Best practices for injection who best practices for. An intramuscular injection is a technique used to deliver a medication deep into the muscles. This chapter assimilates the best practices for delivering injections in healthcare and related facilities. Instructions for im injection technique vary in literature and in nursing texts, including guidelines for weight and gender, injection site, needle gauge and length, bunching or stretching the skin, aspiration, and ztrack method. Proper technique when administering intramuscular injections the trend of medication administration has shifted with medications given more via intravenous route instead of intramuscular route. Pull the 18 g needle cover straight off the syringe. How to give a testosterone intramuscular im injection what is an intramuscular injection. Injections should be prepared in a designated clean area where contamination by blood and.
How to give an intramuscular injection im injection. The importance of choosing the optimal injection site for the prescribed insulin regimen and matching the site with the needle length and injection technique is. Intramuscular im injection is a type of venipuncture that is given into the central area of a certain muscle to distribute medication to the cardiovascular system by allowing it to be absorbed into the bloodstream at a faster rate and at a larger volume than an oral or intravenous medication would allow. It is based on a range of evidence and expands the scope of the who publication best infection control practices for intradermal, subcutaneous, and intramuscular needle injection 7.
To determine intramuscular injecting practice choices made by nurses working in the mental health setting nursing. The administration of intramuscular injections is a common nursing intervention in clinical practice. An evidencebased approach to intramuscular injection technique this learning module has been accredited by the royal college of nursing and was last updated in 2016. Evidencebased clinical guidelines for injection of. How to give yourself a testosterone im injection 3 step 3. The thigh is a good place to give yourself an injection because it is easy to see. Are techniques used for intramuscular injection based on.
Nurses must prepare to handle many different types of medical care for patients of all ages. Injection techniques good injection practice relies on accurate site selection using anatomical markers. Nurses use of appropriate needle sizes when administering. A method of administering medication directly into muscle.
A quantity of published papers and nursing texts on injection sites and techniques were assessed to evaluate their quality and relevance and. Intramuscular injection in deltoid muscle with ztrack. How to give a testosterone intramuscular im injection. Guidelines on the administration of intramuscular and subcutaneous injections version number v3. Trish reynolds and louise saxton describe a programme to improve technique among pre and postregistration nurses. An intramuscular im injection is the administration of medication through the cutaneous and subcutaneous layers, into the muscle.
You have read 1 of 1 freeaccess articles allowed for 30 days. The im route is often used for medications that will not irritate soft tissue and can be suitably dissolved. Who best practices for injections and related procedures. Dg muscle is no longer recommended for im injections in spite of this, many nurses. An evidencebased approach to intramuscular injection. It is also a good spot for children younger than 3 years old. Take some simple steps to prepare the injection site. Many nurses have been taught to aspirate before giving an im injection to ensure the medication is not inadvertently delivered into a vein.
Choose the injection site and needle length that is appropriate to the persons age and body mass. As a nursing student or nurse, this is an injection site youll use. One must take into account the patients anatomy and how it informs the selected site of injection, the technique used by the nurse, the amount of subcutaneous tissue and muscle in the gluteal area, and the length of the needle chosen. An intramuscular injection, illustration on right delivers medication deep into the muscle tissue. The intramuscular route allows the rapid absorption of drugs into the circulation. However, the literature about the proper technique for administering an intramuscular injection presents conflicting information. Intramuscular im injections administer medication deep into the muscle tissue, enabling faster absorption and larger systemic doses than subcutaneous injections. More than 12 billion im injections are administered annually throughout the world. Thus when nurses are providing intramuscular injections it could be once a. The world health organization who defines a safe injection to be one that does not harm the recipient, does not harm the health care worker, and does not harm the community.
A framework for safe practice is included, identifying important points for safe technique, patient care and clinical. It displaces skin and sc layer from the muscle to be injected and seals off the. Administering intramuscular injections is a skill which is frequently performed by nurses and nursing students. This allows the medication to be quickly absorbed into the bloodstream for action. It is essential that nursing practice is evidence based and each.
Intramuscular injection how to give an im injection. Guidelines for medication and vaccine injection safety. Despite it considered as a simple technique, when intramuscular injection process is not done carefully, it can cause. Keywords practical procedures injection technique this. The deltoid muscle is one of the im injection sites you can use to administer vaccines or other medications. Look at your thigh and divide it into 3 equal parts. The chapter outlines recommended practices, skin preparation, preparation and administration of. To consider to what extent intramuscular injection technique can be described to remain entrenched in ritualistic practice and how evidencebased practice should be considered and applied to the. 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. Proper technique when administering intramuscular injections. 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. Im injection technique for the deltoid muscle site using the ztrack technique. World health organization international council of nurses a guide for nurses and others who give injections.
