Injection technique shown in figure is used to administer?

OSSSC Nursing Officer-2021

Nursing Foundation

Easy

Appeared in: OSSSC Nursing Officer-2021

Explanation

The image shows the characteristic technique of an intradermal injection, identified by the shallow 10-15 degree angle of the needle and the formation of a raised wheal or bleb on the skin.
The Bacillus Calmette-Guérin (BCG) vaccine is specifically administered via the intradermal route to ensure a localized immune response.
This method deposits the vaccine into the dermis, which is rich in immune cells, making it ideal for the BCG vaccine's mechanism of action.

Option B: The Measles vaccine (usually as MMR) is administered subcutaneously, not intradermally. A subcutaneous injection uses a 45-degree angle to reach the fatty tissue beneath the skin.
Option C: The Hepatitis B vaccine is administered intramuscularly, at a 90-degree angle, to deliver the vaccine deep into the muscle tissue for systemic absorption.
Option D: The Japanese Encephalitis (JE) vaccine is given either subcutaneously (45 degrees) or intramuscularly (90 degrees), but not intradermally.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Vaccine Administration Routes as background academic context rather than a clinical decision trigger.
Correctly identifying and using the prescribed injection route is a fundamental nursing skill crucial for patient safety and vaccine efficacy. Using the wrong technique can lead to reduced immune response, local injury, or unnecessary pain.
The formation of a wheal during an intradermal injection is a visual confirmation of correct placement. If a wheal does not form, it may indicate the needle was inserted too deeply, and the injection may need to be repeated at another site.
What if? If BCG vaccine were accidentally administered subcutaneously instead of intradermally, it could lead to a severe local reaction, including abscess formation and regional lymphadenitis, without providing optimal protection against TB.

How to Approach the Question

First, carefully analyze the image provided. Identify the key features of the injection technique shown, such as the angle of the needle and the reaction of the skin (formation of a wheal).
Based on these visual cues, classify the injection type. The shallow angle (10-15 degrees) and the wheal are classic signs of an intradermal injection.
Next, review the options provided. Recall or look up the standard administration route for each vaccine listed.
Compare your identification of the injection technique with the known routes for each vaccine. BCG is given intradermally, Measles subcutaneously, Hepatitis B intramuscularly, and JE subcutaneously or intramuscularly.
Select the option that matches the technique shown in the image. In this case, the intradermal technique matches the administration route for the BCG vaccine.

Concept Tested & Keywords

QuKuUC5wvGGR-v44VlhFjp

E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart B (pp 276-535 of 550) pp. 234-236, 233-235

E6 Anatomy Applied Ashalatha 4e p. 232-234