Medically Fit For Exams
Medically Fit For Exams

Injection technique

  • Wash hands and introduce yourself to the patient
  • Check their name and DOB
  • Explain the procedure and gain consent
  • Ask if they are okay with needles, whether they would rather lie down
  • Check whether the patient has an allergy to the drug you are going to inject
  • Tell the examiner that you would have intramuscular adrenaline to hand in case of allergic reaction



  • Non-sterile gloves
  • Ampule of drug
  • Drawing up needle
  • Injecting needle (blue or green, use only blue for subcut, as it is shorter)
  • Syringe (smallest possible for the volume of drug required)
  • Cotton wool + tape
  • Alcohol wipes (70% for patient, 2% for cleaning top of ampule)
  • Sharps bin


Injection preparation

  • Identify injection site, commonly mid deltoid, buttock or lateral thigh
  • Wash the site with alcohol wipe thoroughly
  • Wash your tray and put all equipment in the tray
  • Put on your gloves
  • Look at the drug ampule and check that it is the drug that has been prescribed
    • Look at the prescription chart
    • Check the volume of drug required
  • Check the expiry date. 
  • Ask the examiner to confirm expiry date and drug name.
  • Open the syringe packet from the plunger end, leaving it within the packaging
  • Open the end of the packet of the injecting needle, leaving it in the packaging
  • Open the packet of the drawing up needle
  • Remove the syringe from the packet and attach to the drawing up needle
  • Remove the safety cap, keeping the syringe in your hand
  • Remove the top from the ampule
  • Insert the drawing up needle into the ampule
  • Depending on the type of ampule, change the position of the needle to prevent the drug leaking out (eg a saline container can’t be held upside down)
  • Draw the required amount of drug into the syringe
  • Remove the drawing up needle – dispose directly into the sharps bin
  • Keep the syringe in your hand, and attach the injecting needle
  • Keep the packaging on, you may want to loosen off the safety cap, but leave it in place until just before you inject


Intramuscular injection

  • Turn to your patient, do another 5-point check
    • Full name
    • DOB
    • First line of address
    • Post code
    • Hospital number/NHS number if appropriate
  • Re-identify the place which you had previously cleaned without touching it
  • Remove the packing and cap from the needle
  • Away from the injection site, pull the skin taught (only if full arm manikin)
  • Hold the needle like a dart
  • Penetrate the skin at 90 degrees, using sufficient force to easily break the skin, and inserting the needle fulling
  • Using both hands, draw back some fluid to ensure there is no blood
  • If no blood, depress the plunger to administer the drug. Use both hands if you feel unstable
  • Leave a couple of seconds before removing the needle and disposing directly into the sharps bin
  • Have a cotton wool ball/gauze ready, and apply pressure to the injection site
  • Wait a few seconds, then look at the injection site
  • If it is still bleeding, tape a piece of gauze to the skin
  • Dispose of the equipment and wash hands
  • Document the drug fully (or say that you would do so), including batch number and manufacturer


Subcutaneous injection

  • Stabilise the skin in the area you are going to inject (generally mid deltoid, abdomen)
  • With your dominant hand, insert the needle into the skin at 45 degrees
  • The needle need only be inserted part way
  • Aspiration is not necessary unless specifically stated
  • Depress the plunger to administer the drug
  • Wait a couple of seconds, and prepare the cotton wool/gauze
  • Remove the needle and apply the cotton wool ball
  • Put the needle straight into the sharps bin
  • Apply pressure with the cotton wool for several seconds
  • Check the wound for bleeding
  • Dispose of equipment and wash hands
  • Document the drug fully

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