Intradermal Injection
What does it involve?
Giving drugs via the intradermal route involves injecting a drug using a needle and
syringe into the dermal layer.
Intradermal injections are given in a variety of areas but when testing for allergies the
allergen is often injected into the dermal layer of the anterior of the forearm.
Why is the intradermal route used?
The intradermal route is used for local not systemic action.
The route is often used to test for patient sensitivity to allergens or for administering
local anaesthetics.
Only a very small volume can be given intradermally, 0.5ml or less.
Infection prevention
Standard precautions such as correct hand washing and the use of gloves and aprons
should be used. Skin cleansing prior to injection will depend upon local policy.
Visibly dirty skin should be cleaned with soap and water.
Use of 2% chlorhexidine/70% alcohol products to clean skin prior to administering the
injection will depend on local policy.
Important points
Filter needles should be used to draw up medication if available.
If filter needles are not available one needle should be used for drawing up the
medication and a new needle used to administer the medication, this is in case the
needle gets damaged or blunted.
The needle sizes used for intradermal injection are usually 26G brown.
Intradermal injections are given at 10 degrees into pinched up skin.
Please ensure you refer to local policy before undertaking any procedure
What are the main risks?
Infection – Ensure correct use of standard precautions (refer to local policy)
Oedematous sites - Drugs will not be absorbed
Anaphylaxis - Check allergies before giving drugs
Further information is available from:
The Royal Marsden NHS Foundation Trust (2004) The Royal Marsden Hospital Manual
of Clinical Nursing Procedures. Sixth Edition. Intranet Version. Blackwell Publishing.
National Patient Safety Agency (2007) Patient Safety Alert. Promoting Safer Use of
Injectable Medicines. Available [online] www.npsa.nhs.uk
Please ensure you refer to local policy before undertaking any procedure
Name……………………………………………………….WMS No………………………..
T-DOCS: Intradermal Injection
Please can you give this intradermal injection to this patient / manikin?
Washes Hands
Understands indications &
anatomy
Obtains informed consent
Explanation to patient, often
including complications
Communication skills
Appropriate preparation
Technical ability especially
with any special equipment and
sharps
Aseptic technique
Seeks help as appropriate
Post procedure management
Professionalism
Overall ability to perform
procedure
Overall Grade
Hand wash with water and soap using Ayliffe technique.
Explains basic anatomy and that the injection needs to
go into the dermal layer.
Introduction and identifies patient appropriately.
Obtains informed consent.
Clear explanation: e.g. “I am going to inject this
drug into your skin. You may feel some discomfort as I
insert the needle and then inject the drug. ”
Assessment throughout the procedure and allows
patient to ask questions.
Checks drug name, dose, timing, and expiry date.
Checks for patient allergies.
Uses one needle to prepare the medication and a new
needle to administer the medication.
Chooses correct size of needle and syringe.
Apron, gloves, sharps bin and tray, sterile gauze.
Selects appropriate site e.g. anterior forearm
Cleans site if appropriate.
Gently pinches up skin between thumb and index finger.
Warns patient of sharp scratch.
Holds needle and syringe at a 10º angle to the skin
and inserts the needle just into the skin.
Administers the drug slowly
Removes needle from the skin and safely disposes of
needle and syringe into the sharps bin.
Applies pressure to the site with sterile gauze if required.
Documents administration of the drug
Ensures clean injection site and use of standard
precautions.
Understands need for safe disposal of sharps and
potential infection risk.
Discuss complications e.g. Anaphylaxis / Infection
If area bleeding consider sterile dressing
e.g. sterile plaster.
Communicate with the patient re: procedure and need for
injection.
Encourages patient to ask questions.
Thanks patient.
Assess globally, would you be happy for this
student to be supervised to give an ID injection to
a real patient?
BE
B
S
AE
Please ensure you refer to local policy before undertaking any procedure
T- DOCS:
For Medical Students
Clinical Skill ………………………………..
Name of Student
Areas of good practice
1.
2.
3.
Areas for improvement
1.
2.
3.
Below Expectation
Skills labs
Supervised
Global assessment:
Borderline
Satisfactory
Skills labs
Unsupervised
Job Title
Name
Please print:
Patient Safe
Supervised
Assessor signature:
Date
Above Expectation
Teaching Potential
Signature
How suitable do you think this assessment is for undergraduate medical students?
Not Suitable
Highly Suitable
1
□ □ □ □ □ □ □ □ □ □
2
3
4
5
6
7
8
9
10
Any other Comments: Free text please use!
Please ensure you refer to local policy before undertaking any procedure