Audio podcast - Giving subcutaneous injections

Information about subcutaneous injections and why they might be needed.

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What are subcutaneous injections?

The skin is made of different layers; the top two are the epidermis and dermis which contain sweat glands and hair follicles. Underneath these is a layer of fat which is the area where subcutaneous injections are given.

We use three different types of device at GOSH, but this podcast is about giving subcutaneous injections using an ordinary syringe. If your child is going to use an auto-injector, or pen device, information is provide in the packaging.

Subcutaneous injections are suggested for medicines that need to be absorbed slowly by the body – so are better injected under the skin rather than taken by mouth or injected into the vein. Medicines such as a growth hormone, insulin, and some immunosuppressant medicines are given subcutaneously at GOSH.

How to reduce the pain of subcutaneous injections:

Subcutaneous injections can be painful, but there are ways that you can reduce the pain. You will also find that your child will find them less painful in time.

The skin contains nerve endings that send pain messages to the brain if touched by a needle. Some areas of the body are less painful to inject than others - for instance the thighs are less painful than the abdomen.

How you insert the needle can also make a difference to how painful the injection is. The needles that we use are designed so that the sharp end is cut at a 45 degree angle, if you insert it with the cut angle of the needle facing upwards it will be less painful.

You can avoid the injection site from becoming irritated by rotating the area that you inject - for instance injecting in the abdomen one time and the thigh the next.

Preparing the child for the injection will take their mind off any pain. There are lots of ideas in our distraction therapy information, or you can talk to a play specialist too.

How to give a subcutaneous injection:

  1. Before you give the subcutaneous injection, collect everything that you’ll need together. You’ll need; an alcohol wipe, syringe package, cotton wool or gauze, your site rotation chart, the bottle of medicine to be injected.

  2. Wash your hands thoroughly using soap and water.

  3. Wipe the top of the medicine bottle with the alcohol wipe and leave it to dry.

  4. Choose the injection site for this dose.

  5. Open the syringe packing and put it on a clean surface.

  6. Insert the needle into the top of the bottle at a 90 degree angle and pull up the plunger to draw up slightly more than the prescribed dose.

  7. Remove the needle from the bottle and hold it upwards, tap the syringe gently to move any air bubbles towards the needle.

  8. Push the plunger gently to remove the air bubble and squirt a small amount of the medicine into the air.

  9. Lift the skin in your chosen injection area between your thumb and index finger and hold the needle at a 45 degree angle.

  10. Insert the needle into the skin fold so that the needle is at 90 degrees.

  11. Continue to hold the skin fold and push the syringe plunger to inject the medicine while counting to 10 slowly.

  12. Remove the needle from the skin and let go of the skin fold.

  13. Put a piece of cotton wool or gauze over the injection site and hold there for a few seconds.

  14. Throw the used syringe away in a sharps bin, as you have been taught, and mark where you gave the injection on the injection site chart.

Remember that this podcast is meant to act as a reminder for the teaching that we would have given you at Great Ormond Street Hospital. You can ring your clinical nurse specialist for advice if you have any questions.

Ref: F070108 © GOSH Trust September 2007 Compiled by the Endocrine Clinical Nurse Specialists in collaboration with the Child and Family Information Group, GOSH.

 This information does not constitute health or medical advice and will not necessarily reflect treatment at other hospitals. If you have any questions, please ask your doctor. No liability can be taken as a result of using this information.