Preparing and Administering an Injection

Step-by-Step Procedure

1. 1

   Verify the order against the patient's chart: right patient, right drug, right dose, right route, right time — the "five rights" of medication administration.

2. 2

   Check the medication vial or ampule for expiration date, correct concentration, and visible particulates or discoloration before drawing it up.

3. 3

   Draw up the exact ordered dose using an appropriately sized syringe and needle for the route (IM, subcutaneous, or intradermal) and the patient's body habitus.

4. 4

   Select and clean the injection site appropriate to the route — deltoid or vastus lateralis for IM, abdomen or upper arm for subcutaneous, forearm for intradermal.

5. 5

   Administer at the correct angle for the route (90° for most IM injections, 45° for subcutaneous, nearly flat/15° for intradermal) and aspirate or inject per current technique guidance for that medication.

6. 6

   Dispose of the needle immediately in a sharps container — never recap, bend, or set down an uncapped needle.

7. 7

   Document the medication, dose, site, route, and time given, and observe the patient for any immediate reaction before they leave.

Quality Checkpoints

• ✓

  The five rights (patient, drug, dose, route, time) are checked against the order before drawing up the medication.

• ✓

  The vial/ampule is checked for expiration, correct concentration, and clarity before use.

• ✓

  Needle gauge and length match both the route and the patient's body size.

• ✓

  The patient is observed for a reaction for the period your office protocol requires before discharge.

Common Mistakes

• ⚠

  Drawing up the wrong concentration of a medication that comes in multiple strengths (a well-known source of serious dosing errors).

• ⚠

  Using IM technique and needle length for a medication that should be given subcutaneously, or vice versa.

• ⚠

  Not rotating sites for patients receiving frequent injections, leading to tissue damage at a single overused site.

• ⚠

  Recapping a used needle by hand instead of using a sharps container, risking a needlestick injury.

On-the-Job Tips

• →

  Read the label out loud to yourself while drawing up the medication — this single habit catches more wrong-drug and wrong-concentration errors than people expect.

• →

  Keep epinephrine and emergency supplies within immediate reach any time you're giving an injection with anaphylaxis risk (vaccines, allergy shots).

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