What is the best practice for administering subcutaneous injections in children with 'slim limbs'?

 

Connected Care Quick Hits are up to date and evidence based recommendations for the care of children with medical complexity & technology dependence, from hospital to home.


What is the best practice for administering subcutaneous injections in children with 'slim limbs'?

SITUATION: 

This Quick Hit comes from updated best practice guidelines regarding administering subcutaneous injections in the paediatric population.

BACKGROUND:

Subcutaneous injections are used to deliver a variety of medications common to paediatric populations in home and community care (e.g. low molecular weight heparin, insulin, GCSF). 

Subcutaneous injections are administered using a small needle, to deliver medication just beyond the epidermis and into a fatty layer of subcutaneous tissue where it is absorbed slowly over a period of time.

Best practice guidelines for injection techniques have been updated to address the challenge of delivering medications into the subcutaneous tissue for young children or those who are very lean (i.e. with 'slim limbs').

ASSESSMENT:

Selecting the correct supplies, site and method of administration of a subcutaneous injection will minimize complications and improve a child’s comfort with the procedure.

Prior to performing a subcutaneous injection, partner with the child or family caregiver to explore strategies to prevent needle poke pain and promote comfort, such as comfort positioning, skin numbing agents or distraction.

RECOMMENDATION:

Connected Care recommends following the most up-to-date best practice for administering subcutaneous injections. This includes the following care considerations: 

1. Use a needle no larger than 25 gauge in diameter and no longer than 5/8" (16 mm) in length

2. Select an appropriate injection site. Reference the following AboutKidsHealth article for more information.

3. Perform a “skin lift’ by pinching to lift the skin and subcutaneous tissue while administering the injection to increase the surface area and likelihood of injecting into subcutaneous tissue. 

SKIN LIFT

SKIN LIFT

4. Use clinical skill and judgement when deciding on angle of insertion.

Reference these AboutKidsHealth articles for more information on Subcutaneous Injections and common subcutaneous medications:

Subcutaneous Injections

Enoxaparin

Tinzaparin

Insulin

Connected Care Live is not to be used in the event of an emergency.

Have a Question? Initiate a Consult! 

 
All, Other Home CareAdal Bahlibi