled into the injection from a vial.
- Make sure what you need for the injection. Some people receive more than one type of injection at home.
- The tubes and needles needed for one injection are sometimes difficult to distinguish from the tubes and needles that must be used to inject other drugs.
Step 2. Get to know the product packaging
Not all injection drug packaging is the same. There are drugs that require reconstitution before being administered. There are also medicines that come in the package complete with everything you need, including tubes and syringes. Once again, medical expert must teach about the drug and the steps of preparation for administering the drug. Reading instructions or articles is not enough-you have to ask directly and fully understand the drug and how to inject it.
- After talking to your doctor, you can also review the product information for clear, step-by-step instructions on everything you need to prepare the medication for injection. Again, this information is not a substitute for consulting a medical professional.
- The information also includes recommendations for tube size, needle size, and needle thickness, if not included in the package.
- Give the drug packaged in a single-dose bottle. The usual packaging for most injectable drugs is done by putting the drug in a vial called a single-dose bottle.
- The label on the medicine bottle usually states a single dose vial or its shortened, SDV.
- This means that each bottle contains only one dose. After you have prepared the dose that needs to be injected, there may be some liquid medicine left in the vial.
- Any remaining medication in the vial should be discarded and should not be stored for the next dose.
Step 3. Prepare a single dose from a multidose vial
There are drugs that are packaged in multi-dose bottles, meaning that more than one dose is pulled from the bottle.
- The label on the medicine bottle usually states the multi-dose vial or for short, MDV.
- If the medicine you are taking is packaged in a multi-dose vial, use a permanent marker to write the date the medicine was opened on the bottle.
- Store the medicine in the refrigerator after each use. Don't freeze.
- There are small amounts of preservatives used in the manufacturing process of drugs that are packaged in multidose vials. This helps minimize the growth of contaminants, but only protects the purity of the drug for up to 30 days after the vial is opened.
- The vial should be discarded 30 days after the date it was first opened, unless a doctor advises otherwise.
Step 4. Gather your equipment
You will need the medicine packaging or vial, a syringe that comes with the product if any, a purchased pair of tubes and needles, or separate tubes and needles that are attached during use. Other equipment you'll need may include alcohol swab, small gauze or cotton balls, tape, and an old utensil container.
- Open the outer seal of the medicine bottle, then wipe the top rubber with an alcohol swab. Always allow the rubber to dry on its own after wiping with alcohol. Blowing or wiping the bottle can cause contamination.
- Use gauze or a cotton ball to apply pressure to the injection site to reduce bleeding. Cover the area with plaster.
- Containers for used equipment are an important safety measure to protect patients, caregivers and the public from biohazardous materials. These containers are thick and made of plastic that are designed to hold used utensils. The equipment that comes in here are lancets (scalpels), syringes, and used syringes. If the container is full, you must transfer the contents to a designated area for destroying biohazard equipment.
Step 5. Check the medicine
Make sure the medicine is correct, in the right strength and has not expired. Also make sure the bottle or packaging of the drug has been stored according to the manufacturer's guidelines. Some products remain stable when stored at room temperature before use, while others must be refrigerated.
- Check the packaging for obvious damage such as cracks or dents in the bottle that holds the medication.
- Look at the area above the bottle. Check for cracks and dents in the seal on the top of the medicine bottle. A dented package may mean that the sterility of the package is no longer reliable.
- Look at the liquid in the bottle. Check for any unusual substance or something floating in the bottle. Most injectable drugs are usually clear.
- There is some insulin that looks cloudy. If you notice anything in the bottle other than a clear liquid, other than the insulin product, throw it away immediately.
Step 6. Wash your hands
Wash your hands thoroughly with soap and water.
- Don't forget to wash your nails, between your fingers and wrists.
- This helps prevent contamination and reduces the risk of infection.
- It is recommended to wear gloves that have been approved by BPOM before injecting as extra protection from bacteria and infection.
