Intradermal injections are given in hairless areas of the body that are lightly pigmented and thinly keratinized so that the nurse can observe any reaction to the medication. These are:

• Inner aspect of forearm or scapular area of back.

Medication injected intradermally has a localized effect because it does not enter the bloodstream. It usually causes a wheal (blister) to appear at the injection site. Injections are given using a 26-27 gauge needle and a 1 mL syringe calibrated in 0.01 mL increments. The typical injection is between 0.01 to 0.1 mL.

Here's how to administer medication intradermally:

• Check the prescriber's medication order.

• Wash hands and then put on clean gloves.

• Properly identify the patient.

• Cleanse the area of the site in a circular motion using alcohol or betadine, depending on the medication and agency policy.

• Position the bevel up and insert the needle at a 10- to 15-degree angle. You should be able to see the outline of the needle through the skin.

• Inject slowly to form a wheal.

• Slowly remove the needle.

• Tell the patient not to wash the mark until a healthcare provider assesses the site for a reaction between 24 to 72 hours after the injection.

• Assess the patient in 24 to 72 hours. If the patient is allergic to the medication, then the diameter of the wheal should increase. If the patient is tested for TB, assess the hardness of the wheal and not the redness of the area.

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