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

  • The diagnosis and age of the patient
  • The purpose of injection
  • The doctors order
  • The patient details
  • The nurses record about previous
  • The allergic reactions
  • The necessity for giving test dose
  • The levels of consciousness and follow instructions
  • The site of injection
  • The patient’s previous experiences

Equipment

A tray containing:

  • Syringe and needles of various size (sterile)
  • Transfer forceps in a jar containing antiseptic solution
  • Sterile cotton swabs and gauze pieces in sterile container
  • Methylated spirit in a container
  • Bowl with water
  • Kidney tray and paper bag
  • Drug order sheet
  • Water for injection
  • File to cut upon the ampoules
  • Small covered tray (sterile) to carry the prepared injection to the bed side

Preparation of the Patient and Environment

  • Identify the patient correctly
  • Explain the procedure to the patient
  • Provide privacy
  • Keep the patient’s attention away from the injection by friendly conversation
  • Place the patient in a comfortable and relaxed position
  • Select a site suitable for the route of administration

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

  • Inspect the area for bleeding
  • Help the patient to dress up
  • Ask the patient to take rest for 15 minutes
  • Check the limb movement to confirm there is no nerve injury
  • Watch for the signs and symptoms of allergic reaction
  • Replace the equipment in the proper place
  • Hand wash
  • Record the procedure on the nurse’s record
INTRAMUSCULAR INJECTION - Purpose, Equipment, Nurse Responsibility, Site Selection, Preparation, Procedure, Instructions
INTRAMUSCULAR INJECTION – Purpose, Equipment, Nurse Responsibility, Site Selection, Preparation, Procedure, Instructions

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