Step 7. Check the tube and syringe
Make sure the tubes and needles are in sterile packaging and have not been opened and there is no evidence of damage or defects. When opened, inspect the syringe for cracks or discoloration in the tube. This includes the rubber on the suction part. Any damage or defects indicate that the tube should not be used.
- Check the needle for evidence of damage. Make sure the needle is not bent or broken. Do not use a product that appears to be damaged, including any damage to the packaging that may indicate that the needle is no longer considered sterile.
- Some tube and needle packages have a clear expiration date, but not all manufacturers provide this information on the package. If you are concerned that the product is out of date, contact the manufacturer. Have your product identification number ready when you call.
- Dispose of tubes that are damaged or deformed, or those that have expired, by placing them in a used equipment container.
Step 8. Verify that the syringe size and type are correct
Make sure you are using a tube that is designed for the injection to be given. Do not interchange several types of tubes because it can cause serious errors in dosing. Always use the type of tube recommended for the medicine you are giving.
- Choose a tube that holds slightly more than the number of doses to be administered.
- Follow the manufacturer's recommendations for needle length and width.
- The needle width is indicated by a number indicating the needle diameter. The larger the number, the thinner the needle. There are some drugs that are thicker and require a needle with a smaller number, or in other words a larger diameter.
- Most tubes and needles today are manufactured in a single package for safety reasons. When choosing a tube size, you should also choose the length and width of the needle. Make sure the equipment you have for giving the injection is correct. This is explained in detail in the product information, or you can ask your pharmacist, doctor, or nurse.
- Separate tubes and needles are still available. If your syringe is separate, attach the tube and needle. Make sure the tube is the correct size and the needle is sterile, unused, of the appropriate length and width for the type of injection you are giving. Intramuscular and subcutaneous injections use different types of needles.
Step 9. Fill the syringe
Follow the directions on the package if available or fill the tube directly from the medicine bottle.
- Sterilize the top of the bottle with alcohol and let it sit for a few minutes to dry.
- Get ready to fill the tube. Know exactly how much liquid you should withdraw according to the dose. The tube must be filled with exactly the same amount as the prescribed dose. This information is available on prescription labels or on instructions from your doctor or pharmacist.
- To fill the tube, pull on the suction to fill the tube with as much air as needed.
- Hold the bottle upside down, insert the needle into the rubber seal, and push the suction to inject air from the tube into the bottle.
- Pull on the suction to suck out the right amount of liquid at the required dose.
- Sometimes there are air bubbles in the tube. Gently tap the tube while the needle is still in the medicine bottle. This tap will move the air to the top of the tube.
- Push the air back into the bottle, then continue sucking in the medicine if needed to make sure the amount is correct.
Step 10. Make sure the patient is comfortable
Before injecting, consider compressing the injection area with ice to reduce pain, especially in pediatric patients. Allow the patient to sit in a comfortable position by showing the area to be injected.
- Make sure you can reach the injection area without difficulty.
- Ask the patient to remain still and relaxed.
- If you wipe the injection area with alcohol, wait a few minutes for the area to dry on its own before inserting the needle into the skin.
Method 2 of 4: Giving Subcutaneous Injections
Step 1. Determine the injection area according to the doctor's instructions
A subcutaneous injection (SQ) is given into the fatty layer of the skin. SQ is required for specific drugs and doses are usually in small amounts. The layer of fat where the injection is given is located between the skin and muscle.
- One of the best places for subcutaneous injections is the abdomen. Select the area below the waist and above the hipbone, about 5 cm from the navel. Avoid the navel area.
- SQ injections can be given in the thigh area, just between the knee and hip, and slightly to the side as long as you can pinch 2–5 cm of skin.
- The lower back is also great for SQ injections. Target the area above the buttocks, below the waist, and just between the spine and the sides of the body.
- The upper arm can also work as long as there is enough skin that can be pinched up to 2–5 cm. Use the area of the upper arm that is right between the elbow and the shoulder.
