Intramuscular Injections

Nurs 110 A Fall, 2012 Shauna Miller, R.N.

Intramuscular Injections (IM) IM vs SQ

Medications absorbed more quickly than SQ because of the greater blood supply Muscles can take a larger volume of fluid than SQ tissue

Needles
Standard prepackaged IM needle is 1 inches (@ 4 cm) and #21 or #22 gauge The nurse chooses the length and gauge of needle based on 1) The muscle 2) The type of solution 3) The amt of adipose tissue covering the muscle 4) The age of the client

Syringes
Standard prepackaged is 3 5 mL The nurse decides the syringe based on the amount of solution

IM Injection Technique
Z track method facilitates needle insertion by making the muscle firm Pierce the skin at a 90 degree angle Aspirate for 5 10 seconds for blood If no blood, inject medication at a rate of 10 seconds per ml Wait 10 seconds before withdrawing the needle

IM Injection Sites
Deltoid muscle Rectus Femoris muscle Vastus Lateralis muscle Ventrogluteal site- gluteus medius muscle Dorsogluteal site- gluteus maximus muscle

Deltoid Muscle
Lateral aspect of upper arm Relatively small muscle Very close to the radial nerve Very close to the radial artery

Recommended volume of solution is 0.5 to 1 mL

Maximum volume of solution is 1 mL Landmarks: Acromion process, the axilla

Rectus Femoris muscle

Anterior aspect of the thigh Injection can cause considerable discomfort Site is easily accessed Recommended vol of solution is 1 2 mL Maximum volume of solution 3 mL Landmarks: Anterior superior iliac crest and Patella

Vastus Lateralis muscle

Anterior lateral aspect of the thigh Client can be in sitting position Recommended vol of solution is 1 3 mL Maximum volume of solution 3 mL Landmarks: Greater trochanter and lateral femoral condyle

Ventrogluteal site- gluteus medius muscle

In the gluteus medius muscle Preferred site for IM injections because the site contains no large nerves or blood vessels, provides the greatest thickness of gluteal muscle, it is sealed off by the bone, contains consistently less fat than the buttock area Maximum volume of solution 3 mL Landmarks: Greater trochanter and anterior superior iliac spine

Dorsogluteal site- gluteus maximus muscle

Can be used for clients with well-developed gluteal muscles Bone, major blood vessels and the sciatic nerve must be avoided Maximum volume of solution 3 mL Landmarks: Posterior superior iliac spine and the greater trochanter