IM INJECTION

Administration of medication into muscle

PURPOSES

 Faster rate of absorption

 Muscle tissue can hold large volume of fluid
 This is favorable for some medication

ADVANTAGES

 Reliable
 Absorption is rapid

DISADVANTAGES

 Painful & sometimes it causes abscess

 Chance of sciatic Nerve injury
 In case of some drugs absorption by IM route is slower than oral (e.x) diazepam
 For some drugs IM route should be avoided (e.g) heparin, diazepam

SITES

Deltoid site: locate the acromian process place a finger on process and measure 3 fingerbreath down.

Vastus lateralis: mostly used for infant. Supine position. Divide the thigh into third. Middle third give the injection.

Ventro gluteal : place the palm of your hand on greater trochanter the index finger on anterior superior iliac spine and middle finger
pointing toward iliac crest

Dorso gluteal: Never used for infants and small children. Because of sciatic nerve. Landmark is posterior superior iliac spine and
greater trochanter. Find the centre and give injection
EQUIPMENT

 Medication record or card

 Pen
 Two alcohol swabs
 Disposable gloves
 Medication tray
 Medication to be administered
 3-ml syringe with 1-, 1.5-, or 2-inch needle (21,22, or 23 gauge)

PROCEDURE

 Wash hands.
 Prepare medication, adhering to the rights of drug administration .
 Identify client by reading identification bracelet and addressing client by name.
 Explain procedure and purpose of drug.
 Verify allergies listed on medication record or card.
 Don gloves.
 Assist client into position for comfort and easy visibility of injection site.
 Clean site with alcohol. Expel the air
 Remove needle cap.
 Pull skin taut at insertion area by using the following sequence:
 Place thumb and index finger of non dominant hand over injection site (taking care not to touch cleaned area ) to form a V.
 Pull thumb and index finger in opposing directions, spreading fingers about 3 inches apart.
 Quickly insert needle at a 90-dgree angle with dominant hand (as if throwing a dart).
 Move thumb and first finger of non dominant hand from skin to support barrel of syringe; fingers should be placed on barrel so
that when you can see the barrel clearly
 Pull back on plunger and observe for possible blood return in syringe
  If blood does return when aspirating, pull the needle out, apply pressure to the insertion site, Withdraw and start over with a
new needle, syringe, and injection site.
 If no blood returns, push plunger down slowly and smoothly; encourage client to talk.
 Remove needle
 Quickly remove the needle at same angle as angle of insertion from the skin and dispose of it in a puncture- resistant container.
Massage and clean insertion area with second alcohol wipe (if contraindicated for drug, apply firm pressure instead)
 Replace the articles
 Remove gloves. needle on tray; do not recap.
 Reposition client, raise side rails and place bed in lowest position with call button within reach.
 Wash hands.
 Document administration on medication record.

COMPLICATIONS

 Abscess or collection of pus

 Tissue necrosis, or tissue death
 Granuloma, or inflammation in the tissue
 Muscle fibrosis, or scarring of muscle tissue
 Hematoma, where blood seeps out of blood vessels into the surrounding tissue
 Injury to blood vessels and nerves

Other symptoms:

 Severe pain at the injection site

 Tingling or numbness
 Redness, swelling, or warmth at the injection site
 Drainage at the injection site
 Prolonged bleeding
 Signs of an allergic reaction, such as difficulty breathing or facial swelling
 BIBLIOGRAPHY
 Das Niyati, Procedure manual for pediatric nursing, CBS publishers, Edition first 2018; Pgn:87-90
 https://www.slideshare.net/manivmcon/intra-muscular-injection
 https://www.slideshare.net/manivmcon/intra-muscular-injection