INTRAMUSCULAR INJECTION

INTRAMUSCULAR INJECTION

Intramuscular injection is defines as introduction of medicine into the muscle in form of solution

Purpose

To obtain a quick effect of medicine than is obtained by oral administration and subcutaneous administration
Assures that the total dosage will be administered and the same will be absorbed for the systemic action of the drug
The medicines that is not suitable for intravenous administration

Principle

The knowledge of the anatomy and physiology of the body is essential for the safe administration of the injection
Injections are means of introducing infection into the body, if carelessly given
Drugs that change the chemical composition of the blood will endanger the life of the patient, if not used cautiously
Any unfamiliar situation produces anxiety
Once a drug is injected it is irretrievable. Antidote may be available for particular medications but the best antidote is prevention
Organization and planning results in the economy of time, material and effort

General Instructions

Give injections only on the doctors written orders
Follow strict aseptic techniques
Syringes and needles used for injections should be kept separate from those used for other purpose
Always have the syringe and needles in good order
Change the needle after withdrawing the drug from a rubber stopped container before giving injection to the patient
Observe the five rights of the administration of medicines
Never use a drug whose expiry date is over
Always have a patient relaxed and placed in a comfortable position
Never allow the patient to walk soon after the injection
Select the appropriate site for giving injections
Rotate the site for patients getting insulin to prevent lip dystrophy
Use correct technique of injection – the needle inserted gently and quickly, and the drug injected slowly
After inserting the needle, always withdraw the piston to make sure that it is not in a blood vessel in case of intramuscular and subcutaneous injections
Solution for injection should be clear, sterile, nearly neutral in reaction
Massage the area at the site of injection except in case of intradermal injections
Injection should be charted immediately

Site of Intramuscular Injections

Dorsal gluteal site: find out the greater trochanter of the femur and the posterior superior iliac spine drawn an imaginary line between these two bony prominences. Site will be upper and outer quadrant
Vastus lateralis site: the site is at the outer aspect of the thigh. It is the area between mid-anterior thigh and mid lateral thigh one hands span from elbow and great trochanter to one hands span above knee
Ventrogluteal site: place the tip of the index finger on the anterior superior iliac spine of the patient the middle finger just below the iliac chest
Mid deltoid site: locate the lower edge of the acromion process and form a rectangle. The deltoid area is used to inject very small quantities of non-irritating drugs

Methods of Intramuscular Injection Administration

Air lock method: expel the air from the syringe leaving 0.2 ml, stretch the skin lightly with the index finger. Insert the full needle quickly into the muscle. Withdraw the piston to confirm that the needle is not in the blood vessel. Push the piston gently to give the medicine very slowly
Z-tract method: expel the air from the syringe; displace the skin laterally using the side of your left hand. Insert the needle, aspirate the placement, inject the medicine very slowly, marinating tissue displacement wait for ten seconds to allow the medicine to disperse. Withdraw the needle allowing the displaced tissue to return to its normal position

Nurses Responsibility

Check

Equipment

A tray containing:

Preparation of the Patient and Environment

Procedure

Select the medication
Hand wash
Prepare the medication
Keep the syringe with medications in the sterile tray and cover it
Make sure that the medicine taken right and correct dosage
Carry medication to the patient in a sterile tray
Identify the right patient
Prepare the site of injection
Inject the medicine by correct technique is essential for the safety of the injection
Spread the tissue between the thumb and forefingers to make the skin taut
Needle is inserted at a 90 degree angle holding the syringe back the piston with the left hand
Using a steady push on the needle and aspirate by pulling back the piston with left hand
If no blood comes gives the medication slowly by pushing the piston
Remove the needle quickly and massage the site for quick absorption of the drug

After Care