Subcutaneous Injection Technique: Sites, Angles and Tips for Nurses

Subcutaneous injections are among the most common procedures nurses carry out. Good technique reduces pain, bruising and problems with absorption.

Imagine a patient with diabetes who has injected insulin into the same spot for years and now has a lumpy patch of skin. Her blood sugars are unpredictable, and nobody has checked her sites.

Common medicines given this way

• Insulin
• Low molecular weight heparin
• Some vaccines
• Biologic medicines
• Some palliative care medicines

Common sites

• Abdomen: avoiding about 5 cm around the belly button
• Outer thigh
• Back of the upper arm
• Upper buttock

Technique

1. Check the prescription, patient identity and allergies
2. Wash hands and choose a healthy site, avoiding scars, bruises and lumps
3. Use the needle length recommended for the device, often 4 to 8 mm for insulin pens
4. Lift a skin fold if needed, especially in thin patients
5. Insert at 90 degrees, or 45 degrees if the patient is very thin or as the product advises
6. Inject slowly, wait as recommended, then remove the needle
7. Dispose of sharps safely and document

Rotate sites

Rotating sites helps prevent lipohypertrophy, a lumpy build-up of fat that can affect how insulin is absorbed. Check injection sites regularly.

Frequently asked questions

Should I aspirate?

Aspiration is not generally recommended for subcutaneous injections. Follow the product information and local policy.

Should I rub the site afterwards?

No. Rubbing can increase bruising, especially with heparin.

But it is such a simple procedure

Simple procedures repeated often can still cause harm. Good technique and site checks matter.

Sources: Forum for Injection Technique (FIT UK), Diabetes UK, Centers for Disease Control and Prevention, manufacturer product information.