Subcutaneous (SQ) Injections

May 31, 2022
| Created by Greg Jones, RPh, MBA

Copy for this article was written by Kimberly Wilson, RN, BSN, PharmD

The first time you prepare to give yourself an injection it can seem overwhelming and a bit scary. To help you out, our pharmacists have provided a detailed step-by-step guide to subcutaneous injections. 

Medication is injected into the fatty tissue underneath the skin.

1- Wash hands with soap and water.

2- Clean and inspect injection site. Inspect injection site for bruising, swelling, hardness or irritation. Clean skin with an alcohol swab. Let dry.

3- Prepare syringe with medication.
 If not using a prefilled syringe, draw up medication from the correct medication vial using a new needle and syringe.

  • Remove cap from vial and wipe rubber stopper with an alcohol swab. Let dry.
  • Draw back plunger to fill syringe with air up to the dose to be injected.
  • Inject air into the vial, turn vial upside down and draw the correct amount of medication into the syringe.

TIP: Make sure the needle tip is in the vial liquid before drawing up medication.

  • Tap syringe with a finger or on counter edge to bring bubbles to the top. Gently press the plunger to push the excess bubbles out.

TIP: Leave the needle in the vial while doing this. If needed, the plunger can be used to pull more medication into the syringe or to push air bubbles and extra medication into the vial.

TIP:  Attach a new needle to the syringe before giving the injection.

4- Pinch a 1-1/2 to 2-inch fold of skin between your thumb and index finger. Pull the skin and subcutaneous tissue away from the muscle.

5- Hold the syringe like a pencil or dart. Inject needle into the fold of skin at a 45-degree angle.

6- While keeping the skin pinched, push the plunger on the syringe to push the medication into the tissue. After the medication is delivered, release the skin, and take the needle out.

7- Place the needle into a puncture-resistant container.

8- If injection site bleeds, apply light pressure with gauze and use a band-aid if needed. Some bruising is normal.

TIP: Rotate between injection sites. Possible injection sites include the abdomen below the navel (at least 2 inches away from the belly button), front of the thigh, and side or back of the upper arm. The lower back can be used if someone else is giving the injection.

Needle and syringe sizes for SQ injections: 23, 25, or 27 gauge, 1/2” or 5/8” length needle. 1 mL syringe.