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Intramuscular injections Topic 8. Administering injections   Intramuscular – given deep into muscle tissue - - muscles are highly vascular = rapid drug.

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Presentation on theme: "Intramuscular injections Topic 8. Administering injections   Intramuscular – given deep into muscle tissue - - muscles are highly vascular = rapid drug."— 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 90 0 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 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 90 0 angle to skin (in very thin clients, inserting the needle at 45 0 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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