Nursing Component Task
Nursing procedures & clinical learning

General Nursing (RGN)

ADMINISTRATION OF INTRADERMAL MEDICATION

This procedure describes placement of a small prescribed volume into the dermal layer for a local medication effect or diagnostic test. Accurate shallow insertion, bleb observation, site marking, follow-up assessment and clear documentation are essential.

Purpose

  • Administer a small prescribed dose into the dermis
  • Perform a diagnostic or sensitivity test according to an approved protocol
  • Provide a local response that can be assessed at the specified time

Indications

  • An authorised prescription or protocol specifies the intradermal route
  • A small volume is required for a diagnostic, sensitivity or local medication procedure
  • The selected skin is intact, healthy and suitable for follow-up observation

Equipment

  • Prescribed medication or test preparation and treatment or test form
  • Sterile 1 mL syringe and appropriate fine needle or authorised prefilled device
  • Antiseptic swabs and dry sterile swab
  • Skin marker and ruler when required by the protocol
  • Gloves and PPE according to risk assessment
  • Sharps container, receiver and hand hygiene supplies

Preparation

  • Verify patient, medication or test, dose, route, expiry, allergies, indication and review time.
  • Assess the skin and avoid bruised, scarred, inflamed, infected, hairy or previously tested sites when the protocol requires another site.
  • Explain that a small bleb may form, obtain consent and tell the patient not to rub the area.

Procedure steps

  • Perform hand hygiene and identify the patient using approved identifiers.
  • Prepare the medication or test aseptically, ensure the correct small volume and remove air without contaminating the needle.
  • Position and support the patient, expose the selected site and maintain privacy.
  • Clean the site with approved antiseptic and allow it to dry completely.
  • Pull the skin gently and insert the bevel just under the skin at the shallow angle specified by the protocol, commonly 5 to 15 degrees.
  • Inject slowly until the small prescribed bleb or wheal forms; do not massage or apply pressure.
  • Withdraw the needle, dab any small blood spot gently with dry sterile gauze and discard the sharp immediately.
  • Mark or measure the site when required, record the time and give the patient clear instructions for protection and review.
  • Observe for immediate reaction, perform hand hygiene and reassess the site at the protocol-specified time.
  • Document the medication or test, dose, site, time, appearance, review result, patient response and action taken.

Precautions

  • Do not rub, massage, cover tightly or apply medication to the test site unless the protocol directs it.
  • Do not use an unlabelled or expired preparation or a site that may make the result unreliable.
  • Use the correct shallow angle and small volume; an injection that is too deep may invalidate the test.
  • Report wheeze, facial swelling, widespread rash, collapse or a severe local reaction urgently.

Aftercare

  • Keep the patient informed of the required review time and ensure the site remains visible for assessment.
  • Arrange review or referral according to the approved test or medication protocol.

Nursing considerations

  • Use the approved national or facility protocol for test timing and interpretation; do not independently diagnose a result outside scope.
  • Use an interpreter or communication aid to ensure the patient understands site care and follow-up.

Possible complications

  • Invalid test result from incorrect depth, volume or site handling
  • Local bleeding, bruising, infection or irritation
  • Allergic or systemic reaction
  • Failure to review or document a clinically important response

Patient education

  • Tell the patient not to scratch, rub or apply creams to the site and to return for review at the specified time.
  • Explain which symptoms require immediate assistance, including breathing difficulty, facial swelling or widespread rash.

Documentation

  • Record preparation, dose, site, time, batch or lot number when required and immediate appearance.
  • Record the review measurement or result, patient symptoms, interpretation by the authorised clinician and actions taken.

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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