Intramuscular injections involve administering medication directly into muscle tissue. They are commonly used to deliver vaccines and certain medications. The deltoid, vastus lateralis, ventrogluteal, and dorsogluteal sites are recommended. To properly perform an intramuscular injection, nurses must prepare the patient, equipment, medication and environment. They clean the injection site, insert the needle at a 90 degree angle, aspirate, inject the medication slowly, and massage the site afterwards. Complications can include pain, swelling or bleeding at the injection site.

1. INTRAMUSCULAR
INJECTION
MADE INCREDIBLY EASY…

2. OBJECTIVES
The group :
Defines intramuscular injection
Enlist the indication of intramuscular injection
Enumerate the contraindication of intramuscular
injection
Explains nursing responsibility of intramuscular
injection
Enlist the sites of intramuscular injection
Describes best practices undergoing

3. INTRODUCTION
• Parenteral drug administration means any non-oral means of administration, but is generally interpreted as
relating to injecting directly into the body, bypassing the skin and mucous membranes. The common parenteralroutesare
intramuscular (IM), subcutaneous (SC) and intravenous (IV

4. DEFINITION:
INTRAMUSCULAR (IM) INJECTION:
A METHOD OF ADMINISTERING MEDICATION DIRECTLY
INTO MUSCLE TISSUE.
-
(MACQUEEN ET AL 2012)

5. INDICATION.
some vaccines are administered intramuscularly:
• Gardasil, Hepatitis A vaccine ,Rabies vaccine
• Influenza vaccines based on inactivated viruses are commonly administered intramuscularly.
• Platelet-rich plasma injections can be administered intramuscularly.
• Certain substances (e.g. ketamine) for recreational purposes.
• Vitamin B12 as cyanocobalamin, hydroxocobalamin or methylcobalamin

6. CONTRAINDICATION
Active infection near the site of injection, a known allergy/hypersensitivity to the
material or to the lidocaine
Acute myocardial infarction: The intramuscular injection leads to the release of muscle-
specific enzymes which complicate the laboratory diagnostics of myocardial infarction
Shock: The blood supply in the periphery is reduced, which means insecure absorption
of the active substances
Coagulation disorders, eg. hemophilia or therapy with anticoagulants: Risk of a massive
hematoma formation at the injection site

7. SITES OF ADMINISTRATION
• FOR INFANTS
• RECTUS FEMORIS
• VENTROGLUTEAL
• DORSOGLUTEAL
• VASTUS LATERALIS
• FOR ADULTS
• VENTROGLUTEAL
• DORSOGLUTEAL
• VASTUS LATERALIS

8. DELTOID
• TO LOCATE THE SITE FEEL FOR THE
BON (ACROMION PROCESS)THAT’S
LOCATED AT THE TOP OF THE UPPER
ARM.THE CORRECT AREA TO GIVE THE
INJECTION IS TWO FINGERS BELOW
THE ACROMION PROCESS.
• AT THE BOTTM OF THE TWO FINGERS
WILL BE AN UPSIDE DOWN TRIANGLE
GIVE THE INJECTION ON THE CENTER
OF THE TRIANGLE

9. VASTUS LATERALIS
• DIVIDE THE UPPER THIGHINTO
THREE EQUAL PARTS.LOCATE THE
MIDDLE OF THESE THREE
SECTION.THE INJECTION SHOULD
GO INTO THE OUTER TOP OF THE
PORTION OF THESE SECTION.

10. DORSO GLUTEAL
• DIVIDE THE BUTTOCKS INTO FOUR
QUANDRANTS THE UPPER PUTER
ASPECT OF THE BUTTOCK WILL BE
THE SITE OF THE INJECTION.

11. VENTRO GLUTEAL
• PLACE THE HEEL OF YOUR HAND ON
THE HIP OF THE PERSON WITH THE
FINGER POINTING TOWARDS THEIR
HEAD.POSITION THE FINGERS SUCH
THAT THUMB POINTS TOWARDS THE
GROIN THE INDEX FINGER TOWARDS
ANTERORSUPERIOR ILIAC
SPINE.SPREAD THE FINGER IN “V”
SHAPE AND INSERT INTO MIDDLE OF V

12. FEMORIS LATERALIS
• PUT YOUR PALM ON THE GREATER
TROCHANTER NEAR THE PUBIS AND
OTHER PALM ON THE PATELA AND
COME TO CENTER WITH THE
POINTER FINGER.

