Home » Articles » Prick or injection: what types are there and can you do it yourself?
An injection, or more correctly, an injection, is a method of introducing medications into the human body. Injections are carried out using a syringe and a hollow needle or using a needleless injector by injecting a solution under high pressure.
Types of injections
In medicine, there are several types of injections. Their classification is based on which part of the body the solution is injected into. There are very specific forms of injections, for example, parabulbar (in the area under the eyeball). But below we will talk about the most commonly used varieties.
Intravenous
With intravenous injections, the medication is injected directly into the blood vessel. The most important thing here is compliance with sanitary rules. In theory, any human vein can be used for this type of injection. But more often such injections are given in the veins of the cubital fossa, hand, forearm or lower extremities.
The main thing is that it is well contoured and with sufficient width of the walls. It is better to entrust an intravenous injection to a professional, since there are many nuances in the injection technique, and incorrect execution of the manipulation is fraught with serious complications.
Intramuscular
This type of injection is the most common. A kind of transport depot for the medicine is created inside the muscle, from where the medicine gradually spreads throughout the body, being absorbed into the blood. This helps maintain a stable concentration of the drug for several hours and thereby ensure a long-lasting therapeutic effect.
Large muscles where there are no closely located large vessels are suitable for intramuscular injections. Typically the gluteal, deltoid, or anterior thigh muscles are used for this purpose.
Subcutaneous
This type of injection is also called parental, which literally translates as “bypassing the intestines.” This is an alternative to taking the medication orally by swallowing. The drug is quickly absorbed from the subcutaneous tissue without harming the tissues or changing the osmotic tension of the blood.
A subcutaneous injection is used when there is a need for a quick-acting drug (for example, insulin for diabetes), when the patient is unconscious and cannot swallow a tablet, as well as when there are other obstacles to swallowing - obstruction of the esophagus or stomach, severe vomiting, etc.
For such an injection, it should be easily captured in the fold and not threaten the safety of blood vessels and nerve trunks. A subcutaneous injection is placed in the shoulder, but it can be the area above the shoulder blade, the lower part of the armpit, etc.
Intradermal
With an intradermal injection, a thin needle is inserted at an acute angle under the stratum corneum of the skin to a shallow depth. If the insertion is done correctly, when you press the syringe, a light spherical tubercle up to 4 mm in diameter is formed under the skin.
This type of injection is also called intracutaneous. It is used for local anesthesia, determining the presence of a specific immune response of the body (for example, the Mantoux tuberculin test, allergen tests), testing antitoxic immunity (for example, the Schick reaction to diphtheria) and some other medical procedures. The most common site for such an injection is the outer surface of the shoulder or the front surface of the forearm.
Intraosseous
The intraosseous space is an integral part of the vascular system. The same drugs can be administered intraosseously (intrasternally) as intravenously, and the rate of therapeutic effect is the same.
This injection method was first studied back in the 19th century, was widely used during the Second World War, and since the 80s. last century is included in the recommendations for pediatric resuscitation. But the method began to be truly widely used only at the beginning of the 21st century. with the invention of a special gun apparatus for intraosseous infusion. The fact is that it is not always possible for a doctor to administer medicine intravenously (for example, with extensive burns, in small children, if the patient is in a state of shock or clinical death). Therefore, the intraosseous type of injection is often indispensable when resuscitating a patient.
Intrasternally, the drug is usually injected into the tibia, humerus, or radius. Of course, such manipulation is carried out only by a professional, since if performed incorrectly, it can lead to bone penetration, fracture, cartilage damage and other complications.
Intra-arterial
As the name suggests, this type of injection involves injecting medication directly into an artery, usually the radial or tibial artery. An intra-arterial injection is needed if the medicine quickly breaks down in the body or you need to create a high concentration of the medicine in a specific organ.
This type of injection is also used to administer X-ray preparations for a more accurate study of pathologies (tumors, blood clots, aneurysms, etc.).
When is an intramuscular injection given?
A similar injection is given in cases where:
· the person doing the injection does not have the skills to administer the drug differently;
There is no other way to administer the medicine;
· The patient is in an inadequate condition.
Intramuscular injections should only be performed by medical professionals with special skills.
The gluteus medius and minimus, the thigh muscles and the deltoid muscle - in medicine there are several generally accepted places where intramuscular injections are given.
If the injection is given in the gluteal muscles, it is recommended to visually divide the buttock into 4 parts using perpendicular straight lines and inject the drug into the upper quadrant. This will help prevent the needle from hitting the sciatic nerve. During a course of injections, it is recommended to alternate sides.
If the injection is given into the thigh muscles, it is recommended to inject into the middle third of the vastus lateralis muscle. This is the most suitable place to give intramuscular injections to children.
The deltoid muscle is typically used to administer small doses of medications. The likelihood of blood flow disturbance here is negligible.
What types of injections can you do yourself?
Often patients do not want to go to the hospital or go to a medical facility for procedures because of the need to give injections a couple of times a day. Or, at an appointment with a pediatrician, a mother may wonder whether she can give injections to her child herself, so as not to bring him to the hospital every time. The ability to administer an injection is a useful skill in emergency situations when it is not possible to quickly transport the patient to the hospital. In this case, you can ask one of your family members to give an injection, or in very desperate situations, you can inject yourself.