- Changing the injection site will help prevent bruising and skin damage. You can also reposition the same area by injecting different parts of the skin within the area.
Step 2. Perform the injection
Clean the skin on and around the injection area with rubbing alcohol. Let the alcohol dry on its own before injecting. It won't take more than one to two minutes.
- Do not touch the area that has been wiped with alcohol with your hands or other equipment before the injection is given.
- Make sure the dose is correct, the injection site is correct, and you have prepared the correct dose.
- Hold the syringe in your dominant hand and remove the needle cap with the other hand. Pinch the skin with your non-dominant hand.
Step 3. Determine the insertion angle
You can insert the needle at an angle of 45 degrees or 90 degrees depending on the amount of skin that can be pinched.
- Use a 45 degree angle if you can only pinch 2cm of skin.
- If you can pinch 5 cm of skin, insert the needle at a 90 degree angle.
- Hold the tube tightly and insert the needle in a quick motion from the wrist.
- Insert the needle quickly and carefully at a predetermined angle with your dominant hand, while pinching the skin with the other hand. Rapid puncture allows the patient not to strain.
- Aspiration is not required for SQ injections. But there's also no danger unless you inject a blood-thinning agent, such as enoxaparin sodium.
- To aspirate, pull on the suction slightly and check for blood in the tube. If there is, remove the needle and find another area to inject. If there is no blood, continue.
Step 4. Inject the drug into the patient's body
Push the sucker down until all the liquid is released.
- Lift the needle. Push the skin over the injection site and withdraw the needle in a quick, careful motion at the same angle as the insertion angle.
- This whole process takes no more than five or ten seconds.
- Dispose of all used syringes in the used equipment container.
Step 5. Give insulin injections
Insulin injections are given subcutaneously but require a different tube to ensure each dose is accurate. In addition, insulin injections are carried out continuously. You should note the area of insulin injection because it is important to help with rotation.
- Recognize the differences in insulin tubes. Using a regular tube can lead to serious dosing errors.
- Insulin tubes are divided in units, not cc or ml. You should always use an insulin tube when giving insulin injections.
- Check again with your doctor or pharmacist to make sure you understand what type of insulin tube to use with the type and dose of insulin prescribed.
Method 3 of 4: Giving Intramuscular Injections
Step 1. Determine the injection area
Intramuscular (IM) injections insert the drug directly into the muscle. Choose an injection site that has easy access to muscle tissue.
- There are four main areas recommended for IM injections. The four areas are the thighs, hips, buttocks, and upper arms.
- Change the injection site to prevent bruising, pain, scars, and skin changes.
Step 2. Give the injection in the thigh
The name of the muscle targeted for injecting the drug in the thigh area is the vastus lateralis.
- Divide the thighs into three. The center is the target for IM injections.
- This is a good area if you are giving yourself IM injections because the area is easy to see and reach.
Step 3. Use the ventrogluteal muscle
This muscle is located in the hip. Use the markings on the body to locate the injection site.
- Find the exact location by asking the patient to lie on his back or side. Place the base of the palms on the top and outside of the thigh where it connects with the buttocks.
- Point the finger at the patient's head and bring the thumb between the thighs.
- You should be able to feel the bones in the tips of your ring finger and little finger.
- Form a V by moving the index finger away from the other finger. The injection is given in the center of the V shape.
Step 4. Give an injection in the buttocks
The area for injection is the dorsogluteal muscle. With practice, this injection area is easier to find, but start by using a physical mark and divide the buttocks area into four quadrants to make sure the injection area is correct.
- Draw an imaginary line or a physical line using an alcohol swab if you have one, from the top of the cleavage to the sides of the body. Mark the midpoint of the line and go up another 7 cm.
- Draw another line across the first line, thus forming a cross.
- Look for the arch bone in the upper outer quadrant. The injection should be given in the upper outer quadrant below the arch bone.
Step 5. Give the injection in the upper arm
The deltoid muscle is located in the upper arm and is a good area for IM injections if there is adequate muscle tissue. Use another area if the patient is thin or has little muscle in that area.
