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 INTRAMUSCULAR INJECTION
INTRODUCTION:
Injection is parenteral therapy. It means giving of therapeutic agents including food outside the
alimentary tract .In other words it is the forcing of a fluid into a cavity ,a blood vessel or body tissue
through a hollow tube or needle.
DEFINITION:
Medicine when injected into the muscles in the form of solution it is called intramuscular injection
PURPOSE:
1-To obtain a quick effect of medicine than is obtained by oral administration and subcutaneous
administration.
2-Assures that the dosage will be administration and the same will be absorbed for the systematic
action of the drug.
3-The medicines that is not suitable for intravenous administration.
PRINCIPLE:
1-The knowledge of the anatomy and physiology of the body is essential for the safe administration of
the injection
2-Injections are means of introducing infection into the body, if carelessly given
3-Drugs that change the chemical composition of the blood will endanger the life of the patient, if not
used cautiously
4-Any unfamiliar situation produceces anxiety
5-Once a drug is injected it is irretrievable .Antidote may be available for particular medication but the
best antidote is given
6-Organizatiobn and planning results in the economy of time, material and effort.
GENERAL INSTRUCTION:
1-Give injection only on the doctors written orders
2-Followed strict aseptic techniques
3-Syringes and needles used for injections should be kept separate from those used for other purposes.
4-Always have the syringe and needle in good ordered.
5-Change the needle after withdrawing the drug from a rubber stopped container before giving injection
to the patient.
6-observe the 10 rights of the administration of medicine.
7-Never use a drug whose expiry date is over.
8-Always have a patient to walk soon after the injection.
9-Never allow the patient to walk soon after the injection.
10-Always give a test dose in case of penicillin and all type of sera.
11-Expel the air from the syringe before injection.
12-Select the appropriate site for giving injection
13-Rotate the site for patient getting insulin to prevent up dystrophy
14-Solution for injection should be clear, sterile, nearly neutral in reaction
15-Massage the area at the site of injection except in case of intradermal injections
16-Injection should be charted immediately
SITE FOR INTRAMUSCULAR INJECTION:
1-Dorsal gluteal site –Find out the greater trochanter of the femur and the posterior superior iliac spine
drawn an imaginary line between these two bony prominences .site will be upper and outer quadrant
2-Vastus lateralise site-The site is at the outer aspect of the thigh .It is the mares between mid anterior
thigh and mid lateral thigh one hands span from elbow and great trochanter to one hands span above
knee
3-Ventrogluteal site- Place the tip of the index finger on the anterior superior iliac spine of the patient
the middle finger just below the iliac crest.
4-Mid deltoid site –Locate the lower edge of the acromion process and from a rectangle .The deltoid
area is used to inject very small quantities of non irritating drugs
METHODS OF IM INJECTION ADMINISTRATION:
1-Air lock method-Expel the air from the syringe leaving 0.2 ml, stretch the skin lightly with the index
finger .Insert the full needle quickly into the muscle .Withdraw the piston to confirm that the need is not
in the blood vessel .push the piston gently to give the medicine very slowly.
2-Z-tract method –Excel the from the syringe ,displace the skin laterally using the side of your left
hand ,insert the needle aspiration the placement ,insert the medicine very slowly ,marinating tissue
displacement wait for ten seconds to allow the medicine to disperse .withdraw the needle allowing the
displaced tissue to return to its normal position
NURSES RESPONSIBILITY CHECK:
1-The diagnosis and age of the patient
2-The purpose of injection
3-The doctors order
4-The patient details
5-The nurses record about previous
6-The allergic reaction
7-The necessity for giving test dose
8-The levels of consciousness and follow instruction
9-The site of injection
10-The patient previous experiences
EQUIPMENT
A tray containing:
1-Syringe and needles of various size
2-Transfer forceps in a jar antiseptic solution
3-Sterile cotton swabs and gauze pieces in sterile container
4-Methylated spirit in a container
5-Bowl with water
6-Kidney tray and paper bag the ability to
7-Drug order sheet
8-Water for injection
9-File to cut upon the ampules
10-Small covered tray to carry the prepared injection to the side
PREPARATION OF THE PATIENT AND ENVIRONMENT:
1-Identify the patient correctly.
2-Explain the procedure to the patient.
3-Provide privacy.
4-Keep the patient’s attention away from the injection by friendly conversation.
5-Place the patient in a comfortable and relaxed position.
6-Select a site suitable for the route of administration.
PROCEDURE:
1-Select the medication
2-Hand wash
3-Prepare the medication
4-Keep the syringe with medications in the sterile tray and cover it
5-Make sure that the medicine taken right and correct dosage
6-Carry medication to the patient in a sterile tray
7-Identify the right patient
8-Prepare the site of injection
9-Injection the medicine by correct technique is essential for the safety of the injection
10-Spread the tissue between the thumb and forefinger to make the skin taut
11-Needle is inserted at a 90 degree angle holding the syringe back the piston with the left hand
12-Using a steady push on the needle and aspirate by pulling back the piston with left hand
13-If no blood comes give the medication slowly by pushing the piston
14-Remove the needle quickly and massage the site for quick absorption of the drug
AFTER CARE:
1-Inspect the area for bleeding
2-Help the patient to dress up
3-Ask the patient to take rest for 15 minutes
4-Check the limb movement to confirm there is no nerve injury
6-Watch for the signs and symptoms of allergic reaction
7-Replace the equipment in the proper place
8-Recoird the procedure on the nurse’s records