Master Intradermal Medication Administration with Picmonic for Nursing RN

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Intradermal medication administration is usually performed for skin testing. The two typical types of skin testing are for tuberculin screening and allergy testing. The injection site is the dermis layer of the skin on an area that can easily be assessed, typical locations include the inner forearm and upper back.These locations need to be hairless, lightly pigmented, and lesion free. Since the medication is potent, very little is needed. A TB or small hypodermic syringe is ideal because they are calibrated in small increments for precise measurements. The angle of the injection should be between 5 to 15 degrees with the bevel of the needle up. As the solution is injected, a small skin color bump should form called a bleb.

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Tuberculin screening, also known as the Mantoux tuberculin test, is one of the intradermal injections (ID) that is typically performed. Individuals who should receive testing include people known or suspected of tuberculosis and people who live or work in a community with high rates of tuberculosis, such as long-term care facilities, prisons, and homeless shelters.

Allergy testing is another reason why an ID injection is given. When this test is performed, a small volume of allergen solution is injected into the dermis layer. An intradermal allergy test is completed when the skin prick test presents with a negative result; however, the substance is still suspected as an allergen. The intradermal test is more sensitive than the skin prick test.

ID medications are injected into the dermis layer of the skin because they are potent, and the dermis contains less blood supply. This allows for a more gradual absorption of the medication.

Skin testing sites need to be in areas that can be easily assessed for color changes and reactions. The location needs to be in an area with little hair, light pigmentation, and clear of previous lesions. Typical locations include the inner forearm and upper back.

A 1mL syringe is used for the administration of intradermal medication. Since little solution is needed, 1mL syringes are used because they are calibrated in small increments.

To access the dermis layer of the skin, an angle of 5 to 15 degrees is used. It is also important to make sure that the bevel of the needle is pointed up.

As the medication is injected into the skin, a small skin color bump should appear on the skin's surface. If a bleb does not develop or if the site bleeds, it is likely the medication was injected into the subcutaneous layer.

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