In this video I will demonstrate how to administer a subcutaneous injection.
This route is abbreviated either SC or subcut. Vaccines should be prepared in a designated area
that is not adjacent to any area where potentially contaminated items are placed.
CDC recommends that providers prepare vaccines just prior to administration.
Before preparing or administering any vaccine always start with proper hand hygiene.
CDC has hand hygiene guidelines and resources for health care personnel available online.
♪
The appropriate site for a subcutaneous injection depends soley on the patient's age.
For infants younger than 12 months the recommended subcutaneous site is the fatty
tissue over the anterolateral thigh. If needed the fatty tissue over the triceps area
of the upper arm can also be used. For persons 12 months of age and older the recommended
site is the fatty tissue over the triceps area of the upper arm. Begin by removing the vaccine
from the storage unit. Next gather the appropriate supplies. This includes a syringe and
needle. Use a 23 to 25 gauge 5/8 inch needle for subcutaneous injections regardless of the age
or the size of the patient. Also gather prepackaged sterile alcohol wipes and bandages
Needles and syringes may be packaged together or separately. Verify the vaccine you are
preparing matches the standing order or the provider's order. Then check the expiration date.
Never administer expired vaccine. Shirts with tight-fitting sleeves that cannot be rolled
up should be removed. Sometimes a patient may have a tattoo located on the injection site.
Subcutaneous injections may be given through a tattoo. With the entire site clearly visible
check for lumps, swelling, redness, warmth, bruising, or wounds near the injection site.
Next cleanse the injection site with a sterile alcohol wipe using a circular motion,
starting at the center and working outward. Let it dry. Now hold the syringe in your
dominant hand and remove the protective cover from the needle with your other hand. With your
non-dominant hand pinch up some fatty tissue. With your dominant hand hold the syringe and insert
the needle into the fatty tissue at a 45 degree angle. Inject all the vaccine. Once administered
enable the safety sheath and discard the used syringe and needle into a sharps container. Apply
an adhesive bandage to the injection site if there is any bleeding. Note: in this
demonstration I did not aspirate or pull back on the plunger to check for blood. According to
the Advisory Committee on Immunization Practices aspiration is not necessary
before administering a vaccine because no large blood vessels are present at the recommended
injection sites. A 2007 study from Canada compared injection techniques with and without
aspiration and found that an injection that includes aspiration might be more painful
to infants. No adverse events were reported with either injection technique. Immunization
providers should be aware of the potential for syncope or fainting following vaccination.
Providers should have the patient seated or lying down when administering vaccines.
They should also be aware of symptoms that precede fainting such as weakness, dizziness and
pallor, and provide supportive care if symptoms occur. Providers should consider
observing patients, especially adolescents, for 15 minutes after vaccination.
During this observation period patients should be seated or lying down to reduce the risk of
injury associated with syncope. CDC has injection safety resources for health care
personnel available online at www.cdc.gov/injectionsafety
This video is part of a series designed to demonstrate vaccine administration skills and best
practices. The video is available on the Vaccine Administration web page on the
CDC Vaccines and Immunizations website at www.cdc.gov/vaccines