A nurse, while in nursing school, learns how to give IM (intramuscular) injections. Nurses must prepare to handle many different types of medical care for patients of all ages. One of the many procedures that nurses perform is the intramuscular injection (IM). The process can be very painful if not conducted in the proper manner. Serious medical issues can arise if intramuscular (IM) injections are not performed correctly. It takes a great deal of skill and practice to perform intramuscular injections on patients so nurses must get all the practice that they can in order to master this nursing skill.
How to Give Intramuscular (IM) Injections
Intramuscular injections are part of medical procedures in which medications are injected directly into the muscles. There are certain medications that can only be administered from injections into the patient’s muscles. Depending of the amount or type of medication, intramuscular injections may be necessary. Intramuscular injections are provided for patients who need fast acting medications administered to them.
IM Injection Sites
There are 4 sites that are perfect for intramuscular injections. The best locations to administer intramuscular injections are the:
- Dorsogluteal Muscle
- Deltoid Muscle
- Ventrogluteal Muscle
- Vastus Lateralis Muscle
Selecting the best site is important to prevent injury and proper absorption of the medication. Large muscle sites with little fatty tissue are the best sites for intramuscular injections. Palpate the muscle prior to administering an injection to ensure the muscle is able to support the medicine to be administered. Medical professionals may suggest a particular site to patients so that they experience the least amount of pain during the injections.
Intramuscular injections can be performed using 18-23 gauge needles. For viscous and large amounts of medication be sure to use larger needles. It is possible that patients will faint during the injection process so nurses should take precautions to prevent any type of injury to the patient while administering the intramuscular injection.
Steps on How to Give an IM Injection
- Wash hands thoroughly and dry. Gather the necessary materials, which include a syringe, alcohol pads, 23-guage, syringe, 1-inch needle, and 2-inch-by-2-inch gauze pad.
- Use an alcohol pad to prepare the injection site. Wait a few seconds until the alcohol is completely dry before proceeding with the injection. Doing so will significantly reduce the pain experienced during the injection.
- Select the best site to administer the intramuscular injection. The deltoid muscle is usually the best site to administer the injections, but medications with volumes greater than 2.5 ml should be injected in the gluteus maximus muscle or one of the other muscles mentioned previously.
- Before penetrating the muscle with the needle, it is important to maintain a 90-degree angle to the patient’s skin. This angle penetrates as little of the patient’s skin as possible. Muscles do not contain as many nerves as skin does so repositioning the needle while it is in the muscle may cause a great deal of pain in the muscle tissue.
- Firmly grasp two to three inches of the injection site and lightly squeeze the area. Inject the medication into the injection site as quickly and firmly as possible. Inject the needle up to the hub using a controlled manner.
- Perform the injection slow so that the patient does not experience trauma to the tissue. The injection speed should be approximately one second per ml for most vaccinations and medications.
- Gently massage the muscle tissue around the injection site after removing the needle from the patient’s muscle. Patients may prefer to perform their own massage if the injection is administered in the buttock.