Intramuscular Injections

How to administer an Intramuscular injection

1. Make sure your area is clean. Gather the supplies you need and place them on a clean, dry surface. (Figure 1)

Intramuscular-Injections

Figure 1

2. Wash your hands well with soap and warm water.
3. Take an alcohol wipe and tear down the sides to remove the wipe.
4. Wipe off the top of the vial with the alcohol wipe for 3-5 seconds to make sure the vial is clean. (Figures 2 & 3)

Intramuscular-Injections

Figure 2

Intramuscular-Injections

Figure 3

5. Draw the amount of air equal to the amount of liquid you will draw. (Figure 4)

Intramuscular-Injections

Figure 4

6. Inject the needle into the vial through the rubber stopper on top, push down the plunger, and draw back the prescribed amount of medication. (Figures 5 & 6)

Intramuscular-Injections

Figure 5

Intramuscular-Injections

Figure 6

7. Make sure to get all of the air bubbles out; the maximum amount is about the size of a pin head.
8. Take out the syringe. Turn the syringe needle side up and tap the syringe with your finger to get all of the air bubbles to the top. Clear the air bubbles out of the syringe by pushing up on the plunger slightly until they are all gone. (Figures 7 & 8)

Intramuscular-Injections

Figure 7

Intramuscular-Injections

Figure 8

9. Get in a relaxed position (i.e. standing up, sitting down with back straight in a chair representing good posture).
10. Take an alcohol wipe and tear down the sides to remove the wipe.
11. Clean an area 2 inches in diameter where the injection is going to be made with the alcohol wipe for 3 to 5 seconds. Use firm circular motions while moving outward from the injection site. Let the area dry for 20 seconds. (Figure 9)

Intramuscular-Injections

Figure 9

12. Remove the cap of the needle from the syringe, being careful not to touch the needle.
13. With your thumb and index finger of your non-dominant hand, spread the skin out from the site of the injection.
14. Try to relax the muscle you will be injecting; as injecting into tense muscles will be more painful.
15. Hold the syringe with your thumb and index finger of your dominant hand for maximum support, as you would a pencil. (Figure 10)

Intramuscular-Injections

Figure 10

16. Quickly pierce the skin with the needle at a 90 degree angle and insert the needle all the way into the muscle. Proceed to push down on the plunger so the liquid comes out of the syringe and into the muscle. Make sure all the liquid has left the syringe. (Figure 11)

Intramuscular-Injections

Figure 11

17. Remove the syringe and needle and make sure there is no blood or left over medication. Place the needle cover back on the needle and then place in an appropriate storage container (sharps, orange juice carton, etc.). Dispose of used needles as directed by your doctor. (Figure 12)

Sharps-Container

Figure 12

18. Rub the injection site in a circling motion for 10-15 seconds with slight pressure. Otherwise, a bump or rising of the skin may occur at the site of the injection.
19. Wash your hands with soap and warm water, record the date, time and site of injection on a record sheet. It is recommended that you alternate body sites each time you give an injection. Keeping a written record will help you remember where you injected last.
20. Afterwards, monitor signs of redness, swelling, irritation or bleeding at the injection site. Observe yourself for 15 minutes to make sure no reaction has occurred or ask someone to monitor you as well.
21. Contact your physician if: (i) a fever, sneezing, or coughing develops after the injection; or (ii) there is a lump, swelling, or bruising where the injection was given that does not go away.
22. Seek care immediately or call 911 if: (i) a rash or itching develops after the injection is given; (ii) shortness of breath develops after the injection is given; or (iii) the mouth, lips, or face swells after the injection is given.

Helpful Reminders:
1. The most important aspect to successfully complete this task is to understand the materials that we are using to draw medication from a vial.
2. Understand the dosage prescribed by your doctor.
3. Make sure you are practicing aseptic technique (detailed practices and methods performed under carefully restricted conditions while the goal is to minimize contamination by pathogens). Good hand washing is essential!

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