INTRAMUSCULAR INJECTION

IM injection introduction of larger amounts of drugs (as muc as ! mL"

into muscles# using needle $ s%ringe&
Therapeutic Uses:
[5] IM Route 'referred o(er Oral Route )en*
+& Client , )on-t.can-t s)allo) a drug
/& Client , (omiting.a(ing gastric suction
!& 0rug Action , am'ered.destro%ed 1% 2I secretions
3& 0rug Action , 4uic5er action needed com'ared to Oral route
6& 0rug , irritating to 2IT
[B] IM Route 'referred o(er S4 Route )en*
+& Su1stance , irritating to S4 tissues
/& 0rug Action , more ra'id action desired
!& Amt& Of 0rug (to 1e in7ected" , is more tan )at S4 tissues can
a1sor1
12 Equipment/Supplies common or ! t"pes o Injection:
/C!0 89 /M NSS
Cotton :alls ; soa5ed in <= > alcool
; dr%
0is'osa1le ; 2lo(es
; Container for sar's
; Container for glass (am'ules.(ials"
8%'odermic Tra%; ). Sterile To)el
9idne% :asin ; lined ). )aste rece'tacle
Medication ; in am'ule.(ial
; Card
Needle ; si?e de'ending on route
Sol(ent ; for medication in 'o)der form
S%ringe ; /&6 or ! mL de'ending on amt of drug
#ee$les
%&e 'en&th (in) *au&e
Adults + +@ +A /!
Cildren @ B + /6 /<
Infants !.C
! thin&s #urse shoul$ +no, -eore injectin& a me$ication:
+& Dolume to administer
/& Caracteristics $ Discosit% of medication
!& Location of anatomical structures underl%ing in7ection sites
. ne&ati/e consequences o incorrect injection
a$ministration:
MIST%0ES 1ESU'T
+& Incorrect Site ; Ner(e.:one damage
during needle insertion
/& Trem1ling 8and ; Eain $ Tissue 0amage
!& Failure to as'irate
s%ringe 1efore in7ecting
; Accidental in7ection of
air into arter% or (ein
3& Too large (olume for site
selected
; EGtreme Eain $ Tissue
0amage
2 ,a"s in ,/c #urse ma" minimi3e client4s $iscomort:
+& 5hoice o #ee$le HUse sar'B1e(eled $ in smallest suita1le lengt
$ gauge
/& 6ositionin& 5lient Hmost comforta1le to reduce muscular tension
!& Injection Site Hcorrect selection using anatomical landmar5s
3& 5on/ersation Hdi(erts client-s attention
6& Insertin& %ction HIuic5l% $ smootl% to minimi?e tissue 'ulling
J& 7ol$in& S"rin&e Hstead% )ile needle remains in tissues
<& Injectin& Hslo)l% $ steadil%
AN2LES OF INJECTION
1oute o Injection %n&le o Insertion
IM A=
=
S8 36
=
I9 +6
=
I#T1%MUS5U'%1 I#:E5TI;#S
%9<%#T%*E 9IS%9<%#T%*E
Ero(ides faster med
a1sor'tion 1.c of
greater (ascularit% of
muscle
Less danger of
causing tissue
damage )en
entering dee' muscle
Muscle is less
sensiti(e to irritating
$ (iscous meds
! mL in7ected into
larger muscle
tolera1le ).o se(ere
muscle discomfort
Ris5 of accidental
in7ection into 1lood
(essels
3 Considerations for IM In7ection*
+& #ee$le B Use longer $ ea(ier gauge to 'ass tru S4 tissue $
'enetrate dee' muscle tissue
/& =at/;-ese 5lients ma% reIuire ! in long needle
!& Thin 5lients B ma% reIuire onl% @ B + in long needle
3& Small 5hil$ren > Inants B 2i(e maG of + mL onl%