It is clear that not all types of injections can be done independently. Intraosseous and intraarterial infusions are absolutely excluded without the participation of a doctor. Intradermal injections have a rather specific range of applications.
The following types of injections are allowed without the participation of a health care professional:
- intramuscular;
- subcutaneous;
- intravenous.
There are a number of general rules before carrying out an independent procedure - clean hands, work surface, preparing everything necessary in advance. It is very unpleasant when you have already opened the package with a syringe and suddenly realized that there is no file for opening ampoules or cotton balls.
The parts of the body where you can give an intramuscular injection were described above, but the easiest way is in the gluteal muscle. Before the injection, you need to slightly knead and stretch it, wipe with alcohol. The needle should not be inserted completely with a sharp movement at an angle closer to 90 degrees, and the syringe plunger should be lowered as slowly as possible.
The correct injection is placed subcutaneously smoothly, at an angle of 45 degrees. It is done in the fat layer. For injection, you need to disinfect the soft tissue and compress it into a kind of fold. It must be remembered that a subcutaneous injection in the abdomen cannot be given near the navel.
Before an intravenous injection, it is necessary to wrap the tourniquet 5-10 cm above the injection site and ask the patient to clench and unclench his fist several times. After 30-60 seconds, the outline of the vein should be clearly palpable. If this does not happen, you can apply a warm cloth to your hand.
Before the procedure, it is better to give the patient a drink of fluids (if dehydrated, the veins are very difficult to palpate). If the vein is clearly visible and palpable, you need to wipe the injection site with alcohol, insert the needle at an angle of 45 degrees towards the bloodstream and slowly press the syringe plunger. After administering the drug, you should remove the tourniquet. If the vein is hard to see, it is better to refuse to carry out the procedure yourself and turn to a professional, especially since many institutions now offer this service, and it is very easy to find out how much an intravenous injection costs at home (in addition, our team offers on-site services).
Why are injections given into a vein?
If medications can be taken in the form of tablets or tasty syrups, why inject them into a vein? The fact is that not all medications, when taken orally (by mouth), act effectively and quickly. After the drug is absorbed in the intestine, it does not immediately reach the desired organ. It still has to pass through the liver, where part of it will inevitably be destroyed. In addition, the medicine is forced to “take a detour” through the body, and its effects will not appear immediately.
When administered intravenously, the active substance immediately enters the general bloodstream and, bypassing the liver, reaches the desired organ. Sometimes this is of fundamental importance.
Everyone is well aware of how the procedure goes. The nurse asks the patient to place his arm on the table, palm up, and applies a tourniquet above the elbow. You may be asked to “work with your hand” - clench your hand into a fist several times. Due to this, the veins fill with blood even more, swell, and are easier to get into with a needle.
The nurse inserts the needle and pulls the syringe plunger slightly onto the neck. If blood appears in the syringe, the needle has entered a vein. The tourniquet is removed and the medicine is administered. Many drugs must be administered slowly, otherwise unpleasant symptoms may occur.
The elbow is the most common site for intravenous injections. But some people have veins in this area that are “bad” or already “punctured”, and the whole skin is bruised. In such cases, the nurse may use another vein, for example, on the back of the wrist, in the ankle area.
Possible complications during the procedure
Before you decide to inject yourself, it is worth assessing the risks.
With intramuscular and subcutaneous injection, the needle can enter the vessel, which leads to its blockage - embolism. If the injection is given by a non-professional, a couple of days after the injection, infiltrates appear - painful lumps that arise due to non-compliance with sanitary rules or repeated administration of the drug in the same place. A more serious consequence is an abscess, which requires surgical intervention and serious treatment with antibiotics.
Intravenous injections at home with improper technique are fraught with vascular injury. A hematoma quickly appears at the injection site; the drug partially penetrates the skin, causing tissue burns. If a vein puncture occurs at the site of a blood clot, it may break off. With this type of injection, infection is especially dangerous if the rules of asepsis are not observed. It may be better to find out how much an intravenous injection costs with a specialist visiting, weigh the risks and make a decision.
A common complication with all types of injections is allergic reactions to the drug, which can be quite severe, including anaphylactic shock.
How to avoid negative consequences or precautions
Of course, with any invasive procedures it is very important to follow the rules of hygiene and asepsis:
- It is necessary to wash your hands thoroughly, it is better to wear gloves.
- Select a work surface where you will open the ampoule or syringe. Place cotton swabs and alcohol there, which should be treated with an antiseptic. It is best to use a specially designated tray under the work surface.
- During procedures, only disposable instruments should be used. If you accidentally touch the needle before an injection, you should replace it.
- Do not forget to treat the ampoule with the drug with a disinfectant before opening it.
Before taking the medicine, you need to shake the ampoule and carefully ensure that air does not get into the syringe. You can practice drawing liquid into it in advance and removing excess air. Everything necessary for the procedure must be prepared in advance.
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It is better not to inject several days in a row in the same place. It is highly not recommended to inject into areas with compactions, swollen or damaged tissue.
During the procedure, your hand must be steady, so if you are worried or afraid of doing something wrong, you may want to consult a specialist. The price of an intravenous injection is not very high, and the consequences of a mistake can be very unpleasant.
