An intramuscular injection involves injecting medication into the muscle layer under the skin using a needle. [1] It can be performed either by a healthcare professional or self-administered. Common sites for IM injections include the upper arm, thigh, and buttocks. [2] Medications administered via IM injection include certain antibiotics, contraceptives, vaccines, and epinephrine injections. [3] The procedure carries minimal risks but possible side effects include soreness, redness or bleeding at the injection site, or allergic reaction. [4] To properly perform an IM injection, the injection site must be cleaned prior to insertion of the needle at a 90 degree angle and slow injection of the medication

1. Intramuscular Injection (Self-Injection)
Definition
An intramuscular (IM) injection is a shot where the needle goes into the muscle layer under the
skin in order to deliver medicine. This type of injection can be given by a health care professional
or a patient can self-inject. Intramuscular injections are deeper than subcutaneous injections.
Parts of the Body Involved
• Upper arm
• Top of the thighs
• Buttocks
Reasons for Procedure
Some IM medications are “deposited” in the muscle and absorbed gradually over time. IM
injections are also used to deliver medications that would otherwise be absorbed too slowly or
made ineffective if taken by mouth. Examples of such medications include:
• Certain antibiotics
• Certain contraceptive hormones
• Most vaccines
• Epinephrine injections for people with severe allergic reactions
Risk Factors for Complications during the Procedure
The only significant risk factor is having an allergy to the administered medication. Otherwise, no
serious complications are expected.
What to Expect
Prior to Procedure
• Make sure you have all of the items you will need easily available: syringe, medicine,
cleaning materials, etc.
• Wash hands with warm, soapy water prior to giving the injection and dry with a clean
towel
• Select a site and cleanse the area (about 2 inches) with a fresh alcohol pad or a cotton
ball soaked in alcohol.
• Wait for the site to dry.
During Procedure
• Remove the needle cap.
• Pinch a 2- or 3-inch fold of skin between your thumb and index finger.
• Holding the syringe the way you would a pencil or dart, insert the needle at a 90 degree
angle to the pinched-up skin (the needle should be completely covered by skin).
• Hold the syringe with one hand. With the other, pull back the plunger to check for blood.

2. o If you see blood in the solution in the syringe, do not inject. Withdraw the
needle and start again at a new site.
o If you do not see blood, slowly press down on the plunger until it stops.
• Remove the needle from the skin and gently hold an alcohol pad on the injection site. Do
not rub.
• If there is bleeding at the site of injection, apply a bandage.
• Immediately put the syringe and needle into the proper disposal container. Ideally, this
should be a “sharps box” (which you can purchase from a pharmacy). However, you can
also use a sealed coffee can or leak-proof, closable milk jug, as long as it is a puncture-
proof disposal container. You will need to find out what services are available in your
area for the proper disposal of biological waste.
Will It Hurt?
Depending on the medication administered there is usually some minimal discomfort at the
injection site. Some degree of lingering soreness in the muscle is also common.
Tips for Minimizing Injection Pain
• Inject medicine that is at room temperature
• Remove all air bubbles from the syringe before injection
• Wait until the topical alcohol has evaporated before injecting
• Keep muscles in the injection area relaxed
• Break through the skin quickly
• Don’t change the direction of the needle as it goes in or comes out
• Do not reuse disposable needles
Possible Complications
• If blood is in the solution, you will need to try injecting at another site.
• You may have some bleeding, soreness, or redness at the site.
• Allergic reaction to the medication (never administer medications that you may be allergic
to).
Outcome
You should expect the medicine to work in the prescribed way.
Call Your Doctor If Any of the Following Occurs
• You are unable to give yourself the injection
• The injection site continues to bleed
• There is a lot of pain
• You inject the medicine into the wrong area
• There is a rash or swelling around the injection site
• You develop a fever or experience signs of allergic reaction
RESOURCES:
Bielanowski DA. Gale Encyclopedia of Nursing and Allied Health : Intramuscular Injection.
Thomson Gale; 2002.

3. Johns Hopkins Arthritis Center
http://www.hopkins-arthritis.com/
REFERENCES:
Health And Human Services: Selecting, Evaluating, and Using Sharps Disposal Containers
website. Available at: http://www.cdc.gov/niosh/sharps1.html. Accessed October 14, 2005.
Johns Hopkins Arthritis Center website. Available at: http://www.hopkins-
arthritis.som.jhmi.edu/corner/howtoinject.html. Accessed October 14, 2005.
Last reviewed September 2005 by Rosalyn Carson-DeWitt, MD
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