Using the correct injection technique and selecting the correct site will minimise the risk of complications. For information on how to store and dispose of used. The essential nursing skill of intramuscular injection often appears to fit into the description of a ritualised practice. How to administer intramuscular and subcutaneous vaccine. Injection site and needle size subcutaneous subcut injection use a 2325 gauge needle. Choose the injection site that is appropriate to the persons age and body mass. Intramuscular injection im osce guide geeky medics.
Nursesmidwives and students of nursing and midwifery as. This study investigated whether the size of needles used to administer intramuscular injections is appropriate for patients on the basis of their weight or body mass index. This is a video tutorial on how to give an intramuscular injection in the ventrogluteal butt muscle. How to administer an intramuscular injection in the. An intramuscular injection, as illustrated in the figure below, delivers medication deep into the muscle tissue. The z track technique is the preferred method for administering many im. Recommendations for largevolume intramuscular injections. Intramuscular im injection site for infants and toddlers. An im injection is a shot of medicine given into a muscle intramuscular. Some medicines need to be given into a muscle to work correctly. Are techniques used for intramuscular injection based on research evidence. How to give an im intramuscular injection ventrogluteal.
This allows the medication to be absorbed into the bloodstream quickly. Prior to administering an im injection, refer to your procedure manual to. Follow standard medication administration guidelines for site assessmentselection and site preparation. The success of an intramuscular injection is therefore dependant on multiple variables. There is a wealth of international publications regarding evidencebased practice in relation to administering safe and effective intramuscular im injections.
Bridget malkin, ma ed, bsc, rgn, is senior lecturer, clinical skills, birmingham city university. Scroll down to read the article or download a printfriendly pdf here if the pdf. A large number of these are given via the intramuscular im route. Five videos have been produced to assist in locating the four accepted intramuscular injection sites using anatomical markers as well as the z track technique which should be used with all injection sites. Intradermal injection it is the introduction via needle of tiny amounts of fluid into layers of skin. Using ventrogluteal site in intramuscular injections is a. Using ventrogluteal site in intramuscular injections is a priority or an alternative. Nurses overlook guidelines for intramuscular injection site seven out of 10 hospital nurses who took part in a canadian study reported using the dorsogluteal buttock site to administer intramuscular injections, despite the potential risks of sciatic nerve injury, with only 14% using the ventrogluteal hip site as recommended by nursing.
This is part 1 of a twopart series on injection techniques. Good injection technique can mean the difference between less pain and injury. Published on december 11, 2016 each year around 16 billion injections are given worldwide. The technique for delivering intramuscular injection remains rooted in custom and practice. Even though it can cause tissue, musculoskeletal and neurological complications such as. Syringe used is 1ml tuberculin syringe because of a very small amount of drug. Effectiveness of nursing interventions on pain associated. Injection training guide this section covers general information. Intramuscular injections require a thorough and meticulous approach to patient assessment and injection technique. The aim of the survey was to investigate whether the standardsguidelines for instruction in injection technique for adults with. Intramuscular im injection site for children and adults. Each medication has a specific injection technique and a preferred injection site that your doctor directs you to use. The importance of good injection technique cannot be understated. One of the many procedures that nurses perform is the intramuscular injection im.
The authors address administration of neuroleptic depot drugs within the adult mental health environment and examine the evidence base for this practice. Check the package containing the syringe, if the package has been opened or damaged, do not use that syringe. Intramuscular injection guidelines becton dickinson. A nurse, while in nursing school, learns how to give im intramuscular injections. Helfer skin tap technique on pain during intramuscular injection revealed that the intramuscular injection of medication is a procedure commonly performed by nurses and are associated with discomfort, pain and trauma to the injected tissue. Intramuscular injections im are a common yet complex technique used to deliver medication deep into the large muscles of the body. The nurse should consider the size of the muscle, viscosity of the medication, and volume to be administered when selecting the needle length and gauge. Pdf to consider to what extent intramuscular injection technique can be described to remain entrenched in ritualistic practice and how. Evidence calls for practice change in intramuscular. Alternatively, you may administer the injection with the patient in a seated position. Intramuscular im injection use a 2225 gauge needle. Abstract the intramuscular route allows for rapid absorption of drugs into the circulation. Procedures used to prepare and administer intramuscular.
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