%ssessment -eore IM injection:
+& (B" MassesK
/& (B" S)ellingK
!& (B" TendernessK
3& (B" 8ardened LesionsK
6& (B" EdemaK
5 5onsi$erations or IM Site Selection:
+& (B" Infection.necrosisK
/& (B" :ruising.a1rasionsK
!& Location of underl%ing anatomical structures
3& Dolume of med to 1e administeredK
6& Ad(antages $ 0isad(antages of Site SelectedK
3 Usual IM In7ection Sites* 4D00
+& 4uadrice's
a& rectus femoris
1& (astus lateralis
/& Dentrogluteal
a& gluteus medius
1& gluteus minimus
!& 0orsogluteal
3& 0eltoid
DENTRO2LUTEAL MUSCLE
Safe for all clients , situated dee' $ a)a% from ma7or ner(es $
1lood (essels
Ereferred site for adults $ an%one o(er < monts old
In7uries associated ). all te common IM sites eGce't (entrogluteal*
+& Fi1rosis
/& Ner(e damage
!& A1scess
3& Tissue necrosis
6& Muscle contraction
J& 2angrene
<& Eain
+
INTRAMUSCULAR INJECTION
LOCATIN2 DENTRO2LUTEAL MUSCLE
+& Elace eel of and o(er greater trocanter of client-s i' ). )rist
'er'endicular to femur&
/& Rigt 8and used for left i'
!& Left 8and used for rigt i'
3& Eoint tum1 to)ard client-s groin
6& Eoint fingers to)ard client-s ead
J& Eoint indeG finger to te anterosu'erior iliac s'ine
<& EGtend middle finger (1ac5 along iliac crest" to)ard te 1uttoc5
C& IndeG finger# Middle finger $ Iliac crest form a DBsa'ed triangle
A& Center of Triangle is In7ection site
+=& Client Eosition , l%ing on is.er side
++& Client , FleG 5nee $ i' to relaG (entrogluteal muscle
DASTUS LATERALIS MUSCLE
Tic5# )ell de(elo'ed
Located on anterior lateral as'ect of tig
Lidt of Muscle* eGtends from midline of tig to midline of tig-s
outer side
In Adults*
+& EGtends from a and1readt a1o(e te 5nee
/& EGtends to a and1readt 1elo) te greater trocanter of te
femur
Suggested Site for In7ection , Middle !
rd
of muscle
In Moung Cildren or Cacectic Clients* gras' 1od% of muscle during
in7ection to 1e sure tat medication is de'osited in muscle tissue
To relaG muscle# as5 client to*
+& Lie flat ). 5nee sligtl% fleGed or
/& Sitting 'osition
0ORSO2LUTEAL MUSCLE
%9<%#T%*E 9IS%9<%#T%*E
Traditional
IM in7ection
site
Ris5 of stri5ing underl%ing sciatic ner(e N
'ermanent or 'artial 'aral%sis of in(ol(ed leg
Ris5 of stri5ing underl%ing ma7or 1lood (essels
0ifficult to locate , client-s ). fla11%# sagging
tissues
Site not recommended 1% Eotter $ Eerr%
0ELTOI0 MUSCLE
Easil% accessi1le
Muscle is not )ell de(elo'ed in man% adults
Ris5 , radial $ ulnar ner(es $ 1racial arter% lie ).in te u''er arm
along te umerus
Sould 1e used onl% for* small medication (olumes
Len oter sites are inaccessi1le 1.c of dressings or casts
LOCATIN2 T8E 0ELTOI0 MUSCLE
+& EG'ose client-s u''er arm $ soulder full%
/& RelaG arm at te side or FleG el1o)
!& ! Eositions*
a& Sitting
1& Standing
c& L%ing do)n
3& / Erocedures*
EROCE0URE O +*
a& Nurse 'al'ates lo)er edge of Acromion 'rocess
1& %cromion process B forms te 1ase of a triangle in line ).
mid'oint of te lateral as'ect of u''er arm&
c& In7ection site B center of triangleP a1out + / inces 1elo) te
Acromion 'rocess
EROCE0URE O /*
a& Elace 3 fingers across 0eltoid muscle
1& Elace to' finger along te Acromion 'rocess
c& In7ection site ! finger)idts 1elo) Acromion 'rocess
SEECIAL IM INJECTION TEC8NI4UES
+& AirBLoc5 tecniIue
/& QBTrac5 Metod
AIRBLOC9 TEC8NI4UE
Less irritating to S4 tissues during needle )itdra)al
Small (olume of air in7ected 1eind 1olus of medication
Air clears needle of medication
Ere(ents trac5ing of medication tru S4 tissues
Recommended for suc medications as*
+& Interferon
/& L%et-s (accines 're'ared ). aluminum ad7u(ant
!& Daccines suc as*
a& 0i'teria
1& Tetanus toGoid
c& Eertussis
EROCE0URE FOR AIRBLOC9 TEC8NI4UE
+& Ere'are 'ro'er dose
/& Nurse dra)s u' =&/ mL of air
!& In7ect needle do)n)ard at angle of A=
=
so air rises to to' of med
to)ard te 'lunger&
/
INTRAMUSCULAR INJECTION
3& As nurse in7ects into muscle# air follo)s med creating an air loc5
1is+s o Injection %n&le less than ?@
@
:
+& Air collects along 1arrel of s%ringe $ enters muscle too soon&
/& Medication can ten easil% lea5 1ac5 into S4 tissues&
QBTRAC9 MET8O0
Used to minimi?e irritation 1% sealing med in muscle tissue
Nurse selects IM site# 'refera1l% in larger dee'er muscles (e&g&
(entrogluteal"
Ne) needle must 1e a''lied to s%ringe after 're'aring te med so tat
no soln remains on te outside needle saft
EROCE0URE FOR QBTRAC9 MET8O0
Ere'are site ). antise'tic s)a1
Eull o(erl%ing s5in $ S4 tissues a''roG + + @ inces laterall% to
te side
8old s5in taut ). nonBdominant and
In7ect needle dee' into muscle
Eractice olding s%ringe $ as'irating ). one and
No 1lood return on as'irationK Ten in7ect med slo)l%
Needle remains inserted for += seconds to allo) med to dis'erse
e(enl%
Release s5in after )itdra)ing needle
Lea(es a ?ig?ag 'at tat seals needle trac5 )ere tissue 'lanes slide
across eac oter
Medication cannot esca'e from te muscle tissue
!