Subcutaneous (Sub-Q) Injections

Some medications work best when they are given into subcutaneous tissue. A subcutaneous tissue is the fatty layer of tissue just under the skin. Giving medicines this way is sometimes called "Sub-Q" injection. The medication is absorbed slowly when it is given this way. There are several different devices used to give a Sub-Q injection. All of the devices use a small, short needle.

      • Syringe and vial
      • Pen device

      When a child first begins getting injections, he / she might be scared. Sub-Q injections can cause discomfort for a few seconds, but as your technique improves, and the child gets used to the shots, they will become less painful. There are several ways you can decrease the discomfort your child feels during the injection.

      Test the areas of the skin by pressing gently to see where he / she is less sensitive.

      Rotate the site where you give the injection (see chart below). Keep track of the sites used. If injections will be given for a length of time, it is best to set up an injection site rotation pattern and be sure sites are at least 1 inch apart.

      Distract your child while the injection is happening. For instance, allow him / her to watch television, sing, look at a book, etc.

      1. Wash hands thoroughly and select a clean surface to set up supplies.
      2. If medication is stored in refrigerator, remove it at least 30 minutes prior to giving.
      3. Check label for correct medication name and expiration date.

      Gather Supplies

      • Medication
      • Safety needle
      • Syringe, if needed
      • Alcohol pad
      • Gauze or cotton ball
      • Band-Aid, if needed
      • Container for used needles and syringes
      1. If using a new vial, take cover off vial of medication.
      2. Clean the rubber stopper with an alcohol pad for 15 seconds.
      3. Remove syringe from package. If needle is not attached, attach needle to syringe. Most needles have a plastic safety cover at the base of the needle, feel free to move this cover out of your way while you draw up the medication and give the injection.
      4. Pull back on the plunger to put air into the syringe equal to the prescribed amount of medication.
      5. Pull needle cap straight off.
      6. Put needle straight into the vial of medication and push in the air. Keep plunger pushed down.
      7. Turn the bottle upside down. Make sure the tip of the needle is in the liquid and draw medication into the syringe. Draw up slightly more than is needed.
      8. Remove syringe from the vial and gently tap the syringe until any air bubbles rise to the top of the syringe.
      9. Push on plunger to remove the air from the syringe and to get the ordered amount of medication.
      10. Set the medication on a clean surface or carefully place cover back on needle until prepared to give the medication.
      1. Load device according to instructions provided by your nurse or package insert.
      2. Wipe the end of the device where the needle is attached with an alcohol pad for 15 seconds.
      3. Attach needle to device.
      4. Remove the large plastic cap from the needle and set aside, you will need this cap after the injection. Remove the small plastic needle cover.
      5. Some devices require a very small dose to be pushed into the needle to remove any air. This is called “priming.” Prime the needle of your device as recommended by instructions or package inserts.
      6. Dial up the prescribed dose and set the device on a clean surface until prepared to give the medication.
      1. The injection is to be given into subcutaneous tissue on the upper arms, upper thighs, lower back / buttocks or abdomen. The skin should not be red, swollen or bruised.
      2. A different site should be used each time you give the medication to avoid soreness or irritation at any one site.
      3. Clean selected site with alcohol pad, wiping in circular motion. If numbing medication was applied, remove clear dressing and wipe off numbing medication with gauze pad and then clean skin with alcohol.

      Possible Injection Sites

        • Outer area / top of legs
        • Belly (at least 2 inches from belly button)
        • Back of upper arm between elbow and shoulder
        • Back or outer area of upper arm
        • Lower back or top of buttocks
      1. Hold the syringe with the medication like you are holding a pencil.
      2. With your other hand, pinch the outside area of the skin that was cleaned with alcohol with you index finger and thumb.
      3. Quickly push the needle into the skin at an angle or 45 to 90 degrees.
      4. Relax the pinch and slowly push down on the plunger. Once the plunger is all the way down, count to five before pulling the needle out. This will ensure all of the medication was absorbed.
      5. Pull the needle out quickly. Cover the site with cotton ball or gauze pad.
      6. If using a syringe, push safety cover over needle and drop the syringe and needle into the sharps container. (see below)
      7. If using a pen, recap the needle carefully with the large hard plastic cap so that you don’t stick yourself with the needle. Remove the needle from the device and place it into the sharps container. (see below)
      8. Apply bandage if needed.
      1. Check with your local pharmacy for special “sharps” containers, which are used for needle and syringe disposal. These containers should be available for purchase.
      2. Check with the pharmaceutical company that makes your medication. Some companies have a needle disposal program you can participate in to keep your community safe.
      3. If you are unable to buy a container, here are some general guidelines to follow to keep your family, neighbors and garbage collectors safe:
        a. Use a hard plastic puncture proof container, such as an empty detergent bottle, to dispose of needles and syringes. (2L soda bottles are too thin.)
        b. Tape the lid on the bottle closed so that it can’t be accidentally opened.
        c. Label the container “SHARPS” in big block letters and place it on top on your trash.
      4. It is extremely important for you to contact your local sanitation carrier to make sure you are disposing of needle and syringes appropriately.

      Last Updated 06/2012