Receiving Helpdesk

what happens if you give a subcutaneous injection intramuscularly

by Ashly Stracke Published 3 years ago Updated 2 years ago

Subcutaneous injections can lead to localised cellulitis, granuloma formation and abscess. The COVID-19 vaccine has shown to have high efficacy if given correctly intramuscularly. Subcutaneous injection can happen inadvertently (figure 1), affecting efficacy of vaccination and potentiate local adverse events.

Full Answer

Why are injections given intramuscular instead of subcutaneous?

Muscle tissue can also hold a larger volume of medication than subcutaneous tissue. The speed of absorption is faster for intramuscular injection compared to subcutaneous injection, therefore making intramuscular the preferred method for some/most injections.

How do intramuscular injections work?

In the case of intramuscular injections, usually high lipofilicity drugs and/or ester conjugates are used. These drugs are stored in the muscle tissue and released slowly over to the bloodstream, which allows for sustained action of the drug and saves you the trouble of injecting the drug multiple times causing discomfort to the patient.

How does a subcutaneous fat injection work?

Even slender people have a thin layer of subcutaneous fat underneath their skin. The objective of giving a Sub-Q shot is to deposit the drug in this subcutaneous fat layer. You use a very small gauge needle, say 28–30 gauge, a little thicker than a human hair, at a very shallow, almost flat angle.

What is the angle of subcutaneous injection?

Subcutaneous injections are inserted at 45 to 90 degree angles, depending on amount of subcutaneous tissue present and length of needle- a shorter, 3/8" needle is usually inserted 90 degrees and a 5/8" needle is usually inserted at 45 degrees. Medication is administered slowly, about 10 seconds/milliliter.

What happens if you give a subcutaneous shot intramuscular?

It is important to avoid inadvertently injecting the drug into muscle, as intramuscular injection can affect drug absorption; for example, inadvertent administration of insulin into the muscle can lead to accelerated insulin absorption and lead to hypoglycaemia (Down and Kirkland, 2012).

What are the potential complications of subcutaneous injections?

The most common adverse reactions after subcutaneous injections are administered are termed "injection site reactions". This term encompasses any combination of redness, swelling, itching, bruising, or other irritation that does not spread beyond the immediate vicinity of the injection.

What happens if an intramuscular injection is given in the wrong place?

“A vaccine is an immunologically sensitive substance, and if you were to receive an injection too high – in the wrong place – you could get pain, swelling and reduced range of motion in that area,” says Tom Shimabukuro, deputy director of the Centers for Disease Control and Prevention's immunization safety office.

How do you know if you hit a nerve when injecting?

Unlike some veins, nerves are not visible from outside the body, although you will definitely know if you've hit one while injecting because you'll experience extreme pain and no blood will enter the syringe when you pull back to register. You may feel an electric “burn” along your limb.

Why do you pinch the skin when giving a subcutaneous injection?

Insert the needle quickly and firmly at a 90-degree angle. Release the skin. Option: When using an injection pen or giving heparin, continue to pinch the skin while injecting the medication. Rationale: Pinching the skin elevates subcutaneous tissue and desensitizes the area.

Can intramuscular injections cause nerve damage?

However, iatrogenic nerve injury has long been recognized as a common complication of IM injection. The sciatic nerve is the most commonly injured nerve following IM injection because of its large size and the fact that the buttock is a common injection site.

What happens if the flu shot is given subcutaneously?

Injecting a vaccine into the layer of subcutaneous fat, where poor vascularity may result in slow mobilisation and processing of antigen, is a cause of vaccine failure1—for example in hepatitis B,2 rabies, and influenza vaccines.

What could occur if an injection was given into the shoulder instead of the deltoid?

Description: Shoulder injury related to vaccine administration (SIRVA) is a rare complication of incorrect vaccine administration, when the vaccine is given too high into the shoulder joint. This can cause shoulder pain and restricted range of movement. Diagnoses include bursitis, tendinitis and rotator cuff tears.

Why do you need intramuscular injections?

intravenous (injected into the vein) subcutaneous (injected into the fatty tissue just under the layer of skin) Intramuscular injections may be used instead of intravenous injections because some drugs are irritating to veins, or because a suitable vein can’t be located.

How to isolate muscle injections?

To isolate the muscle and target where you’ll place the injection , spread the skin at the injection site between two fingers. The person receiving the injection should get into a position that’s comfortable, provides easy access to the location, and keeps the muscles relaxed.

What does it mean when you see blood in a syringe?

If you see blood going into the syringe, it means the tip of the needle is in a blood vessel. If this happens, withdraw the needle and begin again with a new needle, syringe with medication, and injection site. It’s rare to have this happen.

How to insert a needle into a muscle?

Insert the needle. Hold the needle like a dart and insert it into the muscle at a 90-degree angle. You should insert the needle in a quick, but controlled manner. Do not push the plunger in.

How to stabilize a needle?

Using the hand that’s holding the skin at the injection site, pick up your index finger and thumb to stabilize the needle. Use your dominant hand — the one that did the injection — to pull back on the plunger slightly, looking for blood in the syringe.

Where to give acromion injection?

The correct area to give the injection is two finger widths below the ac romion process. At the bottom of the two fingers, will be an upside-down triangle. Give the injection in the center of the triangle.

Can you use ventrogluteal for sciatic nerve injection?

However, due to the potential for injury to the sciatic nerve, the ventrogluteal is most often used now. This site is difficult to use this site for self-injection and not recommended. You shouldn’t use an injection site that has evidence of infection or injury.

A Live-Attenuated Virus Vaccine

Varicella vaccine is made from an attenuated, or weakened, form of the varicella zoster virus, the organism that causes varicella.

ACIP Recommendations

The Advisory Committee on Immunization Practices (ACIP) recommends that health care providers always administer vaccines according to the route, site, dose and number of doses recommended by the vaccine manufacturer 2.

Intramuscular Injection

When varicella vaccine is mistakenly administered intramuscularly, or into the muscle, instead of subcutaneously, the ACIP recommends that this dose be considered valid. Although the vaccine was not given according to recommendations, the patient does not need a repeat dose to be protected 2.

Reporting Mistakes

The person who administered the vaccine should report the error to the Institute for Safe Medication Practices (ISMP), a federally certified Patient Safety Organization that monitors medication errors and makes recommendations to prevent future errors 2 3.

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