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Intramuscular injections

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Presentation on theme: "Intramuscular injections"— Presentation transcript:

1 Intramuscular injections
Topic 8

2 Administering injections
Intramuscular – given deep into muscle tissue muscles are highly vascular = rapid drug absorption, usually in 10 – 30 minutes (aqueous soln.) Risk of injecting into a blood vessel ... plunger of syringe is drawn back a little to see if any blood returns before injecting

3 Administering injections
Intramuscular usually a 21 –23G needle is used Depth of injection depends on the amount of body fat to pass through the sc layer & penetrate the muscle layer Needle should be inserted at a 900 angle to the skin Rotate sites to avoid hypertrophy

4 Equipment – IM Injection
What needle should I use for IM injections? 21G or 23G Green or blue hub

5 Administering injections
Intramuscular muscle is less sensitive to irritating & viscous drugs ... as much as 4ml can be administered into larger muscles Small children & older infants should receive no more than 1ml IM

6 Administering injections
Intramuscular - 3 most common sites are: The deltoid muscle in the arm The ventrogluteal in the buttocks The vastus lateralis in the thigh

7 Intramuscular Sites

8 Deltoid Muscle The deltoid – should be used for infrequent injections (limited muscle mass) Located 2-3 finger widths below the acromion process

9 Administering injections
Intramuscular The ventrogluteal muscle – avoids major nerves & blood vessels has consistent thickness is the preferred injection site for adults & children > 7 months of age

10 Old Method

11 Current Method The ‘Double Cross’ 

12 Underlying Structures

13 Administering injections
The vastus lateralis muscle in the thigh – is the preferred site for infants < 7 months of age is commonly used for adults Muscle is well developed & thick Offers ease of access

14 Vastus lateralis muscle
‘Bunch up’ in elderly, emaciated or infants Divide thigh into thirds Inject into the middle third

15 The Z-track Technique Recommended for IM injections, particularly when the med. is irritating to the tissue e.g. iron-dextran complex Involves pulling the skin either downward or laterally before injection (creates a disjointed pathway & locks med. into the muscle) Decreases leakage of med. & minimises pain at the site

16 Remove needle and release skin
The Z-track Technique Pull skin taut then Insert needle Remove needle and release skin

17 Administering injections
Intramuscular What equipment do you need?

18 Procedure Perform the standard protocol for beginning the procedure
Attach the drawing up needle to the syringe If using a vial – swab top of vial with an alcohol wipe If using an ampoule – gently tap to dislodge any med. above the neck of the glass

19 Procedure snap open the ampoule – may use a gauze square to protect fingers; may need to use a file to snap open the ampoule Draw up the correct amount of medication Remove the needle & dispose in sharps container Attach the administration needle

20 Procedure Expel air & any surplus med.
Transport all equipment to the client using a kidney dish or suitable tray Select an appropriate site Cleanse the area with an alcohol swab & allow to dry for 10 sec. Pull the skin sideways if using the Z-track technique

21 Procedure Insert the needle quickly & smoothly at a 900 angle to skin (in very thin clients, inserting the needle at 450 may be more appropriate) Pull back on the plunger & if no blood appears, inject the med. slowly.

22 Procedure If blood appears withdraw the needle & discard. Repeat the whole procedure Smoothly & steadily withdraw the needle, releasing the skin Clean the site with an alcohol swab

23 Procedure Apply pressure to the site if bleeding but do not massage the site Complete the standard protocol for ending the procedure

24 Things to consider… Observe client for any reaction to the medication
Inspect the site for bruising, redness, or heat Prior to injecting, palpate the muscle for any tenderness or hardness & avoid injecting into such an area

25 VOLUME PER MUSCLE SITE Ventrogluteal - Up to 4ml in a well developed muscle Vastus lateralis - Up to 4ml in a well developed muscle Deltoid - Up to 1ml in a well developed muscle

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