Intradermal injections

To avoid confusion: You must follow local policies and procedures regarding technique, equipment used and documentation.

Definition

An intradermal injection is administered into the topmost layer of skin known. It is given into the dermis of the skin just below the epidermis, where the blood supply is reduced and drug absorption can occur slowly. The intradermal route is not regularly used as a route in nursing so you may not see this in every placement area. The intradermal route provides a local rather than systemic effect and is used primarily for administering small amounts of local anaesthetic and skin testing, for example allergy or tuberculin testing

An intradermal injection is given into the dermis of the skin just below the epidermis where the blood supply is reduced and drug absorption can occur slowly (Chernecky et al. 2002). The intradermal route provides a local rather than systemic effect and is used primarily for administering small amounts of local anaesthetic and skin testing, for example allergy or tuberculin testing (Potter 2011).

Evidence-based approaches

Observation of the skin for an inflammatory reaction is a priority, so the best sites are those that are lowly pigmented, thinly keratinized and hairless. Chosen sites are the inner forearms and the scapulae. The injection site most commonly used for skin testing is the medial forearm area as this allows for easy inspection (Downie et al. 2003). Volumes of 0.5 mL or less should be used (Chernecky et al. 2002).

Equipment

The injections are best performed using a 25 or 27 G needle inserted at a 10–15° angle, bevel up, just under the epidermis. Usually a TB (tuberculosis) or 1 mL syringe is used to ensure accuracy of dose.

(Royal Marsden 2015)