INTRAMUSCULAR INJECTION

Skill Activity
Dermato Musculo Sceletal 2011
FK UNISBA

INTRAMUSCULAR INJECTION

IM INJECTION SITES

Deltoid
Dorsogluteal
Ventrogluteal
Vastus lateralis

DELTOID MUSCLE

GLUTEUS MAXIMUS

GLUTEUS MEDIUS

VASTUS LATERALIS

Procedure

Assessment
Assess medication record to identify
whether any medications are to be
given to an individual patient
Check medications listed against
physicians orders
Review information regarding the
medication
Assess size and general build of patient
Assess need for assistance

Planning
Determine appropriate needle and syringe
to be used
Wash your hand
Gather eqiupment

Implementation
Read name of medication to be given
from record
Check label on medication and take
from shelf or drawer
Check label again, before calculating
and preparing dosage
Draw up correct dosage of medication

Implementation
a. From vial :
Clean top of vial and allow to dry
Discard alcohol swab
Prepare syringe and needle
Remove needle guard
Insert needle into vial through rubber stop

Implementation
a. From vial :
Pick up vial with non dominant hand and
withdraw correct volume of medication
Examine for air bubbles and expel them
Recheck volume of medication for accuracy
Remove needle from vial
Replace needle guarg

 b. From ampule
Get all medication into lower part of ampule
Clean neck ampule with alcohol swab
Prepare syringe and needle
Wrap neck of ampule and break off the top,
away from yourself
Remove needle guard

 b. From ampule
Hold ampule in nondominant hand and insert
needle into ampule
Aspirate medication into syringe
Withdraw needle from ampule
Point needle vertically and pull back slightly
Expel air from syringe
Make sure that you have the exact volume of
medication needed
Replace needle guard

 to check the label a third time and

recalculate the dosage
Place syringe, needle, and alcohol swab
on cart
Place patient identification card with
medication

 Approach and identify patient

Explain to the patient and perify
appropriate site
Provide privacy
Select the appropiate site for injection by
identifying anatomical landmark

 For intradermal : inner aspect of forearm

or scapular area of back
For subcutaneous : abdomen, lateral
aspect of upper arm or thigh
For intramuscular : lateral aspect of thigh
(vastus lateralis), buttocks (gluteus
maximus), ventral gluteal, upper arm
(deltoid)

Give the injection :

Cleanse area with alcohol wipe, using
circular motion, cleance from inside
outwards
Allow site to dry
Remove needle guard
Express any bubbles from syringe

Insert the needle :

1) for intradermal :

at a10 15 degree angle with the bevel of

needle facing up
inject the medication slowly.
observe for wheals and blanching (normal
finding) at the site
withdraw the needle, wiping area gently with a
dry 2 x 2 pad

Insert the needle :

2) for subcutaneous

at a 45 degree angle while forming a cushion

of subcutaneous tissue by gently pinching the
tissue
pull back on plunger to check if needle is a
blood vessel
inject the medication slowly
withdraw needle quickly, and massage area
with alcohol wipe to aid absorption, put on
bandaid if needed

Insert the needle :

3) for intramuscular

at a 90 degree angle
pull back on plunger. If blood return, you know
you have entered the blood vessel and need
to reposition the needle and aspirate again
inject the medication slowly
withdraw needle quickly and massage the
area with alcohol wipe. Put on a bandaid if
needed

 Return patient to a comfortable position

Evaluation
Evaluate the patients condition 15 minutes
after administering medication

Documentation
Date and time of administering medication
Dosage and type of injection
Patients respons to medication
Name and signature of operators