Definition

A subcutaneous (SQ) injection is a shot where the needle goes into the fat layer between the skin and the muscle to deliver a certain amount of medicine. This type of injection can either be given by a healthcare professional, or a patient can self-inject.

Parts of the Body Involved

These injections must be given on a part of the body that contains enough of a fat layer to easily deliver the medicine into the correct area.

  • Outer surface of the upper arm
  • Top of the thighs
  • Buttocks
  • Abdomen, except the navel or waistline

Reasons for Procedure

Subcutaneous injections are a relatively convenient way to deliver medication that would otherwise be absorbed too slowly or made ineffective if taken by mouth. Examples include:

  • Insulin injections for people with diabetes
  • Epinephrine injections for people with severe allergic reactions
  • Administration of low molecular weight heparin (eg, Lovenox)

Risk Factors for Complications During the Procedure

  • Allergy to administered medication may be a risk factor. Otherwise, no serious complications are expected.

What to Expect

Prior to Procedure

  • Make sure you have all of the items you will need easily available: syringe, medicine, cleaning materials, etc.
  • Wash hands with warm, soapy water prior to giving the injection and dry with a clean towel.
  • Select a site and cleanse the area (about 2 inches) with a fresh alcohol pad or a cotton ball soaked in alcohol.
  • Wait for the site to dry.

Giving the Subcutaneous Injection

  • Remove the needle cap.
  • Pinch a 2-inch fold of skin between your thumb and index finger.
  • Holding the syringe the way you would a pencil or dart, insert the needle at about a 45 degree angle to the pinched-up skin (the needle should be completely covered by skin).
  • Hold the syringe with one hand. With the other, pull back the plunger to check for blood.
  • If you see blood in the solution in the syringe, do not inject (withdraw the needle and start again at a new site).
  • If you do not see blood, slowly push the plunger all the way down to inject the medicine.
  • Remove the needle from the skin and gently hold an alcohol pad on the injection site. Do not rub.
  • If there is bleeding, apply a bandage.
  • Immediately put the syringe and needle into the proper disposal container. Ideally, this should be a “sharps box” that you can purchase from local pharmacists. However, you can also use a sealed coffee can or leak-proof, closable milk jug, as long as it is a puncture-proof disposal container. You will need to find out what services are available in your area for the proper disposal of biological waste.

Will It Hurt?

The needles for this injection just below the skin are very thin and short, so pain is usually minimal.

Tips for Minimizing Injection Pain

  • Inject medicine that is at room temperature.
  • Remove all air bubbles from the syringe before injection.
  • Wait until the topical alcohol has evaporated before injecting.
  • Keep muscles in the injection area relaxed.
  • Break through the skin quickly.
  • Don’t change the direction of the needle as it goes in or comes out.
  • Do not reuse disposable needles.

Possible Complications

  • If blood is in the solution, you will need to try injecting at another site.
  • You may have some bleeding, soreness, or redness at the site.
  • Allergic reaction to the medication may occur. (Never administer medications that you may be allergic too.)

General Injection Tips

  • Rotate your injection site in a regular pattern
  • Give new injections at least 1.5 inches away from the last injection.
  • Do not use the abdomen as an injection site if you are very thin.

Outcome

You should expect the medicine to work in the prescribed way.

Call Your Doctor If Any of the Following Occurs

  • You are unable to give yourself the injection
  • The injection site continues to bleed
  • There is a lot of pain
  • You inject the medicine into the wrong area
  • You get a rash around the injection site
  • You develop a fever or experience signs of allergic reaction