Intramuscular Injections
Goal:
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-After giving this review session student/co-worker
will be able to confidently administer an
intramuscular injection, know sites used for
injections, and demonstrate different techniques of
giving an intramuscular injection.
-Perform giving IM injections.
-Demonstrate correct technique for giving IM
injections.
-Identify equipment used for giving IM injections.
-Demonstrate and explain: Z track method and
Air
lock technique.
-Demonstrate correct disposal of used needle.
-Explain and be able to identify how the patient
tolerated the IM injection.
-In this session learner will be
educated in IM injections
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-Where to give an IM injection.
-Technique for giving IM injection
-Demonstrate different method for
giving an IM injection.
-Equipment needed to perform an
IM injection.
-Equipment needed to perform
an IM injection
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-Syringe 1-2 inches in length.
-Medication to be administered.
-Gloves
-Band-Aid
-Alcohol swab
-Patient
-Muscle where medication will be
administered
-Choosing the site to
administer medication-There are several different sites an IM
injection can be given.Site determination
-Stage of patients development.
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-Body build
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-Physical condition
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-Amount of the medication to be
given
-SitesMid Deltoid- common site, upper arm,
3 fingers width.
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Dorsalgluteal- look out for sciatic
nerve, given in the butt.
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Rectus femoris- right on top of the
thigh.
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Ventrolgluteal- side of the butt, or on
the hip.
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Vastis lateralis- outer thigh, in the
middle.
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How to find sites-
Mid Deltoid
-Is on the upper arm.
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- Take 3 fingers and place them at
the top of the shoulder.
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-At the end of the third finger in the
middle of the muscle is where the
injection can be made.
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Dorsalgluteal
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-Injection is in the butt.
-Watch out for the sciatic nerve.
-Have patient stand or lay face down
with toes pointing inward. (relaxes muscle)
-Divide the buttocks into 4 quadrants; give
the injection in the outer, upper quadrant
toward the hip.
-DO NOT give to children who are not
walking yet. (Muscles are not developed
enough)
Ventrogluteal
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-Good for adults and small children.
- Find the upper part of the hip.
-Place palm on hip (greater trochater),
with fingers point to the ground, and make
a very large “V”
with your pointer
finger and middle
finger.
-In the middle of the “V” is where the
injection can be done.
Rectus Femoris
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-On the anterior thigh, above the
knee.
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-Used mostly by people who have
to get themselves injections.
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-This is painful, because the
muscles in the anterior thigh are tense
when given.
Vastus Lateralis
-Most preferred site.
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-Given to children under 5 years of
age.
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- Patient should be sitting when this
injection is to be given.
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-On the outer thigh about half way
between the knee and the hip.
-Technique of Giving an
Intramuscular Injection
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-Check the 5 rights of medication
administration.
-Choose the site the IM injection.
-Check the patient for any allergies.
-Gather you supplies needed to perform IM
injection.
-Wash your hands.
-Put on gloves.
-Open alcohol swab and in a circular
motion, clean area in a 2 inch diameter at the
site of the intended IM injection.
-Let fully dry.
Continued…
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-Pull skin around the clean site taut.
- take needle in dominate hand between the thumb and the
index finger.
- At a 90 degree angle, plunge the needle into the skin in a
dart like motion.
-Depending on the site and the condition of the patient,
determine how far the needle is going to have to go into the skin
to be in the muscle.
-Stabilize the needle with the non dominate hand.
-Use dominate hand to pull back on the plunger and aspirate
or blood. (If there is blood aspirated back into the needle, remove
and dispose in a sharps container. start from the beginning.)
-Push the medication at a slow and steady pace. Remember to
hold the needle as steady as
possible.
Continued..
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To take the needle out, quickly pull up at a 90 degree angle.
-Make sure to cover the needle immediately after
withdrawing it from the skin.
-Apply some pressure at the site with the alcohol swab
that was used to clean the site.
-Message the site to help disperse the medication that
was just given.
-Cover site with Band-Aid.
-Dispose of needle into a sharps container.
-Throw away gloves and wash hands.
-Observe the patient for signs of any allergic reaction,
N&V, or any other adverse reactions that
may go along
with the medication.
- Always remember to document.
-Different Methods of Giving
IM injections
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-Just giving IM injection and
massaging site- Z track
- Air lock
Just giving IM injections and
messaging site-Just dose of medication given.
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-Message site after to help disperse
medication in to the
muscle.
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Z track method
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-Used for medications that can cause
irritation, can be used for all IM medications.
-Pull skin at the site to the side.
- Still give the injection at 90 degree angle.
-When shin is let go and needle removed
the needle track is cut off and the
medication can not leak out.
-This will decrease irritation and bruising of
the skin.
Air lock Technique
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-Medication is drawn up.
-0.2mL of air can be added to the medication.
-This will ensure that all the medication has been
pushed though the needle.
- Still given at a 90 degree angle.
-Make sure medication is given first and the air
lock second.
-Seals needle track so medication will not go into
the subquncaneaus tissue, which can cause pain,
soreness and bruising.
Review
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-Always remember 5 rights of medication administration.
-Right dose
-Right patient
-Right time
-Right route
-Right medication
-Choosing an IM Injection site that works best for your
patient.
(Ex: Infants can not have injections in the dorsal gluteal
(butt), In determining a site take into
account the
patients body build, try to avoid flabby tissue.)
-Different techniques of giving an IM injection: Z track, Air
lock.
Evaluation:
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1.) Name the site that should not be used
for children who are not walking yet?
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Dorsal gluteal.
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-Describe Z track method:
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pulling skin to the side, then giving
the shot, cutting off the needle
track.
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2.) How do you clean a site for injection?
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Alcohol swab, 2inches around the
site in diameter, let dry completely.
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3.)How do you determine where to give
a mid deltoid IM injection?
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Upper arm, 3 fingers down from the
top of the shoulder. In the middle of
the arm. Use patients non dominate
arm.