What can the nurse do to ensure proper site selection for subcutaneous insulin injection?

28 August, 2018

Part 2 of this two-part series on injection techniques describes the evidence base and procedure for administering a subcutaneous injection Abstract The subcutaneous route allows drugs such as insulin and heparin to be absorbed slowly over a period of time. Using the correct injection technique and selecting the correct site will minimise the risk of complications. This is the second article in a two-part series on injection techniques. Part 1 covers the intramuscular route. Citation: Shepherd E (2018) Injection technique 2: administering drugs via the subcutaneous route. Nursing Times [online]; 114: 9, 55-57. Author: Eileen Shepherd is clinical editor at Nursing Times. Scroll down to read the article or download a print-friendly PDF here (if the PDF fails to fully download please try again using a different browser) Read part 1 of this series here This articles was updated 12th November 2021.

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Do not administer the medication into the injection site if the skin is damaged, burned, bruised, hard, inflamed, or swollen.

Some syringe plungers and rubber stoppers on vials contain latex; read the package insert to determine if the equipment contains latex.

Use one needle, one syringe, one time, for only one patient.undefined#ref3">3

Do not pull back on the syringe (i.e., aspirate) after injecting heparin or insulin.

Take steps to eliminate interruptions and distractions during medication preparation.

OVERVIEW

Subcutaneous tissue is not as richly supplied with blood vessels as are muscles; therefore, medications are absorbed more slowly via subcutaneous injections than with intramuscular (IM) injections. If there is a deviation in the correct route (e.g., IM instead of subcutaneous or subcutaneous instead of IM), the medication may be absorbed too quickly and cause adverse reactions related to the injection medication. Any condition that impairs blood flow is a contraindication for subcutaneous injection.10

The best sites for subcutaneous injection in adults include the outer aspect of the upper arms, the abdomen from below the costal margins to the iliac crests, and the anterior aspects of the thighs (Figure 1)