Stephen Weyel Northeastern University HOW TO GIVE AN INTRAMUSCULAR INJECTION

 Shots of medicine given into a muscle  Certain medicines need to be injected into muscle for them to work properly  Injecting vaccines into subcutaneous fat can cause vaccine failure due to poor vascularity of fat, thus slow mobilization of antigen  Often administered into thigh, hip, upper arm, or buttocks INTRAMUSCULAR (IM) INJECTIONS

 Prep area by wiping it with an alcohol wipe and letting it dry  Hold syringe in dominant hand between thumb and index finger, letting the barrel rest on your second finger  With free hand, gently pull skin in area so it is slightly tight  Hold syringe tightly and use wrist to inject needle at a 90 degree angle through skin into muscle ADMINISTERING THE INJECTION

 Once the needle is fully inserted, release skin and secure syringe with both hands  Pull back on plunger slightly to ensure blood vessels weren’t punctured during injection  If blood comes back into barrel, remove the needle immediately and do not inject the medicine  If no blood comes back into syringe, push down on plunger to inject medicine  Pushing slowly on plunger will reduce amount of pain experienced by patient  Once medicine is fully injected, remove needle at 90 degree angle and dispense in sharps bin ADMINISTERING THE INJECTION (CONTINUED)

 Have patient in lateral recumbent position, supine, or sitting  Divide thigh into 3 equal parts  Shot is given into outer middle third  Advantages: large muscle, easy to see  Standard for children below age 3, as it is their largest muscle VASTUS LATERALIS (THIGH MUSCLE)

 Have patient in lateral recumbent position or supine  Place heel of hand on upper, outer part of thigh where it meets the buttocks  Point thumb at groin and fingers towards patient’s head  Form “V” by separating first finger from other three fingers, inject into middle of “V”  Utilized for adults and children older than 7 months VENTROGLUTEAL (HIP MUSCLE)

 Have patient in lateral recumbent position or sitting  Palpate and locate bone on top of upper arm (acromion process)  Between bottom of acromion process and armpit level is injection site, 1 to 2 inches below acromion process  Site should not be used if patient is very thin with little muscle DELTOID (UPPER ARM MUSCLE)

 Have patient in prone position  Palpate and locate posterior superior iliac spine, then locate greater trochanter of femur  Visualize diagonal line between these two locations, injection site is above center of line (upper, outer quadrant of buttocks), but below iliac crest  Extreme caution should be used with this site, as the sciatic nerve and superior gluteal artery are in this area DORSOGLUTEAL (BUTTOCKS MUSCLE)

 Tell patient to contact physician if:  Fever, coughing, or general symptoms of illness develop after injection  Swelling or bruising develops at injection site  Seek immediate care if:  Rash develops at injection site  Experience shortness of breath  Mouth or face swelling occurs INFORM PATIENT insurance/need-a-health-plan-for-2014.html

 injection.html   intramuscular-injection.aspx  video/deltoid-injection-site.html    ,00.html  insurance/need-a-health-plan-for-2014.html RESOURCES

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