Intramuscular InjectionsIntramuscular Injections

Rakesh PatidarVice principal

JCN, Bhandu,Mehsana, Gujarat

Goal:Goal: -After giving this review session student/co-

worker will be able to confidently administer an intramuscular injection, know sites used for injections, and demonstrate different techniques of giving an intramuscular injection.

-Perform giving IM injections. -Demonstrate correct technique for giving IM

injections. -Identify equipment used for giving IM

injections. -Demonstrate and explain: Z track method and

Air lock technique. -Demonstrate correct disposal of used needle. -Explain and be able to identify how the patient

tolerated the IM injection.

-In this session learner -In this session learner will be educated in IM will be educated in IM injections-injections- -Where to give an IM injection. -Technique for giving IM

injection -Demonstrate different

method for giving an IM injection.

-Equipment needed to perform an IM injection.

  -Equipment needed to -Equipment needed to perform an IM injection-perform an IM injection- -Syringe 1-2 inches in length. -Medication to be

administered. -Gloves -Band-Aid -Alcohol swab -Patient -Muscle where medication

will be administered

--Choosing the site to Choosing the site to administer medication-administer medication--There are several different sites

an IM injection can be given.-Site determination-

-Stage of patients development.

-Body build -Physical condition -Amount of the medication to

be given

  -Sites--Sites- Mid Deltoid- common site,

upper arm, 3 fingers width. Dorsalgluteal- look out for

sciatic nerve, given in the butt. Rectus femoris- right on top

of the thigh. Ventrolgluteal- side of the

butt, or on the hip. Vastis lateralis- outer thigh,

in the middle.

How to find sites-How to find sites-

Mid Deltoid- -Is on the upper arm. - Take 3 fingers and place

them at the top of the shoulder. -At the end of the third finger

in the middle of the muscle is where the injection can be made.

DorsalglutealDorsalgluteal--

-Injection is in the butt. -Watch out for the sciatic nerve. -Have patient stand or lay face down

with toes pointing inward. (relaxes muscle)

-Divide the buttocks into 4 quadrants; give the injection in the outer, upper quadrant toward the hip.

-DO NOT give to children who are not walking yet. (Muscles are not

developed enough)

--

Ventrogluteal- -Good for adults and small

children. - Find the upper part of the hip. -Place palm on hip (greater

trochater), with fingers point to the ground, and make a very large

“V” with your pointer finger and middle finger.

-In the middle of the “V” is where the injection can be done.

Rectus Femoris -On the anterior thigh, above

the knee. -Used mostly by people who

have to get themselves injections.

-This is painful, because the muscles in the anterior thigh

are tense when given.

 Vastus Lateralis- -Most preferred site. -Given to children under 5

years of age. - Patient should be sitting when

this injection is to be given. -On the outer thigh about half

way between the knee and the hip.

-Technique of Giving an -Technique of Giving an Intramuscular Injection-Intramuscular Injection- -Check the 5 rights of medication

administration. -Choose the site the IM injection. -Check the patient for any allergies. -Gather you supplies needed to

perform IM 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.

Continued…Continued…

-Pull skin around the clean site taut. - take needle in dominate hand between the

thumb and the index finger. - At a 90 degree angle, plunge the needle into

the skin in a dart like motion. -Depending on the site and the condition of

the patient, determine how far the needle is going to have to go into the skin to be in the muscle.

-Stabilize the needle with the non dominate hand.

-Use dominate hand to pull back on the plunger and aspirate or 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. Remember to hold the needle as steady as possible.

Continued..Continued..

To take the needle out, quickly pull up at a 90 degree angle.

-Make sure to cover the needle immediately after withdrawing it from the skin.

-Apply some pressure at the site with the alcohol swab that was used to clean the site.

-Message the site to help disperse the medication that was just given.

-Cover site with Band-Aid. -Dispose of needle into a sharps container. -Throw away gloves and wash hands. -Observe the patient for signs of any

allergic reaction, N&V, or any other adverse reactions that may go along with the medication.

- Always remember to document.

-Different Methods of -Different Methods of Giving IM injections-Giving IM injections- -Just giving IM injection and

massaging site- - Z track - Air lock

Just giving IM injections Just giving IM injections and messaging site-and messaging site- -Just dose of medication

given. -Message site after to help

disperse medication in to the muscle.

Z track method-Z track method-

-Used for medications that can cause irritation, can be used for all IM medications.

-Pull skin at the site to the side.- Still give the injection at 90 degree

angle.-When shin is let go and needle

removed the needle track is cut off and the medication can not leak out.

-This will decrease irritation and bruising of the skin.

Air lock Technique-Air lock Technique-

-Medication is drawn up.-0.2mL of air can be added to the

medication.-This will ensure that all the

medication has been pushed though the needle.

- Still given at a 90 degree angle. -Make sure medication is given first

and the air lock second.-Seals needle track so medication will

not go into the subquncaneaus tissue, which can cause pain, soreness and bruising.

Review-Review-

-Always remember 5 rights of medication administration.

-Right dose -Right patient -Right time -Right route -Right medication -Choosing an IM Injection site that works best for

your patient. (Ex: Infants can not have injections in the

dorsal gluteal (butt), In determining a site take into account the patients body build, try to avoid flabby tissue.)

-Different techniques of giving an IM injection: Z track, Air lock.

Evaluation:Evaluation:

1.) Name the site that should not be used for children who are not walking yet?

Dorsal gluteal.

-Describe Z track method:

pulling skin to the side, then giving the shot, cutting off the needle track.

2.) How do you clean a site for injection?

Alcohol swab, 2inches around the site in diameter, let dry completely.

3.)How do you determine where to give a mid deltoid IM injection?

Upper arm, 3 fingers down from the top of the shoulder. In the middle of the arm. Use patients non dominate arm.