Intradermal Injection - An Insight

Introduction

A substance is injected superficially or shallowly into the dermis, which is situated between the epidermis and the hypodermis, during an intradermal injection (also known as intracutaneous or intradermic, abbreviated as ID). A higher immune response to immunizations, immunology, innovative cancer therapies, and quicker drug absorption can occur when some drugs are administered by an ID route instead of subcutaneous injections.

Additionally, as administration occurs nearer to the skin's surface, the body's response to chemicals is more clearly discernible. Administration by ID, however, is extremely uncommon and only used for specific medicines, TB (tuberculosis), allergy testing, and immunization against monkeypox. This is because the method is more difficult than subcutaneous and intramuscular injections.

What Are Intradermal Injections?

According to the CDC (Centre for Disease Control), an intradermal injection places the vaccine in a layer of skin called the hypodermis between the epidermis, the top layer of skin, and the dermis, the bottom layer. The CDC states that it is often administered on the inside of the forearm, and a wheal, a pronounced elevation of the skin, should result.

What Are the Injection Sites for Intradermal Injections?

The inside surface of the forearm.

• The upper back.

• The deltoid.

• The thigh.

• Areas behind the shoulder blade are all popular injection sites.

Thicker skin is preferred when selecting injection sites.

What Are the Benefits of Intradermal Injections?

• When the capacity of the production process constrains the supply of vaccines, dose-sparing may also "stretch" their availability. When it comes to pandemic influenza vaccinations, this is arguably the most important since the capacity of global manufacturing restricts access to a vaccine at the beginning of a pandemic. In 2009, most low-income nations only had access to the H1N1 (Swine flu) vaccination eight months after the WHO (World Health Organization) declared the pandemic.

• Boost vaccination effectiveness.

• Dose-sparing tactics in a crisis.

• Lower cost.

• Overcome inadequate reaction, such as in old or immunocompromised people.

What Are the Side Effects of an Intradermal Injection?

The following injection site adverse effects have been linked to intradermal vaccination, according to the research the FDA (Food and Drug Administration) cited:

• Firmness.

• Redness.

• Itching. 

• Swelling.

• Skin can only store a certain amount.

• Timing and competence are needed for the ID injection procedure.

• Discoloration at injection sites.

• Painful.

What Are Other Common Mode of Injections?

In the United States, immunizations are commonly administered in a number of distinct methods. The CDC lists these as follows:

• Intramuscular: These vaccinations are often injected into the upper arm's deltoid muscle or the thigh at a 90-degree angle to the skin. Both the COVID-19 and flu vaccines are administered intramuscularly.

• Subcutaneous: Subcutaneous injections are administered at a 45-degree angle, often in the upper-outer triceps area for adults and the thigh for infants under 12 months. MMR and varicella vaccinations are administered subcutaneously.

What Is the Angle for Intradermal Injection?

An intradermal injection typically contains less than 0.5 ml (milliliter). An intradermal injection is administered at a 5 to 15-degree angle. An under-the-skin bleb (small blister) should form when the intradermal injection is finished.

How Should Intradermal Injection Be Given?

The following are the steps to give intradermal injections:

• With the non-dominant hand, tighten the skin, then slowly enter the needle.

• Bevel upward at an angle of 5 to 15 degrees until it is just below the epidermis.

• Inject the drug gradually.

• Immediately a wheal or bubble-like region on the skin's surface appears.

What Is the Use of Intradermal Injection?

The intradermal injection has a mostly local and little systemic impact. In addition to being used for local anesthetics and allergy testing, it is frequently utilized for tuberculin skin testing. An intradermal injection is administered with a 25-gauge or smaller needle placed immediately beneath the epidermis at a 10° angle.

What Is Z Track Technique?

When administering an injection using the Z-track technique, the provider pulls and maintains pressure on the skin just enough to leave a zigzag trail behind when they withdraw the needle and release the skin. When administering an intramuscular injection, the Z-track technique is employed.

What Are the Complications of Intradermal Injection?

• Bleeding at the injection location (possibly up to 3 days after the skin test).

• Scabbing.

• Blistering or crusting at the injection site.

• Cough: a deep, dark purple bruise that appears at the injection site and lasts up to 3 days.

• Respiratory difficulty.

• Dizziness.

• Rapid heartbeat when dizzy.

• Stiff bump at the injection site.

• Fever.

• Hives.

• An injection site that is itchy, painful, red, or swollen.

• Significant, hive-like swelling on the face, eyelids, lips, tongue, neck, hands, legs, or sex organs.

• Erratic breathing.

• Scar at the place of the injection.

• Unusual weariness or weakness.

• Puffiness or swelling of the eyelids, face, lips, or tongue.

Certain potential side effects often do not require medical treatment. These side effects could fade during therapy as body becomes used to the medication. Additionally, the healthcare provider can provide information on how to avoid or lessen some of these adverse effects. See a medical expert if any of the following side effects persist or disturb you.

Conclusion

Diagnostic procedures like allergy or tuberculosis (TB) testing may include intradermal injections. Use a 26- to 29-gauge needle between 3/8 and 1/2 inch in length for intradermal injection. Between 0.01 and 0.1 milliliters of medicine are only delivered through this route.

An under-the-skin bleb (small blister) should form when the intradermal injection is finished. The bleb's appearance shows that the drug was applied to the dermis properly. A local and barely perceptible systemic impact is delivered via intradermal injection.

Injections into the skin are frequently administered into the upper arm. Intradermal injection's key benefit is it acts very quickly. The biggest drawback is that it may cause greater discomfort than other injection methods.