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Intra Muscular Injection

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.

Health & Medicine◦
Mr. Manikandan.T, RN., RM., M.Sc(N)., D.C.A .,(Ph.D) Assistant Professor, Dept. of Medical Surgical Nursing, VMCON, Puducherry.
Administration of medication into muscle
• Faster rate of absorption • Muscle tissue can hold large volume of fluid • This is favorable for some medication
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
• Deltoid site: locate the acromian process place a finger on process and measure 3 fingerbreath down.
Vastus lateralis: mostly used for infant. Supine position. Divide the thigh into third. Middle third give the injection.
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
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
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)
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.
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.
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
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)
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.
Z track: • Displacing the skin and subcutaneous tissue 1- 1.5 inches laterally prior to injection and releasing the tissue immediately after injection
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