This document provides instructions for administering intramuscular injections including the advantages and disadvantages, recommended injection sites, necessary equipment, and procedures. It discusses delivering injections into the deltoid, vastus lateralis, ventrogluteal, and dorsogluteal regions. The procedures outline preparing the medication, identifying the client, explaining the process, selecting an injection site, administering the injection, and documenting properly. Complications that can arise include abscesses, tissue damage, granulomas, hematomas, and nerve injuries.

1. Mr. Manikandan.T,
RN., RM., M.Sc(N)., D.C.A .,(Ph.D)
Assistant Professor,
Dept. of Medical Surgical Nursing,
VMCON, Puducherry.

2. Administration of medication into muscle

3. • Faster rate of absorption
• Muscle tissue can hold large volume of fluid
• This is favorable for some medication

4. ADVANTAGES & DISADVANTAGES
Advantages:
• Reliable
• Absorption is rapid
Disadvantages:
• Painful & sometimes it causes abscess
• Chance of sciatic Nerve injury
• In case of some drugs absorption by IM route is
slower than oral (e.x) diazepam
• For some drugs IM route should be avoided (e.g)
heparin, diazepam

5. • Deltoid site: locate the acromian process place
a finger on process and measure 3
fingerbreath down.

6. Vastus lateralis: mostly used for infant.
Supine position. Divide the thigh into
third. Middle third give the injection.

7. Ventro gluteal :
place the palm of your hand on greater
trochanter the index finger on anterior
superior iliac spine and middle finger
pointing toward iliac crest

8. Dorso gluteal: Never used for infants and small
children. Because of sciatic nerve. Landmark is
posterior superior iliac spine and greater
trochanter. Find the centre and give injection

9. EQUIPMENT
• Medication record or card
• Pen
• Two alcohol swabs
• Disposable gloves
• Medication tray
• Medication to be administered
• 3-ml syringe with 1-, 1.5-, or 2-inch needle
(21,22, or 23 gauge)

10. PROCEDURE
• Wash hands.
• Prepare medication, adhering to the rights of
drug administration .
• Identify client by reading identification bracelet
and addressing client by name.
• Explain procedure and purpose of drug.
• Verify allergies listed on medication record or
card.
• Don gloves.

11. Cont.,
• Assist client into position for comfort and easy visibility
of injection site.
• Clean site with alcohol. Expel the air
• Remove needle cap.
• Pull skin taut at insertion area by using the following
sequence:
• Place thumb and index finger of non dominant hand
over injection site (taking care not to touch cleaned
area ) to form a V.
• Pull thumb and index finger in opposing directions,
spreading fingers about 3 inches apart.

12. Cont.,
• Quickly insert needle at a 90-dgree angle with
dominant hand (as if throwing a dart).
• Move thumb and first finger of non dominant
hand from skin to support barrel of syringe;
fingers should be placed on barrel so that
when you can see the barrel clearly
• Pull back on plunger and observe for possible
blood return in syringe

13. Cont.,
• If blood does return when aspirating, pull the needle
out, apply pressure to the insertion site, Withdraw and
start over with a new needle, syringe, and injection site.
• If no blood returns, push plunger down slowly and
smoothly; encourage client to talk.
• Remove needle
• Quickly remove the needle at same angle as angle of
insertion from the skin and dispose of it in a puncture-
resistant container.
• Massage and clean insertion area with second alcohol
wipe (if contraindicated for drug, apply firm pressure
instead)

14. Cont.,
• Replace the articles
• Remove gloves. needle on tray; do not recap.
• Reposition client, raise side rails and place bed
in lowest position with call button within
reach.
• Wash hands.
• Document administration on medication
record.

15. Z track:
• Displacing the skin and subcutaneous tissue 1-
1.5 inches laterally prior to injection and
releasing the tissue immediately after
injection

16. Complications
• Abscess or collection of pus
• Tissue necrosis, or tissue death
• Granuloma, or inflammation in the tissue
• Muscle fibrosis, or scarring of muscle tissue
• Hematoma, where blood seeps out of blood vessels into the
surrounding tissue
• Injury to blood vessels and nerves
OTHER SYMPTOMS:
• Severe pain at the injection site
• Tingling or numbness
• Redness, swelling, or warmth at the injection site
• Drainage at the injection site
• Prolonged bleeding
• Signs of an allergic reaction, such as difficulty breathing or facial
swelling