- inform patient, check for pain
- stretch skin, clean site (pinched only in deltoid?)
- 90 degree, aspirate to check for blood - remove needle if positive, drop in designated contained - change area.
Indications:
- When rapid response is required
- Medication can not be taken orally (ex. Dysphagia, Profound vomitting…)
- No availability for oral preparation
- Drug is ineffective after oral administration (Patient has malabsorption syndrome)
Contraindication:
- Active infection (cellulitis)
- Known allergy/hypersensitivity of the medication
- Muscular atrophy
Common Sites for Injection
Mid Deltoid
- Common site, upper arm, 3 fingers width above and below (adults)
Dorsalgluteal
- Outer quadrant of the buttocks
- Look out for sciatic nerve
Rectus femoris
- Upper anterior aspect of the thigh
Vastis lateralis
- Lateral aspect of thigh, in the middle third
Amount of injection for IM
-
Buttocks, up to 5 mL may be given by IM injection although more than 3 ml can be painful
-
Deltoid up to 1 ml, 1 ½ inch, 19 or 21-gauge needle usually used
Equipment
- Sterile syringe with appropriate size
- Drug
- Alcohol swab
- Non sterile gloves
- Band-Aid
Technique
- Identify your patient, explain procedure and take permission
- Check if you have the appropriate drug
- Fill the syringe with the drug and empty air bubbles
- Choose the site of injection
- Wash your hands
- Put on gloves
- Open alcohol swab and in a circular motion, clean area in a 2 inch diameter at the site of the intended IM injection
- Let fully dry
- Pull skin around the clean site
- Open the syringe cap and take needle in dominant hand between the thumb and the index finger
- Inform the patient to relax and you will prick him/her which might be uncomfortable
- Insert the needle at 90 degree angle
- Stabilize the needle with the non dominate hand
- Use dominate hand to pull back on the plunger and aspirate for blood
- If there is blood aspirated back into the needle, remove and dispose in a sharps container. start from the beginning.
- Push the medication at a slow and steady pace.
- Pull the needle out and immediately discard in the sharp container (do not cover the syringe)
- Apply gentle pressure on the site and cover with the Band-Aid
- Write full documentation
Complications
- Pain
- In gluteal administration, injury to the sciatic nerve
- Tissue necrosis and abscess
- Hemorrhage
- Infection
•StatPearls