Daily subcutaneous injections may be given for a week or more after each chemotherapy treatment.
Colony stimulating factors are prescribed during chemotherapy to promote white blood cell production. Parents are taught to administer these injections, so daily hospital visits are not needed. You will be given specific instructions, and the nurse will ensure you are confident in giving the injection.
A subcutaneous injection is given into fatty tissue just below the skin. Though usually given on the outer upper arm, other sites include
- upper buttock
- front outside thigh
- Just above or below the waist, except a 2-inch circle around the navel.
Certain areas of the body may be smaller in malnourished children. Ask your doctor for guidance if this is the case with your child. Regularly changing injection site prevents formation of lumps or dents called iipodystrophies.
During the Procedure
During the Procedure
Instructions will vary, but here is a general overview of what to expect.
- If the medication is refrigerated, take it out about a half hour before the injection so it is at room temperature when administered.
- Wash your hands thoroughly to prevent infection
- If the medication requires mixing, follow the instructions given, and draw the prescribed dose into the syringe. If the syringe is preloaded, jump to step 6.
- Attach the syringe to the injection needle. Hold it upright, needle point up, and gently tap the side to move air bubbles to the top. Carefully press the plunger, until a drop of medication appears on the needle tip.
- Replace the needle cap. Do not let the needle tip touch any surface. If this happens accidentally, start the process again with a sterile needle.
- If you have not used a topical anesthetic, rub an ice cube on the skin to numb the area.
- Clean the skin at the injection site with an antiseptic wipe, and let it air dry. Do not blow on the site as this will reintroduce germs.
- Remove the needle cap or safety cap of a preloaded syringe.
- Pinch about an inch of skin to move subcutaneous tissue away from the underlying muscle. In your other hand, hold the syringe like a dart, and gently but firmly push the needle through the skin at a 90 degree angle. Carefully press the plunger to deliver all the medication.
- Gently remove the needle. Pressing a gauze pad against the skin next to the needle will prevent skin being pulled with the needle. The site will only bleed if you accidentally nicked a blood vessel. This bleeding is normal and should stop quickly. Apply a small plaster/band-aid.
- Place the needles in a sharps container. If the hospital or pharmacy has not given you one, use an empty plastic milk carton or juice bottle.
Injecting your child can be scary. Nerves are normal, and he first injection is the most difficult as you don’t know what to expect – it does get easier.
Advanced preparation for your child is important in supporting her coping through these routine injections. Ensure medical play opportunities are regularly available to promote familiarity wirh medical materials and mastery of the steps involved in this procedure.