How To Give An Intramuscular Injection

1. How To Give An Intramuscular Injection Stephen Weyel Northeastern University

2. Intramuscular (IM) Injections • Shots of medicine given into a muscle • Certain medicines need to be injected into muscle for them to work properly • Injecting vaccines into subcutaneous fat can cause vaccine failure due to poor vascularity of fat, thus slow mobilization of antigen • Often administered into thigh, hip, upper arm, or buttocks http://www.drugs.com/cg/how-to-give-an-intramuscular-injection.html

3. Administering the injection • Prep area by wiping it with an alcohol wipe and letting it dry • Hold syringe in dominant hand between thumb and index finger, letting the barrel rest on your second finger • With free hand, gently pull skin in area so it is slightly tight • Hold syringe tightly and use wrist to inject needle at a 90 degree angle through skin into muscle http://www.drugs.com/cg/how-to-give-an-intramuscular-injection.html

4. Administering the injection (continued) • Once the needle is fully inserted, release skin and secure syringe with both hands • Pull back on plunger slightly to ensure blood vessels weren’t punctured during injection • If blood comes back into barrel, remove the needle immediately and do not inject the medicine • If no blood comes back into syringe, push down on plunger to inject medicine • Pushing slowly on plunger will reduce amount of pain experienced by patient • Once medicine is fully injected, remove needle at 90 degree angle and dispense in sharps bin

5. VastusLateralis (thigh muscle) • Have patient in lateral recumbent position, supine, or sitting • Divide thigh into 3 equal parts • Shot is given into outer middle third • Advantages: large muscle, easy to see • Standard for children below age 3, as it is their largest muscle http://www.drugs.com/cg/how-to-give-an-intramuscular-injection.html http://jagged81.hubpages.com/hub/Vastus-Lateralis-Injection

6. Ventrogluteal (Hip muscle) • Have patient in lateral recumbent position or supine • Place heel of hand on upper, outer part of thigh where it meets the buttocks • Point thumb at groin and fingers towards patient’s head • Form “V” by separating first finger from other three fingers, inject into middle of “V” • Utilized for adults and children older than 7 months http://jagged81.hubpages.com/hub/Ventrogluteal-Injection http://www.drugs.com/cg/how-to-give-an-intramuscular-injection.html

7. Deltoid (Upper arm muscle) • Have patient in lateral recumbent position or sitting • Palpate and locate bone on top of upper arm (acromion process) • Between bottom of acromion process and armpit level is injection site, 1 to 2 inches below acromion process • Site should not be used if patient is very thin with little muscle http://nursingfile.com/nursing-procedures/demo-video/deltoid-injection-site.html

8. Dorsogluteal (buttocks muscle) • Have patient in prone position • Palpate and locate posterior superior iliac spine, then locate greater trochanter of femur • Visualize diagonal line between these two locations, injection site is above center of line (upper, outer quadrant of buttocks), but below iliac crest • Extreme caution should be used with this site, as the sciatic nerve and superior gluteal artery are in this area http://wps.prenhall.com/chet_wilson_drugguides_1/0,5513,403564-,00.html http://wps.prenhall.com/chet_wilson_drugguides_1/0,5513,403564-,00.html

9. Inform patient • Tell patient to contact physician if: • Fever, coughing, or general symptoms of illness develop after injection • Swelling or bruising develops at injection site • Seek immediate care if: • Rash develops at injection site • Experience shortness of breath • Mouth or face swelling occurs http://www.whatis-healthinsurance.com/individual-health-insurance/need-a-health-plan-for-2014.html

10. resources • http://www.drugs.com/cg/how-to-give-an-intramuscular-injection.html • http://pcos.about.com/od/medication1/f/IMsite.htm • http://www.dana-farber.org/Health-Library/Instructions-for-intramuscular-injection.aspx • http://nursingfile.com/nursing-procedures/demo-video/deltoid-injection-site.html • http://jagged81.hubpages.com/hub/Vastus-Lateralis-Injection • http://jagged81.hubpages.com/hub/Ventrogluteal-Injection • http://wps.prenhall.com/chet_wilson_drugguides_1/0,5513,403564-,00.html • http://www.whatis-healthinsurance.com/individual-health-insurance/need-a-health-plan-for-2014.html

11. Reflective letter I decided to make a PowerPoint describing the general procedure of intramuscular injections and the various sites that can be utilized for them. I made use of medical terminologies as well as concise language to guarantee the document had a professional and educational tone. The audience would be other healthcare professionals or physician assistants that would partake in administering injections for patients. The audience would need a clear description and demonstration of the process through the use of straightforward language and visuals, as proper technique while giving shots is an important aspect of ensuring the patient’s comfort during treatment. Accuracy and precision need to be the focal point, as injections can be in areas of the body where mistakes would cause the patient pain, or even serious injury, if given in the wrong location. The document best suits these needs because it is very straight forward and informative, and makes use of pictures that depict the correct locations and procedures for injections. Readers would encounter this document in the doctor’s office or in a database if they were searching for instructions on how to perform intramuscular injections. The reader would encounter medical terminologies in the document, so they would have to be educated in medicine to understand its text. This piece would be suitable for my professional portfolio, as it demonstrates my knowledge of medicine and ability to incorporate professional language into an educational document.