2. Introduction
• Intramuscular injection is injected into large muscles.
• Intramuscular injection may be preferred because muscles
have larger and more numerous blood vessels than
subcutaneous tissue, leading to faster absorption
than subcutaneous or intradermal injections.
• A volume of 3-5 mL can be given at a time.
• Common sites for intramuscular injections include the
deltoid muscle, ventrogluteal muscle, dorsogluteal muscle
and vastus lateralis.
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3. Indications
• Muscles have more blood supply so that rapid absorption
can occur.
• More amount of drug can be given as compared to
subcutaneous and intradermal routes.
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4. Contraindications
• Avoid site with any lesion, lumps, or any surgery
• Avoid site over the bone
• Fractured area
• Burn area
• Chances of sciatic nerve injury
• Painful and sometimes it causes abcess
• people with low platelet count or clotting problems
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5. • Intramuscular injections commonly result in pain, redness,
and swelling or inflammation around the injection site.
These side effects are generally mild and last no more
than a few days at most. Rarely, nerves or blood vessels
around the injection site can be damaged, resulting in
severe pain or paralysis.
• If proper technique is not followed, intramuscular injections
can result in localized infections such
as abscesses and gangrene. While historically aspiration,
or pulling back on the syringe before injection, was
recommended to prevent inadvertent administration into a
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6. • As an injection necessitates piercing the skin, there is a
risk of infection from bacteria or other organisms present in
the environment or on the skin before the injection.
• This risk is minimized by using proper aseptic technique in
preparing the injection and sanitizing the injection site
before administration.
• There is also a risk of nerve or vascular injury if a nerve or
blood vessel is inadvertently hit during injection.
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7. Sites
• The site selection basically depends upon patient.
• The site should be free from necrosis or any the infection.
• There should be no bruising and abrasions age of the in
the area.
• The volume of injection also depends upon the site of
administration and age of the patient.
• Intramuscular injections should not be used in people
with myopathies or those with trouble clotting.
• The following sites are most commonly used
for IM injection →
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8. Deltoid Muscle
• This site is the most accessible site.
• Only suitable for relatively small amounts
of solution such as 1-2 mL.
• The muscle is located in the lateral aspect
of the upper arm, approximately 2.5 to 5
cm below the lower edge of the acromion
process.
• The needle is inserted 2.5 cm below the
acromion process on the lateral aspect of
the arm.
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9. Vastus Lateralis
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• Most preferred site for giving injection to children less than
1 year.
• Located in anterior lateral aspect of the thigh as there are
no major blood vessles or significant nerve structures.
• Provide position to the child or adult in back lying or sitting
position.
• In infants; divide the upper thigh from the area between
greater trochanter of the femur and the lateral femoral
condyle into three parts, use the middle third of the muscle
for injection.
11. DorsoGluteal Muscle
• Typical volume of medication given can be up to 3-5 mL.
• Provide side lying or prone position to the patient.
• Divide the buttocks into four quadrants, the upper outer
quadrants is the injection site.
• Since this site is very close to sciatic nerve and artery,
so it is associated with complications such as
numbness, paralysis and pain; therefore do not use this
site without proper knowledge and specialization.
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13. VentroGluteal muscle
• This is an alternative site to the dorsogluteal site, avoid
damage to all major nerves and blood vessels.
• Can be used for administration of narcotics, antiemetics,
sedatives and deep intramuscular injections.
• It is the most preferred site for giving injection in adult patient.
• Provide a comfortable position to the patient such as prone or
side lying to locate the site easily.
• Locate the site by placing the palm of hand onto patient’s
greater trochanter. The index finger is towards anterior
superior iliac supine and the middle finger is stretched towards
the iliac crest towards the buttocks.
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• The index finger, middle finger
and iliac crest form V-shaped
triangle. Inject the needle in
the centre of the triangle.
• 1-5 mL of volume of
medication can be given.
15. Rectus Femoris Muscle
• Locate in the
anterior aspect of
thigh.
• Used for self
administration of
injection and
sometimes used in
infants.
• Usually 1-5 mL of
volume of
medication can be
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16. Z-Track Method
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• An intramuscular injection technique designed to deposit
the medications deep into the muscle tissue.
• It prevent the leakage and tracking into the subcutaneous
tissue.
• Seal the medication into the muscle tissue.
• Minimizes subcutaneous tissue irritation from tracking of
the medication as the needle is withdrawn.
• Used more frequently to decrease comfort and the pain.
• Mainly used for ventrogluteal and dorsogluteal sites.
