Administering an Intramuscular Injection

Medical Equipments:

• Medication administration report (MAR)
• Sterile 3-ml syringe and long bevel 33 to 22 gauge
• Medication as prescribed
• Alcohol swab
• Non-sterile gloves
• Sterile 2 x 2 gauze pad

Nursing Procedures:

1. Identify the patient's allergies to any known medication
2. Wash your hands
3. Follow the rule of five rights
4. Obtain the medication from an ampule or vial
5. Check the patient identification or arm band
6. Position patient in an appropriate position to expose the site of injection
7. For deltoid area: sitting position
8. For ventrogluteal area: side-lying, flex the knee, pivot the leg forward the hip about 20 degrees so it can rest on the bed; supine position, flex the knee on injection site; or prone position, point toes inward toward each other to internally rotate the femur
9. Don non-sterile gloves
10. Assess the skin for redness, scarring, breaks and palpate for lumps or nodules
11. Select using the anatomic landmarks
12. The area for injection is cleansed by an alcohol swab from inside outward using friction and wait 30 seconds to allow to dry
13. Remove the needle cap by pulling it straight off and expel any air bubbles from the syringe
14. Pull the skin down or to one side (Z-track technique) with non-dominant hand
15. Administer in deltoid: quickly insert the needle with a cart-like motion at 90 degrees angle
16. Administer in ventrogluteal: quickly insert the needle using a dart-like motion and steady pressure at 90 degrees angle to the iliac crest in the middle of the V
17. Aspirate it by pulling back the plunger and observe for blood
18. If blood is appeared, remove the needle and discard
19. If blood is not appeared, inject the medication slowly about 10 sec per ml
20. Wait 10 seconds after the medication has been injected, then smoothly withdraw the needle at the same angle of insertion
21. Gently pressure is applied at the site with a dry sterile 2 x 2 gauze and do not massage the injection site. Swab using gentle pressure
22. Discard the syringe and needle in sharps box container and never recap the needle
23. Place the patient in comfort position and encourage him/her to perform leg exercises (flexion and extension) after receiving ventrogluteal injection
24. Remove gloves and wash your hands
25. Record on the medication administration report the dosage, route, site and time or injection
26. Observe the injection site within 2-4 hours and evaluate the patient's responses