Giving Im Injections (Intramuscular Injection) is the technique where you can give shot of medicine into the muscle. Being a doctor or nurse you must know that, How you can successfully give Im injection to the patient.
- Drugs more than 2 cc which can not be given through intramural route can be given by intramuscular route.
- Irritating drug which cause irritation over skin are given through muscular route.
- Only preparation of drugs are given through intramuscular route.
Components and Supplies Required
- Sterilized needles (20*23 gauze). The gauze depends on whether the liquid is oily or non oily, the site of administration of injection and the age of the patient and Whether obese or thin.
- Sterilized syringe. The ‘size of the syringe depends on the amount of the drug required for administration. Nowadays disposable sterilized syringes and needles are available for once use only.
- Cotton swab.
- Antiseptic solution like rectified spirit not methylated spirit or savlon. If antiseptics are not available, boiled cool water may serve the purpose.
- Sterile container for keeping needle, syringe and cotton swab
What Is The Actual Procedure of Giving Im Injections To The Patient
- Explain the procedure to the patient for his awareness and co-operation. In case of child explain to the attending relatives and to the child if elderly one.
- Collect all materials in a sterile container may be small bowl or kidney tray.
- Assemble the syringe being careful so as not to touch the plunger except by the handle and the needle by hub. Twist the hub of the needle to make sure that it is securely attached to the syringe.
- Use a cotton swab moistened with anti-septic to clean the rubber top of the vial. Discard the swab.
- Hold the barrel of the syringe in your hand and pull back on the plunger to the marking on it equal to the amount of liquid that you want to withdraw from vial.
- Insert the needle to rubber cap push in plunger to force air into the vial.
- Turn the vial upside down while holding on to the syringe.
- Withdraw the amount of the drug by pulling on to the plunger up to the required marking on the barrel.
- Select the site of injection* If the buttock is used— upper and outer quadrant is preferred. The parent is positioned on his stomach or on his side to make it easier to pin point the correct area. If the upper arm is selected, ask the patient to place his hand on the hip. In case of a child the arm is steadied by holding it against the side of the body.
- Use friction to clean the skin site selected using a cotton swab moistened with anti-septic.
- Remove any air bubbles in the syringe by holding the syringe with needle pointing upwards and pushing in the plunger
- Stretch the skin by grasping the area between the thumb and forefinger.
- Use the other hand to hold the needle at 90° angle and pierce the skin smoothly and firmly. Release the tissue holding by the other hand so that the fluid will not be injected under pressure.
- Before injecting the drug, pull back the plunger to make sure that the needle has not entered into a blood vessel. If blood appears in the syringe while pulling back, remove the needle and replace by a sterile needle to select another site and proceed again as above. If at the same site the prick should be 1 cm away from earlier prick.
- If there is no blood while pulling back, then push it and inject,the drug into the muscle.
- Place a cotton swab on the site and withdraw the needle in the same direction as inserting the needle. If the direction or angle of needle to the skin is changed, there is possibility of tear to the muscle fibres inside and later may cause more tenderness or pain at the site.
- Use the swab to massage the area gently. Then discard the swab.
- Record the procedure and name of drug in patient’s chart.
- Also intimate the action of the injection.
- Make sure that you use needle which has sharp point and no hooks on the end to minimise pain and injury to the tissue.
- Select the proper sight taking into consideration of age and built of patient. Otherwise you may hit a bone or blood vessel or nerve.
- Maintain sterile technique properly.