d. Remove Needle Guard. Pull the guard straight off.
e. Stabilize Injection Site.
(1) Using your nondominant thumb, apply downward pressure, directly
below and outside the prepared injection site. (Do not draw the skin back or move the
skin to the side because the skin will return to its normal position when pressure is
released and will cause the needle bevel to either go deeper into the skin or to leave the
skin, depending upon which direction the skin moves.)
(2) Hold the skin taut until the needle bevel has been inserted between the
skin layers (see figure 2-10).
f. Insert Needle.
(1) Using your dominant hand, hold syringe, bevel up, with fingers and
thumb resting on the sides of the barrel. If you insert the needle at a 20 degree angle,
lower it at once to 15 degrees. Do not place thumb or fingers under syringe because
this will cause the angle of insertion to exceed 15 degrees causing the needle to insert
beyond the dermis.
(2) Insert needle, bevel up, just under the skin at an angle of 15 to 20
degrees until the bevel is covered (see figure 2-11). Continue stabilizing thumb
pressure. You should feel some resistance. If the needle tip moves freely, you have
inserted the needle too deeply. At this point, withdraw needle slightly and check again
Figure 2-11. Position of needle.