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How to give intramuscular injection (IM)

Intramuscular injection

Watch one of our videos on intramuscular injection (other, related materials can be found on our YT channel).

In addition to intramuscular injections, we also distinguish subcutaneous and intradermal and intravenous injections, but the most common are intramuscular injections. Injections are a popular form of drug administration which, thanks to bypassing the gastrointestinal tract, usually work faster and more effectively than e.g. tablets. The information contained here is intended for patients to know what an intramuscular injection is and how professionals perform it. If you are concerned about the injections your doctor has prescribed this video should help you overcome the anxiety associated with the procedure. Remember not to give the injection if you do not have medical training, as an incorrectly performed injection can pose a threat to health and life. The injection performed by a professional is practically painless and minimizes the risk of potential complications. If you have any doubts about the injections, consult your nurse or doctor.

How to give an injection?

Only sterile, disposable equipment such as: needle and syringe is used to perform the injection. Container for used medical supplies (needles) may be required as well. Person conducting the injection have an anti-shock kit and appropriate training- in case the patient has an unexpected allergic reaction to the administered drug. Before starting the injection, the patient should be interviewed to make sure that there are no contraindications to particular medicine. In the second step condition of the ampoule should be checked. The professional will also take care of the patient’s comfort, e.g. suggest a comfortable position for him and inform him about the course of the procedure. When administering the injection, rules of asepsis should be followed- washed hands and disinfectants, gloves. For an intramuscular injection, the brachial muscle, lateral or transverse thigh muscle can be used but most often intramuscular injections are made into the gluteal muscle, which, due to its size and good blood circulation, ensures optimal distribution and absorption of the administered substance. Larger muscle also allows for the application of larger volumes without discomfort to patient. No more than 5 ml of the substance should be administered intramuscularly, larger volumes should be administered intravenously or if necessary divided in separate IM injections. An injection in the buttock is made in the upper outer quarter of the muscle (to bypass the nerves, Figure 1) by inserting the needle perpendicular to the buttock (Figure 2). An aspiration test is then performed to make sure that the needle did not hit a blood vessel. Slowly depressing the syringe plunger minimizes the patient’s discomfort; children can use ointments or numbing patches to anesthetize the injection site. After administering all the liquid, it is worth waiting a while before removing the needle, this reduces the leakage of the drug from the injection site. Due to the limited visibility and range of the puncture site, self-intramuscular injection is very difficult, even for a professional. Improper puncture may result in nerve damage or hemorrhage. For the injection into the buttock, it is best to place the patient in a supine position with the leg bent at the knee joint.

Figure 1.  Buttock injection site.

Figure 2. Puncture angle.