What is the first thing you need to determine before giving the patient their injections after identifying the patient?

September 28, 2025 •

4 min read

Following proper medical protocol is essential for patient safety, with the Centers for Disease Control and Prevention (CDC) emphasizing a standardized pre-injection checklist. A critical and non-negotiable step is to determine the correct vaccination history or medication order, which helps answer the question: What is the first thing you need to determine before giving the patient their injections after identifying the patient?

Quick Summary

After identifying the patient, the critical first step before administering any injection is to confirm the specific medication or vaccine and the correct dosage against the physician's order and the patient's record.

Key Points

Verify the Medication and Dosage: After confirming the right patient, the immediate next step is to verify the correct medication and its specific dosage against the official order to prevent errors.
Screen for Contraindications: Always check for any conditions, such as allergies or recent illnesses, that could prevent the injection from being administered safely.
Follow the Seven Rights: Healthcare professionals must adhere to the full checklist of the 'Seven Rights' of medication administration, including the right patient, medication, dose, time, route, site, and documentation.
Patient Education and Consent: Inform the patient about the procedure, benefits, and risks, and obtain their informed consent before proceeding with the injection.
Prepare the Injection Aseptically: Use strict aseptic techniques when preparing the syringe and needle to prevent contamination and maintain sterile conditions.
Confirm Route and Site: Before administration, confirm the correct route of injection (e.g., IM, SC) and the appropriate anatomical site, which may vary by age and other factors.

Verifying the Patient and the Order

Once a patient has been correctly identified using two unique identifiers, such as name and date of birth, a healthcare provider must perform several crucial checks to ensure the patient's safety. This initial phase of verification is often part of a broader checklist that should be followed for every injection, whether a routine vaccination or a prescribed medication. This process, often referred to as the "Seven Rights" of medication administration, helps prevent errors that could have serious health consequences for the patient.

The "Seven Rights" of Medication Administration

Following the "Seven Rights" is a core tenet of patient safety in injection procedures. While patient identification is the first "right," the subsequent steps are equally vital. Adherence to this checklist ensures that the correct medication is administered safely and effectively.

Right Patient: Confirmed with two identifiers (e.g., name and date of birth). This is the step completed before the question of the article arises.
Right Medication: Verify that the drug in the syringe matches the one ordered.
Right Dose: Confirm that the amount of medication is correct for the patient and their specific condition.
Right Time: Ensure the injection is administered at the appropriate time according to the treatment schedule.
Right Route: Check that the administration method (e.g., intramuscular, subcutaneous) is correct.
Right Site: Confirm the correct anatomical location for the injection.
Right Documentation: Record the administration accurately in the patient's chart.

Assessing for Contraindications and Precautions

After confirming the order and before preparing the injection, a healthcare professional must screen the patient for any contraindications or precautions. This is an essential safety measure that involves reviewing the patient's medical history for allergies, current health status, and other factors that might affect the injection. For vaccines, this includes reviewing for conditions like pregnancy, immunosuppression, or severe reactions to previous doses. A standardized screening tool or questionnaire is often used to ensure this step is performed consistently and correctly.

Comparing Dosage and Route by Patient Age

Different injections and patient demographics require different considerations for dosage and route. For example, the same medication might be given via an intramuscular route in an adult but require a different approach or needle size for a pediatric patient due to differences in muscle mass and tissue thickness.


Factor	Adult	Infant / Child
Injection Site (IM)	Deltoid muscle is common; ventrogluteal can also be used.	Anterolateral thigh muscle is often preferred due to greater muscle mass.
Needle Length	Longer needle length (typically 1–1.5 inches) is standard for intramuscular injections.	Shorter needle length (e.g., 5/8–1 inch) is used to avoid hitting bone.
Technique	Skin may be spread tight depending on patient fat distribution.	Muscle tissue may be bunched up for proper depth.
Dosage	Standard dose per manufacturer guidelines, adjusted for specific health conditions.	Pediatric dose based on age, weight, or specific protocols, not just weight.
Needle Gauge	Typically 22–25 gauge.	Same gauge range is common, but needle length is adjusted.

Preparing the Injection

Once the order and patient details are verified and the patient has been screened, the injection can be prepared. This process must be done meticulously to prevent medication errors and contamination. The healthcare provider should follow strict aseptic techniques and inspect the vaccine or medication vial carefully.

Hand Hygiene: Always perform proper hand hygiene before preparing the injection.
Aseptic Technique: Prepare the medication using strict aseptic practices in a designated, clean area.
Vial Inspection: Check the vial for any damage, particulate matter, or contamination before drawing the medication.
Expiration Dates: Verify that both the medication and any diluent are not expired.
Right Equipment: Ensure the correct syringe and needle size are selected based on the route and patient characteristics.

The Final Steps Before Injection

With all prior steps confirmed, the final checks before administration are crucial. The healthcare provider should reconfirm the patient’s identity one more time and verbally confirm the injection details with them.

Patient Comfort and Education: Explain the procedure to the patient and obtain informed consent. This is a good time to answer any final questions and discuss potential side effects.
Verbal Confirmation: Verbally confirm the medication and dose with the patient, if they are able to communicate, as an added layer of safety. This also helps build trust.
Site Preparation: Clean the injection site with an alcohol wipe and allow it to dry completely. This minimizes the risk of infection.

Conclusion: Prioritizing Patient Safety in Healthcare

In summary, the first critical action after identifying the patient and before giving their injections is to review and verify the medication or vaccine order against the patient's medical history and current health status. This crucial step encompasses checking for contraindications, ensuring the correct drug and dose, and confirming patient consent. By meticulously following a robust checklist, such as the "Seven Rights," and implementing standardized safety procedures, healthcare professionals can significantly reduce the risk of errors and protect patient well-being during injection procedures. Adhering to these best practices is a cornerstone of safe and effective medical care.

For more information on proper vaccine administration, consult the official guidelines from the CDC: https://www.cdc.gov/vaccines/hcp/admin/administer-vaccines.html.

Frequently Asked Questions

Confirming the medication and dosage is a critical safety check to prevent medication errors. Even with the right patient, administering the wrong drug or an incorrect amount could cause serious harm or be ineffective.

A healthcare provider should check for allergies to the injection components, known severe reactions to previous doses, pregnancy, or immunocompromised status, especially for vaccines.

Yes, improper preparation, such as using an expired medication or failing to use aseptic technique, can lead to contamination and potential infection. Proper preparation is an integral part of ensuring patient safety.

The final verbal confirmation of the patient's identity acts as a redundant safety measure to prevent errors. It ensures there hasn't been a mix-up since the initial identification.

Patient age affects the recommended injection site, needle size, and technique. For example, infants often receive injections in the thigh muscle, while adults typically receive them in the deltoid.

Yes, patient education is a crucial step that involves explaining the procedure, its benefits, and potential side effects. It ensures informed consent and can help reduce patient anxiety.

Right Documentation involves accurately recording the vaccine's manufacturer, lot number, and administration details in the patient's medical record. This is vital for tracking and safety purposes.