Intro Skill DMdweS IM Injection

INTRAMUSCULAR INJECTION

Skill ActivityDermato Musculo Sceletal 2011

FK UNISBA

INTRAMUSCULAR INJECTION

IM INJECTION SITES

Deltoid

Dorsogluteal

Ventrogluteal

Vastus lateralis

DELTOID MUSCLE

GLUTEUS MAXIMUS

GLUTEUS MEDIUS

VASTUS LATERALIS

Procedure

Assessment

• Assess medication record to identify whether any medications are to be given to an individual patient

• Check medications listed against physician’s orders

• Review information regarding the medication

• Assess size and general build of patient• Assess need for assistance

Planning

• Determine appropriate needle and syringe to be used

• Wash your hand• Gather eqiupment

Implementation

• Read name of medication to be given from record

• Check label on medication and take from shelf or drawer

• Check label again, before calculating and preparing dosage

• Draw up correct dosage of medication

Implementation

• a. From vial :– Clean top of vial and allow to dry– Discard alcohol swab– Prepare syringe and needle– Remove needle guard– Insert needle into vial through rubber stop

Implementation

• a. From vial :– Pick up vial with non dominant hand and

withdraw correct volume of medication– Examine for air bubbles and expel them– Recheck volume of medication for accuracy– Remove needle from vial– Replace needle guarg

• b. From ampule– Get all medication into lower part of ampule– Clean neck ampule with alcohol swab– Prepare syringe and needle– Wrap neck of ampule and break off the top,

away from yourself– Remove needle guard

• b. From ampule– Hold ampule in nondominant hand and insert

needle into ampule– Aspirate medication into syringe– Withdraw needle from ampule– Point needle vertically and pull back slightly– Expel air from syringe– Make sure that you have the exact volume of

medication needed– Replace needle guard

• to check the label a third time and recalculate the dosage

• Place syringe, needle, and alcohol swab on cart

• Place patient identification card with medication

• Approach and identify patient• Explain to the patient and perify

appropriate site• Provide privacy• Select the appropiate site for injection by

identifying anatomical landmark

• For intradermal : inner aspect of forearm or scapular area of back

• For subcutaneous : abdomen, lateral aspect of upper arm or thigh

• For intramuscular : lateral aspect of thigh (vastus lateralis), buttocks (gluteus maximus), ventral gluteal, upper arm (deltoid)

Give the injection :

• Cleanse area with alcohol wipe, using circular motion, cleance from inside outwards

• Allow site to dry• Remove needle guard• Express any bubbles from syringe

Insert the needle :

• 1) for intradermal : – at a10 – 15 degree angle with the bevel of

needle facing up– inject the medication slowly. – observe for wheals and blanching (normal

finding) at the site– withdraw the needle, wiping area gently with a

dry 2 x 2 pad

Insert the needle :

• 2) for subcutaneous– at a 45 –degree angle while forming a cushion

of subcutaneous tissue by gently pinching the tissue

– pull back on plunger to check if needle is a blood vessel

– inject the medication slowly– withdraw needle quickly, and massage area

with alcohol wipe to aid absorption, put on bandaid if needed

Insert the needle :

• 3) for intramuscular– at a 90 degree angle – pull back on plunger. If blood return, you know

you have entered the blood vessel and need to reposition the needle and aspirate again

– inject the medication slowly – withdraw needle quickly and massage the

area with alcohol wipe. Put on a bandaid if needed

• Return patient to a comfortable position• Evaluation

– Evaluate the patient’s condition 15 minutes after administering medication

• Documentation– Date and time of administering medication– Dosage and type of injection– Patient’s respons to medication– Name and signature of operators