Author eileen shepherd is clinical editor at nursing times. This guide discusses how to perform an im injection in an artificial osce setting and should not be used as a guide to administering injections to actual patients without first consulting your local medical school or hospital. This article examines the available evidence about intramuscular injection techniques to generate simple evidencebased or best practice guidelines for. The administration of intramuscular injections is a. Efficacy and safety in intramuscular injection techniques using ultrasonographic data article pdf available in health 1003.
Choose the injection site that is appropriate to the persons age and body mass. How to give an intramuscular injection im injection. Intramuscular injections require a thorough and meticulous approach to patient assessment and injection technique. The thigh is a good place to give an injection to yourself or a child less than 3 years old.
Abstract the intramuscular route allows for rapid absorption of drugs into the. Prior to administering an im injection, refer to your procedure manual to. How to administer intramuscular and subcutaneous vaccine. Syringe used is 1ml tuberculin syringe because of a very small amount of drug. A framework for safe practice is included, identifying important points. Intramuscular versus subcutaneous injection of unmodified insulin. Im injection sites should be rotated to decrease the risk of hypertrophy. The aim of this article was to indicate a safe and effective im injection technique based on evidenced data derived from ultrasonographic data. Some vaccines are approved by the food and drug administration fda for administration by the pharmajet stratis needlefree injection system. Principles of injection technique becton dickinson. Subcutaneous injection is administered into the subcutaneous tissue, the layer of skin underlying the dermis and epidermis. Who best practices for injections and related procedures toolkit. Guidelines on the administration of intramuscular and sub.
Older adults and thin patients may only tolerate up to 2 ml in a single injection. Intramuscular injection guidelines for needle length and. Intramuscular im injections have been an integral part of drug administration in nursing practice for almost half a century. Given a certain patient situation, the students distinguish the appropriate site for the administration of medication.
More than 12 billion im injections are administered annually throughout the world. The administration of intramuscular injections is a common nursing intervention in clinical practice. Following administration of an intramuscular injection, the patient should be observed for a period of time to reduce any risk of harm. Use a needle long enough to reach deep into the muscle. Thus, proper injection techniques and procedures contribute to the safety of both patients and. Fatty tissue over anterolateral thigh muscle children 12.
The use of a squeeze cage makes this technique the method of choice for delivering drugs that are available in intramuscular injection form. This allows the medication to be absorbed into the bloodstream quickly. Hold the skin around the injection site in the manner described above. Common reasons for unsuccessful im injection included poor injectionsite selection and not advancing the needle to full length. The registrant confirms that the information supplied for this submission is accurate and complete. After you inserting the needle into the muscle take your hand off the skin. The importance of good injection technique cannot be understated. Insert the im needle into the muscle at a 90 degree angle with one quick and firm motion. Intramuscular injection, often abbreviated im, is the injection of a substance directly into muscle.
Intramuscular injection volume is three milliliters mls or less. An intramuscular im injection is a shot of medicine given into a muscle. Administer the vaccines centers for disease control. Clean the injection site skin with an alcohol swab. Intramuscular im injection site for infants and toddlers. Choose this site if are injecting to yourself, or if a caregiver gives you the injection. The poster illustrates site landmarks and muscles in the deltoid, dorsogluteal, and vastus lateralis regions. Intramuscular injection guidelines for needle length and gauge selection adapted from fundamentals of nursing. Intramuscular injection sites poster muscle this visual aid was developed specifically for teaching, demonstrating, training, and studying of intramuscular injection site locations.
Intramuscular and subcutaneous pdf icon external icon. Preventing needle stick injury anticipate abrupt movement of the patient and take care more the used needle is handled or carried, the greater is the risk of sharp injury never try to recap, bend or manually remove needle from syringe do not move around with used equipment in hand keep needle destroyer near by only properly dispose it 33. Full text full text is available as a scanned copy of the original print version. The typical injection dosage is one syringe every 6 months. Pdf 226 pages provides evidencebased recommendations for safe injection practices and reflects the minimum standards that healthcare personnel should follow to prevent.
In medicine, it is one of several methods for parenteral administration of medications see route of administration. The intramuscular route allows the rapid absorption of drugs into the circulation. Pull the skin around the injection site with your thumb and index finger to make it taut. An intramuscular injection, as illustrated in the figure below, delivers medication deep into the muscle tissue. Certain medicines need to be given into the muscle for them to work correctly. When administering a vaccine by injection, choose the correct needle size based on the route, age, patient size, and injection technique. Injection technique, choice of needle length and gauge diameter, and injection site are all important considerations, since these factors can affect both the immunogenicity of the vaccine and the risk of local reactions at the injection site, and are discussed in. You should clean the injection site thoroughly, pinch your skin at the injection. Injection safety, or safe injection practices, is a set of measures taken to perform injections in an optimally safe manner for patients, healthcare personnel, and others. Intradermal injection it is the introduction via needle of tiny amounts of fluid into layers of skin. Hold the syringe barrel tightly and use your wrist to inject the needle through the skin and into the muscle at a 90 degree angle. Or, divide the buttock into quadrants and inject in the upper outer quadrant, about 2 to 3 below the iliac crest. Intramuscular injection, long acting injectable, injection site reaction, ultrasound diagnostic device, intramuscular injection technique.
