COMMON MEDICAL INTRAMUSCULAR INJECTION SITES 5 P’S OF

ABBREVIATIONS M ID -D ELTOID A REA CIRCULATORY CHECKS

The recommended boundaries of the injection area Pain
ABG arterial blood gas

P
form a rectangle bounded by the lower edge of the
a.c. before meals acromion process on the top to a point on the later- Pallor
ADL activities of daily living al side of the arm opposite the axilla or armpit on Paralysis
ad lib the bottom. Avoid the acromion and humerus, as Paresthesia
as desired Pulse
AP anteroposterior well as the brachial veins and arteries. Limit the
A&P anterior and posterior number of injections here as the area is small and
cannot tolerate repeated injections or large quantities
ASHD arteriosclerotic heart disease
AV arteriovenous, atrioventricular
of medications >1 ml. EDEMA
b.i.d. twice a day POSTERIOR GLUTEAL AREA (DORSOGLUTEAL) Assess by placing thumb over the dorsum
bpm beats per minute The most common site for injections. Restrict of the foot or tibia for 5 seconds
c with injections to that portion of the gluteus medius 0 No edema
CAD coronary artery disease which is above and outside of a diagonal line 1+ Barely discernible depression
cc chief complaint, cubic centimeter drawn from the greater trochanter of the femur to 2+ A deeper depression (less
the posterior superior iliac spine. than 5 mm) accompanied by
cm centimeter
normal foot and leg contours
C&S culture and sensitivity 3+ Deep depression (5 to 10
CSF cerebrospinal fluid VENTROGLUTEAL AREA mm) accompanied by foot
CT computed tomography A good site as it is removed from major nerves and vas-
cular structures. Palpate to find the greater trochanter, and leg swelling
cu cubic the anterior superior iliac spine and the iliac crest. When 4+ An even deeper depression
DIC disseminated intravascular coagulation injecting into the left side of the patient, place the palm of (more than 1 cm) accompanied
DSA digital subtraction angiography the right hand on the greater trochanter and the index finger by severe foot and leg swelling
FUO fever of undetermined origin on the anterior superior iliac spine. Spread the middle finger
g, gm gram posteriorly away from the index finger as far as possible
along the iliac crest, as shown in the drawing. A “V” space
gr grain or triangle between the index and middle finger is PULSES
gt, gtt drop, drops formed. The injection is made in the center of the triangle Peripheral pulses should be com-
HS at bedtime, hour of sleep with the needle directed slightly upward toward the crest of pared for rate, rhythm, and quality.
ICS intercostal space the ilium. (When injecting into the right side of the Pulses are graded as follows:
patient, use your left hand for placement).
IU international unit 0 Absent
kg kilogram VASTUS LATERALIS AREA +1 Weak and thready
KVO, KO keep vein open, keep open A relatively safe injection site free from major nerves and +2 Normal
KUB kidneys, ureters, and bladder blood vessels. This injection area is bounded by the mid- +3 Full
l liter anterior thigh on the front of the leg, the mid-lateral thigh +4 Bounding
lb pound on the side, a hand’s breadth below the greater trochanter of
LUQ left upper quadrant the femur at the proximal end and another hand’s breadth
above the knee at the distal end.
M molar DOSAGE CUP
m meter, minim Z-TRACK TECHNIQUE
µ micron A Z-track technique is used for administering any irritating fluid to ‘seal’ med-
mEq milliequivalent ication in the muscle. Figure A shows the normal tissue before the injection. As
mg milligram in figure B, retract the tissue, insert the needle, administer medication, remove
µg microgram the needle, and release tissue. Note in figure C, the tissue relationships after the
ml milliliter angled Z-tract left by the needle.
µl microliter A B C
mm millimeter
NPO nothing by mouth
OTC over the counter
oz ounce
p.c. after meals
PERRLA pupils equal, round, reactive to light
and accommodation CALCULATING I.V. DRIP RATE HOUSEHOLD/APOTHECARY/
P.O. by mouth The physician’s order states: 1,000 ml LRS to infuse METRIC EQUIVALENTS
prn as needed, whenever necessary over 8 hours. The administration set delivers 15 drops Household Apothecary Metric
per milliliter. What should the drip rate be?
PTCA percutaneous transluminal coronary Volume
angioplasty Use the equation: --- = 15-16 minims = 1 milliliter(ml)*
Total no. of ml
_______________ x drip factor = drip rate 1 tsp = 1 fld. dram
q every Total no. of min = 4-5 ml
qh every hour 1 Tbs = 3-4 fld. drams = 15-16 ml
Set up the equation using the given data: 1 cup
q2h every 2 hours 1,000 ml = 8 fld. ounces = 240 ml
_______________ x 15 gtt/ml = X gtt/min 1 pint = 16 fld. ounces
8 hr x 60 min. = 480 ml
q.i.d. four times a day 1 quart = 32 fld. ounces 960 ml
After multiplying the number of hours by 60 minutes =
RLQ right lower quadrant Weight
in the denominator of the fraction, the equation is:
R/O rule out 1,000 ml --- = 1 grain = 60-65 mg
______________ x 15 gtt/ml = X gtt/min
ROM range of motion 480 min --- = 15-16 grains = 1 gram
RUQ right upper quadrant After dividing the fraction, the equation is: --- = 1 dram = 4 grams
2.2 pounds = --- = 1 kg
Rx prescription 2.08 ml/min x 15 gtt/ml = X gtt/min Length
s without The final answer is 31.2 gtt/min, which can be rounded 1 inch = --- 2.54 cm
to 31 gtt/min. The drip rate is 31 drops per minute. =
SC, SQ subcutaneous 39.37 inches = --- = 1 meter
subq subcutaneous
SI International System of Units
SOB short of breath I.V. FLOW RATES CONVERSION FACTORS
ss one-half Vary with the type of administration set and the manufacturer. Weight o o
C F
stat immediately Drops/ Drops/minute to infuse 1 gr = 60-65mg
Mgf. (GTTS) 1 mg 37.0 98.6
sx symptoms cc = 1000 mcg
T&C type and crossmatch 1,000ml 24 hr 20 hr 10 hr 8 hr 6 hr 1 Gm = 1000 mg = 15 gr 37.8 100
cc/hr 42 50 100 125 166 1 kg = 1000 Gm = 2.2 lb 38.4 101.1
t.i.d. three times a day
Abbott 15 10 12 25 31 42 Volume 39 102.2
TPR temperature, pulse, respirations
Baxter 15 or 16
tsp teaspoon 10 7 8 17 21 28 1 ml* = minims 39.6 103.3
Healthcare 5 ml
UA urinalysis = 1 fld. dr = 1 tsp
ung, ungt ointment Cutter 20 14 17 34 42 56 15 ml = 4 fld. dr = 1 tbsp oF = ( oC x 1.8) + 32
IVAC 20 14 17 34 42 56 30 ml = 8 fld. dr = 1 ounce
URI upper respiratory infection * ml and cc oC = ( oF-32) ÷ 1.8
UTI urinary tract infection McGaw 15 10 12 25 31 42 are equivalent