Intravenous,

Subcutan and
Intracutan Injection

dr. A.A.A. Lila Paramasatiari, M.Biomed

FKIK UNIVERSITAS WARMADEWA

Learning Objective
Mahasiswa mampu:
 Menjelaskan rasionalitas pemilihan metoda
injeksi IV, subcutan dan Intracutan
 Menjelaskan prinsip-prinsip perlindungan diri
dalam melakukan berbagai tindakan injeksi
 Menjelaskan prosedur dan prinsip-prinsip
melakukan teknik injeksi IV, subcutan dan
Intracutan
 Mahasiswa mampu menjelaskan berbagai
komplikasi teknik injeksi IV, subcutan dan
Intracutan
Injeksi
 Alasan
 Pertimbangan
 Preparasi
pasien
 Keamanan
Anatomi Vena
Factor Influencing Vein choice
 Age of patient
 Condition of vein
 Clinical status of patient
 Type and length treatment
 Medications
 Try and use non-dominan arm
 Site
Condition of vein
A good vein is:
 Bouncy
 Soft
 Refill when depressed
 Visible
 Has a large lumen
 Well supported
 Straight
Avoid veins which are:
 Trombosed/ sclerosed/fibrosed
 Inflamed
 Hard
 Thin
 Mobile
 Near bony prominences, painful
 In the lower extremities
 Area or sites of infection, oedema and phlebitis
 Have undergone multiple previous puncture
Equipment of vein puncture
 Tray
 Mediswab
 Tourniquet
 Small adhesive dressing.
 Sharps Container
 Gloves
 Isopropyl alcohol 70% solution hand rub solution
 ‘Vacutainer’ system needle, holder,
appropriate evacuated tubes Or Sterile
syringe, Sterile needle, Appropriate evacuated
tube
VENA PUNCTURE
 Check the equipment and patient
(mannequin) completely
 Prepare intravenous drug on the syringe
and use the syringe contain saline solution
 Identify the vein and palpate the vein at
the puncture site
 Place the tourniquet proximal to the
pucture site
 Use glove both of your hand
 Apply alcohol solution to the puncture site
 Touch the vein with one hand and needle with the
other hand
 Pierce the skin 0.5 cm beside the vein, bevel up a 15
– 30 degree angle, and decrease the angle to
puncture the vein
 Withdraw the blood just to ensure the needle enter
the correct vein, push the plunger so the saline
solution enter the blood current
 Change the syringe contained blood with syringe
contained drug
 Inject the intravenous drug to the blood current
smoothly
 Withdraw the needle, cover the wound with alcohol
soaked cotton wool and tape it.
Equipment of IV line
 Tourniquet
 Gloves
 Infus set
 Abocath
 Alcohol wipe
 2ml syringe
 needle
 Adhesive dressing for fixation of cannula
 Sharps Container
 Isopropyl alcohol 70% solution hand rub
solution
Intravenous Infusion
 Check the equipment
 Identify the vein
 Check the spike and tube closed regulator
(remove the infuse set from the package)
 Pierce the outflow with a spike
 Hang the infuse bottle at the infusion stand and fill
half of the drip chamber with infuse solution
 Open the fluid regulator to allow fluid to fill tubing
to get rid of air bubbles within the tubing
 Put tourniquet on proximal set
 Use handschoon
 Clean the puncture site with antiseptic
solution and pierce the vein correctly with a
sterile approach
 Push the nylon part of the needle correctly if
there is blood fill the needle chamber
 Connect the nylon part the needle infuse
tube
 Release the tourniqet
 Open the regulator to let the fluid flow
 Regulate the outflow
 Fixate the infusion needle
Failure in intravenous fluid
administration
 Failure to introduce needle into the vein
 The infusion tubing is obstructed
 The air connecting the pipe is impotent
 The position of the arm/leg causes
obstruction of the infusion needle
 The infusion needle punches out the vein
(extravasation)
Resiting Or Removal Of
Cannula
 Cannulae should not remain in situ for any
longer than necessary to reduce the risks
of infection.
 Consideration should be given to resiting
them after 48-72 hours.
 When removing the cannulae, pressure
should be applied to the site for at least a
minute and the site should be occluded
with a sterile dressing.
Possible complications of IV
infusion
 Phlebitis
 Hematoma
 Extra vasation
 Infection
 Nerve fiber injury
Subcutaneus Injection
A subcutaneous injection is given in the fatty layer
of tissue just under the skin.
 Chosen when slow, continuous absorption of the
drug is required (sometimes over 24 hours)
Subcutaneus Injection
 Growth hormone, insulin, epinephrine, low
molecular weight heparin, and other substances
 Use a 25 or 26 gauge needle
Injection subcutan
Speed absorption in injection
sites
Procedure for Subcutaneous
Injection
 Liftskin fold
 Puncture Skin at 90 degrees
 Do not aspirate
 Inject slowly and remove needle
 Release lifted skin fold
Intradermal Injection
 Usually given for skin testing procedures
such as tuberculin screening and allergy
test
 Also for vaccinate BCG
 Give intradermal because the drug
(substances) very potent
 Needle 26 or 27 gauge