Paediatric intramuscular injections for developing world. Learning objectives identifies the parts of a syringe and the needle gauge. Intramuscular im injections administer medication deep into the muscle tissue, enabling faster absorption and larger systemic doses than subcutaneous injections. An intramuscular injection is a technique used to deliver a medication deep into the muscles. Delivered by intramuscular im injections, long acting injections lai, offering comparatively long term medicinal effects from several weeks to several months, are gaining much attention. Before you give a prolia injection, make sure you are trained by a health professional to master the technique. This is a shot that is given into the fatty tissue just under the skin. This is part 1 of a twopart series on injection techniques. This allows the medication to be quickly absorbed into the bloodstream for action. Pdf efficacy and safety in intramuscular injection techniques. An educational class was developed and implemented to include appropriate needle sizelength, proper placement of an im injection in the deltoid, proper positioning of the. Abstract the intramuscular route allows the rapid absorption of drugs into the. Search for intramuscular injection in these categories. Intramuscular injection im is injection of medication into the muscle through the.
Intramuscular injection im osce guide geeky medics. Using the correct injection technique and selecting the correct site will minimise the risk of complications. Intramuscular injection an overview sciencedirect topics. Intramuscular injections im are a common yet complex technique used to deliver medication deep into the large muscles of the body. Accurate anatomical knowledge is necessary in order to. Giving injection make the patient comfortable and give him a proper position so as to identify the proper site for injection properly hold the child hold the syringe in your hand as if holding a pen remove needle cap immediately before giving injectionnot earlier 30 31. Surrounding the deltoid im injection site, the thickness of the deltoid muscle. Injection site and needle size subcutaneous subcut injection use a 2325 gauge needle. Many medications used in mental health settings require im route of administration and im injections are often given in circumstances in which there are be risks to both consumers and staff. An evidencebased approach to intramuscular injection. Small nonhuman primates may be restrained by physical means. To ensure rational and safe use of injections globally, better injection safety practices are needed. Efficacy and safety in intramuscular injection techniques.
You have been prescribed a medicine that must be given by subcutaneous sq injection. Pull back on the plunger a little to make sure you did not hit a blood. Clinical experience of intramuscular immunoglobulin for. Choose a site that is free from pain, infection, abrasions, or necrosis.
This handout explains how to give yourself a subcutaneous injection. Who best practices for injections and related procedures. Those available considered assessment of needle length and gauge, 8 complications from im injections, 9, 10 and site of injection in relation to muscle mass, 11 but no studies specifically examined maximum volumes for. Injection site reaction was greater with subcutaneous compared with intramuscular injection in the two studies in which needle parameters and injection technique were specified. Scroll down to read the article or download a printfriendly pdf here if the. Pdf efficacy and safety in intramuscular injection.
The thigh is a good place to give yourself an injection because it. Depending on the chemical properties of the drug, the medication may either be absorbed quickly or more gradually. Proper technique when administering intramuscular injections. Intramuscular im injection site for children and adults. Injection site vastus lateralis muscle in the thigh. Give in the central and thickest portion of the deltoid muscle above the level of the armpit. Look at your thigh and divide it horizontally into 3 equal parts. This article aims to help nurses to administer intramuscular injections in a safe, effective and patientcentred manner. Z track technique the ztrack technique involves displacing the skin and subcutaneous layer in relation to the underlying muscle so that the needle track is sealed off when the needle is withdrawn, thus minimizing reflux fig 1. Intramuscular injection guidelines becton dickinson. How to give a testosterone intramuscular im injection.
A subcutaneous or intramuscular injection is almost always painless if the skin is stretched firmly before inserting the needle. The responsibility for ensuring injection safety rests with national governments. The hip is a good place to give an injection to adults and children older than 7 months. Intramuscular injection in deltoid muscle with ztrack technique duration. Intramuscular injections are one of the most common routes of administering drugs to nonhuman primates. Good injection technique can mean the difference between less pain and injury. Muscles have larger and more numerous blood vessels than subcutaneous tissue. The ztrack method is used for intramuscular injections for following reasons. If injecting the arm, for example, the third, fourth and fifth fingers should go medial to the arm while the thumb and index finger stretch the skin on the lateral surface fig. We identified few primary studies of injection technique in children.
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