Intramuscular Injection

Supplies:

Medicine
Syringe and needle
Alcohol pad
Heavy plastic empty container with a wide mouth and secure cap. Used to put syringe and needle into after the injection is given.

Getting Ready:

Wash your hands with soap and water. Clean thoroughly between your fingers and under your nails. Dry your hands.
Gather the needed supplies.

Drawing Up The Medicine Into The Syringe:

Check the label on the medicine bottle to make sure the right medicine is used. Check the expiration date on the bottle. Do not use expired medicine. Inspect medication for any discoloration. Do not use if discolored.
Remove the cap from the medicine bottle, if it is a new bottle. Clean the top of the bottle each time with an alcohol pad. Do not touch the top of the bottle after it is cleaned with the alcohol.

Attach and / or tighten the needle onto the syringe.

Take the needle cap off the needle and place the cap on the table.
Pull back on the end of the plunger. Draw air into the syringe equal to the amount of medicine ( _____ cc / ml) to be drawn up. Do not touch the plunger or the needle.

Insert the needle into the rubber stopper on top of the bottle.
Push down on the plunger to push the air into the bottle. Leave the syringe in the bottle.
Invert the bottle and syringe so the bottle is on top and the syringe below. Be sure to support the syringe and the bottle so the needle is not bent.
Pull down on the plunger allowing the medicine to fill the syringe. Stop at the amount ordered.

Check for bubbles in the syringe. If air bubbles are present:
Tap the barrel of the syringe with your finger to move any bubbles to the top of the syringe.

Push the plunger slightly up to move any air bubbles out of the syringe
Pull down on the plunger again and fill the syringe with the correct amount of medicine.
Check again for air bubbles and if present, repeat the steps above.

Remove the needle from the bottle.
Carefully replace the needle cap.

Selecting The Site For Injection:

Carefully select the site for injection so major blood vessels and nerves are avoided.
Use different sites to prevent repeated injections in the same area. Change sites with each injection.

Do not use areas that are bruised, tender, scarred from surgeries or injury, or swollen.
Your nurse can help you choose the site that is best for you.

Buttock (Gluteus Medius) Site For IM Injection

Find the trochanter. It is the knobby top portion of the long bone in your upper leg (femur). It is the size of a golf ball.

Find the posterior iliac crest. Many people have "dimples "over this bone. The nurse will help you find the bone landmarks.

Draw an imaginary line between the two bones.
After locating the center of the imaginary line, find a point one inch toward your head. This is where (X) you will put the needle in.
Stretch the skin tight.

Hold the syringe like a pencil or dart. Insert the needle at a right angle to your skin (90 degrees).
You may give up to 3 ml. (cc) of fluid in this site.

Hip (Ventrogluteal) Site For IM Injection

Find the trochanter. It is the knobby top portion of the long bone in your upper leg (femur). It is about the size of a golf ball.

Find the anterior iliac crest. The nurse will help you find the bone landmarks.
Place the palm of your hand over the trochanter. Point the first or index finger toward the anterior iliac crest. Spread the second or middle finger toward the back, making a 'V'.

The thumb should always be pointed toward the front of the leg. Always use the index finger and middle finger to make the 'V'.
Give the injection between the knuckles on your index and middle fingers.
Stretch the skin tight.

Hold the syringe like a pencil or dart. Insert the needle at a right angle to the skin (90 degrees).
You may give up to 3 ml. (cc) of fluid in this site.

Leg (Vastus Lateralis) Site For IM Injection

To find the thigh injection site, you will be making an imaginary box on your upper leg. Find the groin. One hand's width below the groin becomes the upper border of the box.
Find the top of knee. One hand's width above the top of the knee becomes the lower border of the box.

The center of the top to your leg becomes the left border of the box.
The center of the side of your leg becomes the right border of the box. The nurse will help you find the landmarks.

The best areas to use for injection is in the middle of this imaginary box. The sites are marked with X's.
Stretch the skin to make it tight.
Insert the needle at a right angle to the skin (90 degrees) straight in.
You may give up to 2 ml. (cc) of fluid into the site.

Arm (Deltoid) Site For IM Injection

To find this site you will form an imaginary box on the upper arm.
Find the knobby top of the arm (acromion process).

The top border of the box is two finger widths down from the acromion process.
The bottom border is an imaginary line running from the crease of the armpit, from front to back.

To make the two side borders, divide the arm into three equal sections, from front to back. The site is in the center of the middle third.
Stretch the skin and then bunch up the muscle.

Insert the needle at a right angle to your skin (90 degrees). The nurse will show you how.
Caution: This is a small site. Give only 1 ml. (cc) or less of fluid in this site. Use only if other sites are not available.

Giving The IM Injection

Choose the site you will use for the injection.
Clean your skin with an alcohol pad in a circular motion. Let the alcohol dry.
Pull the needle cap straight off the needle (do not twist). Set the cap aside.

Hold the syringe like a dart or pencil. Stretch the skin at the injection site. If you are thin, you may need to pinch the tissue using your thumb and index finger. Be careful not to touch the injection site itself.

Insert the needle at a 90 degree angle into the prepared injection site. Use a quick dart-like motion. The quicker you insert the needle, the less discomfort.
Release the skin. Hold onto the syringe so that it will not move. Pull back on the plunger to check for blood in the syringe. Remove the needle if you see blood in the syringe. You will need to discard this syringe and start over again if blood is in the syringe.

Inject the medicine by pushing down on the plunger at a moderate rate. Be sure to inject all the medicine in the syringe.

Hold the alcohol wipe near the injection site. Remove the needle and quickly press the alcohol pad onto the site. Hold the pad tightly for a minute or rub the skin in a gentle circular motion. Check the area for any redness, bleeding or bruising. If bleeding occurs, wipe it off. It may be necessary to apply a bandage to the site.

Clean Up The Supplies:

Put the used syringe and needle into a heavy puncture-resistant plastic container and secure the cap. Do not recap the needle. Dispose of all other supplies in the trash.
Wash your hands again after disposing of all materials.
Record the date, time and site of injection on the attached record sheet.

Please refer to the following diagrams, showing glute/hip/thigh and deltoid IM injections: X marks the spot!!!