Intradermal injection

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Intradermal injection
Intradermal injection.jpg
A medical professional performs an intradermal (ID) injection

Intradermal injection (ID) is a shallow or superficial injection of a substance into the dermis, which is located between the epidermis and the hypodermis. This route of administration is relatively rare compared to injections into the subcutaneous tissue or muscle. Due to the more complex use, ID injections are not the preferred route of administration for injection and therefore used for certain therapies only, such as tuberculosis tests and allergy tests. Specific benefits are a higher immune responses for vaccinations, immunology and novel cancer treatments and faster drug uptake,[1] since for certain small and well soluble proteins or molecules, ID route of administration is associated with fast uptake systemically compared to subcutaneous injections, applied in novel closed loop insuline infusion systems. Additionally, the body's reaction to substances is more easily visible since it is closer to the surface.[2]

Injection sites

Common injection sites include the inner surface of the forearm and the upper back, under the shoulder blade.[2]

Equipment

Equipment include syringes calibrated in tenths and hundredths of a milliliter. The dosage given is usually less than 0.5 mL, less than given subcutaneously or intramuscularly. A 14-to-12-inch-long (6 to 13 mm) and 26 or 27 gauge thick needle is used.[2]

Mantoux procedure

Mantoux intradermal injection
Intradermal needle insertion angle compared with other injection types.

The traditional procedure of ID injection known as the Mantoux procedure (as used in the Mantoux test) involves injecting at angle of administration of 5 to 15 degrees angle, almost against the skin. With bevel (opening) side up, the needle is inserted about 18 inch (3 mm) with the entire bevel inside and injected while watching for a small wheal or blister to appear.

Intradermic needles

Traditionally hypodermic needles are used for intradermal injections, instead of intradermic needles. Various microneedle technology researchers worldwide develop new devices and therapies to overcome typical usability issues associated with the traditional Mantoux procedure. Most intradermic needles require a change in injection technique or instruction to use, for example a perpendicular intradermal injection.[3]

Immune reaction tests sometimes use a set of non-hollow needles for scarification, shallowly abrading the skin. The inoculation is limited to the dermis.

See also

References

  1. Rini CJ, McVey E, Sutter D, Keith S, Kurth HJ, Nosek L, Kapitza C, Rebrin K, Hirsch L, Pettis RJ (August 2015). "Intradermal insulin infusion achieves faster insulin action than subcutaneous infusion for 3-day wear". Drug Delivery and Translational Research. 5 (4): 332–45. doi:10.1007/s13346-015-0239-x. PMC 4529466. PMID 26037035.
  2. 2.0 2.1 2.2 Taylor CR, Lillis C, LeMone P, Lynn P (2011). Fundamentals of nursing : the art and science of nursing care (7th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. pp. 749, 788. ISBN 978-0-7817-9383-4. Archived from the original on 2022-03-28. Retrieved 2022-08-02.
  3. Tuan-Mahmood, TM; McCrudden, MT; Torrisi, BM; McAlister, E; Garland, MJ; Singh, TR; Donnelly, RF (18 December 2013). "Microneedles for intradermal and transdermal drug delivery". European Journal of Pharmaceutical Sciences. 50 (5): 623–37. doi:10.1016/j.ejps.2013.05.005. PMC 4119996. PMID 23680534.