OSCE: Intradermal Injection (ID)

📎 Intradermal injection.pdf

Objectives and Key Competencies:

• Demonstrate correct intradermal injection technique.
• Identify potential errors in the procedure.
• Address the "Rights of Medication Administration."

Steps for Intradermal Injection:

1. Patient Preparation:
   • Right Client: Introduce yourself, verify patient identity (name and date of birth).
   • Right Drug: Check and confirm the drug name.
   • Right Dose: Verify the correct dosage.
   • Right Route: Confirm the route (intradermal injection).
   • Right Time: Ensure the injection is administered at the prescribed time.
   • Right to Refuse: Respect the patient's right to refuse and explain potential consequences of refusal.
   • Right Documentation: Record the administration details accurately.
2. Indications for Procedure:
   • Skin allergy testing.
   • Tuberculin skin testing.
   • Xylocaine sensitivity testing.
   • Local anesthesia administration.
   • Specific vaccinations.
3. Contraindications:
   • Active skin infections.
   • Erythema or swelling at the site.
4. Complications:
   • Immediate severe allergic reactions.
   • Abscess formation.
   • Keloid scars (e.g., BCG vaccination).
5. Precautions:
   • Follow universal precautions, including hand hygiene.
   • Ensure sterile technique throughout the procedure.

Procedure:

1. Site Selection:
   • Preferred areas include:
     • Anterior forearm.
     • Upper back below the scapula.
     • Posterior arm.
     • Upper chest just below the clavicle.
   • Ensure the site is free of infection or irritation.
2. Positioning:
   • Position the patient comfortably in a sitting or supine position.
3. Preparation of Equipment:
   • Use a 26-gauge, half-inch needle.
   • Prepare the drug as per protocol.
4. Site Cleaning:
   • Clean the site with alcohol in a circular motion, starting at the center and moving outward.
5. Injection Technique:
   • Stretch the skin taut.
   • Insert the needle at a 5-15° angle into the dermis.
   • Slowly inject the solution, ensuring a raised wheal forms, indicating proper intradermal placement.
6. Post-Injection Care:
   • Remove the needle in the same angle of insertion.
   • Avoid pressing or massaging the site.
   • Observe the patient for adverse reactions.

Evaluation Criteria:

Important Reminders:

• Accurate technique is validated when a wheal forms after injection.
• Avoid areas with swelling, redness, or irritation.
• Monitor for immediate allergic reactions, providing emergency care if necessary.