13. PREPARATION
• OF ARTICLES:-
• A CLEAN TRAY CONTAINIG
1. SYRINGE TRAY
2. SYRINGE [3ML] [24G] NEEDEL
3. DRY AND WET COTTON / ALCOHOL SWAB
4. MEDICATION { AMPOULE OR VIAL}
5. PAPER BAG
6. MEDICATION CARD
7. KIDNEY TRAY
8. GLOVES
9. PUNCTURE PROOF CONTAINER

14. • PREPARATIONOFNURSE
1. WASH HANDS
2. CHECK THE MEDICATION ORDERS IN THE FILE OF THE PATIENT.
3. PREPARE THE MEDICATION FROM THE VIAL FOR THE DRUG WITHDRAWL
4. REMOVE THE NEEDLE COVER WITHOUT CONTAMINATING THE NEEDLE
5. IF USING THE PREFILLED UNIT DOSE MEDICATION, TAKE CAUTION TO AVOID
DRIPPING MEDICATION ON THE NEEDLE PRIOR TO INJECTION. IF THIS THUS
OCCUR WIPE THE MEDICATION OFF THE NEEDLE WITH A STERILE GAUZE
6. LOAD THE MEDICATION INT THE SYRINGE FROM THE VIAL.
7. INVERT THE SYRINGE NEEDLE UPPERMOST AND EXPEL ALL THE AIR

15. • PREPARATION OF ENVIRONMENT
1. PROVIDE PRIVACY
2. ENSURE THERE IS GOOD LIGHTING
3. PROPER AIR VENTILATION
• PREPARATION OF PATIENT
1. EXPLAIN PROCEDURE TO THE PATIENT
2. FOLLOW THE CHECKS OF THE PATIENT IDENTIFICATION.

16. PROCEDURE
1. EXPLAIN THE PROCEDURE TO THE PATIENT
2. Select the location and clean the site
3. Select a site free of skin lesion ,tenderness ,swelling ,inflammation
4. If injections are to be frequent, alternate sites. Avoid using the same site twice in a row
5. Put on clean gloves
6. Clean the site with an antiseptic swab. Using a circular motion, start at the center and move outward about 5cm
7. Transfer and hold the swab between the third and fourth fingers of non dominant hand in readiness for needle withdrAWl,or
position the swab on the client’s skin above the intended site.

17. 1. Holding the syringe between the thumb and forefinger pierce the skin quickly and smoothly at a 900 angle and insert the
needle into the muscle.
2. Hold the barrel of the syringe steady with non dominant hand and aspirate by puling back the plunger with the dominant
hand. Aspirate for 5-10 seconds.
3. If blood does not appear inject the medication steadily and slowly.
4. After injection wait 10 seconds
5. Place the cotton near the hub and withdraw the needle quickly and dis card in the puncture proof container
6. Massage the site using a cotton
7. Discard the articles in the appropriate bags.
.

18. COMPLICATIONS
Severe pain at the injection site
Tingling or numbness
Redness ,swelling or warmness at the injection site.
Prolonged bleeding.
Sign of allergic reaction

19. BIBLIOGRAPHY
• LIPPINCOTT WILLIAMS & WILKINS,FUNDAMENTALS OF NURSING MADE INCREDIBILY
EASY,SOUTH ASIAN EDITION,WOLTERS KLUWER,NEW DELHI,Pg235.
• BT BASAVANTHAPPA,FUNDAMENTALS OF NURSING,2nd EDITION JAYPEE BROTHERS
MEDICAL PUBLISHERS,NEW DELHI , Pg628 & 629
• KOZIER ERB BERMAN BURTEN,FOUNDATION OF NURSING,7th EDITION, KINDERLY
,INDIA,Pg864-865
• P.D HINDUJHA COLLEGE OF NURSING,MEDICAL SURGICAL NURSING1 ,PROCEDURE
MANUAL