IM INJECTIONS

1. ADMINISTRATION
OF
INTRA MUSCULAR
INJECTION

2. ◦
PRESENTED BY,
LEKSHMY RAJAGOPAL.G.
Ist YEAR MSc NURSING,
SGNC,VJMD.

3. INDICATIONS
• Muscles have more blood supply ,so
quicker action of drugs.
• More amount of drug can be administered
than the intradermal and subcutaneous
tissue.

4. CONTRA-INDICATIONS
• Avoid sites of lesions, lumps, tissue
injury,presence of nodules other pathology.
•Avoid sites near to large blood vessels, nerves
and bones.

5. SITES OF IM INJECTIONS
• VENTRO GLUTEAL
•DORSO GLUTEAL
•VASTUS LATERALIS
•DELTOID
•RECTUS FEMORIS SITE

6. 1.VENTROGLUTEAL SITE
◦It is the site where the gluteus medius muscle
lies over the gluteus minimus

7. ADVANTAGES OF VENTROGLUTEAL
SITE
1.No large nerves or blood vessels in this area.
2.Provides greatest thickness of gluteal muscles.
3.It is sealed off by bone.
4.Contains less consistency fat than buttock
area.
5.Most suitable for adults and children over 1 yr

8. PROCEDURE-VENTRO GLUTEAL
1.Place patient on side-lying position, bent the knees and
raise it slightly to chest.(use alternate hands for hips).
2.Place the nurses heel of hand over the greater
trochanter of patient with fingers pointing towards head
of patient.
3.Index finger should rest on anterior superior iliac
spine, middle finger stretched dorsally.
4.Midpoint of triangle formed between index finger
,middle finger and iliac crest is the site.

9. VENTRO - GLUTEAL

10. VENTROGLUTEAL SITE

11. DORSO GLUTEAL SITE
◦It is composed of the thick gluteal muscles of the
buttocks.
◦CONTRA-INDICATION
◦Not used for children below 3 years ,because these
muscles are developed by walking.

12. PROCEDURE FOR DORSOGLUTEAL
1.Patient is positioned in prone position with toes facing
inwards or side-lying position with upper knee flexed and
in front of the lower leg.
2. Palpate the posterior superior iliac spine and draw an
imaginary line to the greater trochanter.(This line is parallel
and lateral to the sciatic nerve ).
3.Injection site is parallel and superior to this site.

13. DORSOGLUTEAL SITE

14. VASTUS LATERALIS
◦It is thick and well developed in both adults
and children.
◦The area is divide into 3 parts from the greater
trochanter of femur and lateral femoral
condyle.
◦The middle third is injection site.

15. VASTUS LATERALIS

16. DELTOID SITE
◦It is found in the lateral aspect of the upper
arm.

17. PROCEDURE FOR DELTOID SITE
1.Place 4 fingers over the deltoid muscle,first
finger over the acromion process.
2.Top of axilla is the line that marks the lower
border.
3.Triangle formed between these boundaries is
the site for injection.

18. DELTOID SITE

19. RECTUS FEMORIS
◦IT BELONGS TO THE QUADRICEPS
GROUP OF MUSCLES.IT IS SITUATED IN
THE ANTERIOR ASPECT OF THE THIGH

20. RECTUS FEMORIS

21. STEPS OF IM INJECTION
◦ASSESSMENT
1.Assess any drug allergy
2.Specific drug’s action, side-effects and
adverse reactions
3.Client knowledge about the medication.
4.Client’s age and weight to determine the site
and needle size.

22. PLANNING
1. PATIENT FILE WITH PHYSICIAN’S ORDER

23. 2. STERILE MEDICATION
( AMPULE,VIAL,PREFILLED SYRINGE).

24. 3.SYRINGE AND NEEDLE OF
APPROPRIATE SIZE

25. 4.ANTISEPTIC SWABS AND CLEAN
GLOVES

26. IMPLEMENTATION-preparation
◦PEFORM THE 3 CHECKS:-Read the label
1.When medicine is taken from cart or
cupboard.
2.Before withdrawing the medicine .
3.After withdrawing and before giving the
medicine.

27. ◦Confirm the correct dose and organize the
equipment near the patient.
◦Also check the expiry date of the drug.

28. PERFORMANCE.
1.Perform hand hygiene and wear a clean glove.
2.Prepare medication from the ampule or vial .
3.Change the needle after drug withdrawal.
4.Invert syringe to upside and expel the air .
5.Provide client privacy
6.Introduce yourself and explain procedure

29. Continued………
7.Position the patient according to the site.
8.Locate and clean the site –clean site in a circular
movement- start from centre and move outward about
5 cm .
9.Transfer and hold the swab between the third and
fourth finger of your non-dominant hand .

30. 10.Remove needle cover without contaminating
needle.
11.Use the Z track method-
use ulnar side of non dominant hand to pull
skin approximately to the side (2.5 cm).

31. 12.Holding the syringe between thumb and forefinger
pierce the skin to muscles quickly and smoothly at
90* angle.
13.Aspirate by holding barrel of syringe with non-
dominant hand(for 5 to 10 sec)
14.If blood doesn’t appear inject the medicine.

32. 15.After injection wait for 10 sec to permit the drug to
disperse and remove the needle at the same angle.
16.Apply gentle pressure with dry sterile gauze/cotton.
17.Discard all items as per protocol
18.Document in drug chart and nurses notes.
19.Look for effectiveness of medication.