- Locate the acromion process, or the bone that crosses the upper arm.
- Draw an imaginary inverted triangle with the bones as the base and the top of the triangle parallel to the armpits.
- Inject in the middle of the triangle, 2–5 cm below the acromion process.
Step 6. Clean the skin above and around the injection area with an alcohol swab
Let the alcohol dry before giving the injection.
- Do not touch the cleaned area with your fingers or other equipment before the injection is given.
- Hold the syringe firmly with your dominant hand and remove the needle cap with the other hand.
- Press the skin at the injection site. Gently press and pull the skin tight.
Step 7. Insert the needle
Use your wrist to inject the needle into the skin at a 90-degree angle. You will need to push the needle deep enough to ensure that the drug enters the muscle tissue. Choosing the correct needle length will help guide you through the injection process.
- Perform aspiration by pulling the suction slightly. As you pull on the suction, look for blood that is drawn into the tube.
- If there is blood, gently remove the needle and look for another injection site. If no blood is visible, continue the injection.
Step 8. Inject medication carefully into the patient
Push the sucker down until all the liquid is released.
- Do not push the suction too hard as this will force the medicine into the area too quickly. Push the sucker in a steady but slow motion to reduce pain.
- Lift the needle at the same angle as the injection angle.
- Cover the injection area with a small gauze or cotton ball and tape, and check regularly. Make sure the plaster is clean and the injection site does not continue to bleed.
Method 4 of 4: Paying Attention to Safety After Injection
Step 1. Watch for allergic reactions
New drugs should be given first at the doctor's clinic so that signs and symptoms of allergies in patients can be monitored. However, if signs or symptoms of an allergic reaction develop during subsequent treatment, seek immediate medical attention.
- Signs of an allergic reaction include hives, rash or itching, shortness of breath, difficulty swallowing, feeling that your throat and airways are closed, and swelling of your mouth, lips, or face.
- Call an ambulance if symptoms of an allergic reaction continue to develop. If there is indeed an allergy, you have recently received an injection of a medicine that speeds up the reaction.
Step 2. Seek medical attention if you have an infection
Even the best injection technique can sometimes allow contaminants to enter.
- Call your doctor as soon as possible if you have a fever, flu-like symptoms, headache, sore throat, joint and muscle pain, and gastrointestinal problems.
- Other symptoms that require immediate medical attention are chest tightness, nasal congestion or congestion, a rash that has spread, and mental changes such as confusion or disorientation.
Step 3. Monitor the injection area
Watch for changes in the skin tissue at the injection site and the area around it.
- There are certain drugs that cause reactions at the injection site. Read the product information before giving the injection to know what to look out for.
- Common reactions that occur at the injection site are redness, swelling, itching, bruising, and sometimes a lump or hardening.
- If injections must be given frequently, damage to the skin and surrounding tissue can be minimized by changing the injection site.
- Stubborn problems with reactions at the injection site require a medical evaluation.
Step 4. Dispose of used equipment safely
The used tool container is a safe place to dispose of used lancets, tubes, and needles. These containers can be purchased at pharmacies and are also available on the internet.
- Never dispose of lancets, tubes, or needles in the regular trash.
- Read applicable disposal guidelines. Your pharmacist can help find a disposal program that fits your needs. Countries have clear guidelines and advice on safe systems for the disposal of biohazard waste generated by home injections.
- Used injecting equipment, including needles, lancets, and tubes, is biohazardous waste because it has been contaminated with skin and blood from direct contact with you or the person receiving the injection.
- Consider making arrangements with the company that provides return shipping kits. Some companies offer a service that provides the used equipment containers you need and makes arrangements that allow you to ship the containers back to them once they are full. Companies are responsible for destroying biohazard waste in the right way.
- Ask the pharmacy about how to safely dispose of bottles containing used medications. Usually, medicine bottles that have been opened can be put in used equipment containers.
