Insert the needle into the V formed between your index and middle fingers. This is the preferred site for all oily and irritating solutions for patients of any age.
Needle gauge is determined by the solution. An aqueous solution can be given with a 20 to 25 gauge needle. Viscous or oil-based solutions can be given with 18 to 21 gauge needles. The needle length is based on patient weight and body mass index. Children and infants will require shorter needles. Refer to the agency policies regarding needle length for infants, children, and adolescents. The vastus lateralis is commonly used for immunizations in children from infants through to toddlers.
The muscle is thick and well developed. The middle third of the muscle is used for injections. The width of the muscle used extends from the mid-line of the thigh to the mid-line of the outer thigh.
To help relax the patient, ask the patient to lie flat with knees slightly bent, or have the patient in a sitting position. The gauge of the needle is determined by the type of medication administered. Aqueous solutions can be given with a 20 to 25 gauge needle; oily or viscous medication should be administered with 18 to 21 gauge needles. A smaller gauge needle 22 to 25 gauge should be used with children.
The length will be shorter for infants and children; see agency guidelines. Select needle length based on age, weight, and body mass. In general, for an adult male weighing 60 to kg to lbs , a 25 mm 1 inch needle is sufficient. Refer to agency policy regarding specifications for infants, children, adolescents, and immunizations. The maximum amount of medication for a single injection is generally 1 ml. For immunizations, a smaller 22 to 25 gauge needle should be used. Consider the type of medication and the age, condition, and size of the patient when selecting an IM site.
Rotate IM sites to avoid complications. Potential complications include lingering pain, tissue necrosis, abscesses, and injury to blood vessels, bones, or nerves. If administering a vaccination, always refer to the vaccination guidelines for site selection. Checklist 58 outlines the steps to perform an IM injection. Ensuring the sharps container is close by allows for safe disposal of the needle.
Locate correct site using landmarks, and clean area with alcohol or antiseptic swab. Allow site to dry completely. Allowing the site to dry prevents stinging during injection. If blood appears, discard syringe and needle, and prepare the medication again. Because the injection sites recommended for immunizations do not contain large blood vessels, aspiration is not necessary when immunizing. Cover injection site with sterile gauze, using gentle pressure, and apply Band-Aid as required.
Covering prevents infection at the injection site. Place a clean swab or dry gauze between your third and fourth fingers. Gauze between fingers 3 and 4 This allows for easy access to dry gauze after injection. Remove needle cap by pulling it straight off the needle. Hold syringe between thumb and forefinger on dominant hand as if holding a dart.
This prevents needle from touching side of the cap and prevents contamination. With skin held to one side, quickly insert needle at a degree angle. After needle pierces skin, continue pulling on skin with non-dominant hand, and at the same time grasp lower end of syringe barrel with fingers of non-dominant hand to stabilize it. Move dominant hand to end of plunger. If required by agency policy, aspirate for blood. If no blood appears, inject the medication slowly. Insert the needle with a dart-like motion.
A quick injection is less painful. All rights reserved. Membership is free and comes with many benefits. Note: You must also be a member and log in to purchase articles.
Share This. Authors Winslow, Elizabeth H. Article Content Where should an intramuscular IM injection be given? More Featured Jobs. Good injection technique can mean the difference between less pain and injury. Angela Cocoman and John Murray explain.
The administration of intramuscular injections is a common nursing intervention in clinical practice. The importance of good injection technique cannot be understated. It should not be forgotten that among potential complications of IM injection are abscess, cellulites, tissue necrosis, granuloma, muscle fibrosis, contractures, haematoma and injury to blood vessels, bones and peripheral nerves. Sites of the thigh Rectus femoris and Vastus lateralis The uptake of drugs from the thigh region is slower than from the arm but faster than from the buttock, thus facilitating better drug serum concentrations than is possible with the gluteal muscles.
The thigh may be utilised when other sites are contraindicated or by clients who administer their own medication, as it is readily available in the sitting or lying back position. However, the main disadvantage is that injections in the Rectus femoris site may cause considerable discomfort.
This site can be used for infants, children and adults. Needle length used is usually 2. The dorsogluteal site This site is commonly referred to as the outer upper quadrant and is contraindicated in children. The presence of major nerves and blood vessels, the relatively slow uptake of medication from this site compared with others and the thick layer of adipose tissue commonly associated with it, makes this site problematic.
Parameters were measured with a digital vernier calliper. Data Analysis was performed using spss and the Wilcoxon Signed-Rank Test was used to examine differences among measurements from the two injection regions.
Data were collected between February and May Results: Sum of the thickness of the muscles is greater in the dorsogluteal region.
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