Table of Contents. Intramuscular Injection Secrets. Page 2 of 9. Nursing School Made Simple Guaranteed 2014 SimpleNursing.com All Rights Reserved.

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Valentine Davidson
6 years ago
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2 Table of Contents 1 Intramuscular Injection Sites Deltoid Muscle Ventro Gluteal Muscle Dorso Gluteal Muscle Vastus Lateralis Muscle Before You Give IM Injections DICE Your Drugs Black Box Warnign Drugs... 8 Page 2 of 9

3 1 Intramuscular Injection Sites 3

4 1.1 Deltoid Muscle Location NEEDLE Amount (ml) Common Meds? 1. LOCATE: gauge Max: Vaccines: Acromion Process, 2 fingers down Make (normal) ml - Flu Shot a V with your other hand - Hep B series 2. AIM: LEGNTH: in the middle of the V like aiming at a dart board 3. INSERT & ASPIRATE at a 90 degree angle (Like a throwing Darts at a Dart Board) aspirate to avoid blood stream injection. 1.2 Ventro Gluteal Muscle Location NEEDLE Amount (ml) Common Meds? ***Please note**** USE RIGHT HAND on patients RIGHT side Use LEFT HAND on patients LEFT side To find landmarks LEGNTH: MAX: 4.0 ml depends on size of your patient & hospital policy Physciatric Medications: Haldol Geodon 1. LOCATE: Palm of hand on greater trochanter (the darn tip of the big bone in your leg the femur ) Index finger, YOUR DARN POINTER FINGER on the front part of the HIP BONE (anterior superior iliac spine) 2. AIM: Once your hand is in position move your middle finger back along the iliac towards the buttock as far as you are able to go. This forms the triangle with the index and middle finger and the center of that triangle is the injection site for a ventrogluteal injection. 3. INSERT & ASPIRATE at a 90 degree angle (Like a throwing Darts at a Dart Board) aspirate to avoid blood stream injection. Page 4 of 9

5 1.3 Dorso Gluteal Muscle Location NEEDLE Amount (ml) Common Meds? ***PLEASE NOTE **** D is for Dorso Gluteal, the buttocks makes a Make sure your thumb always faces toward the buttocks when you are locating your landmarks. RIGH HAND - LEFT HIP LEFT HAND - RIGHT HIP 1. LOCATE: The POSTERIOR iliac Spine (THE RIM OF THE HIP BONE) this is the back part of the hip bone leading to you re Assets LEGNTH: inches MAX: 4.0ml 5.0ml Drugs are often broken down into 2.5ml and 2.5ml Antibiotics: - Rocephin - Levaquin ( Any Thick Viscous Medications ) Locate the greater Trochanter ( put your hand on the hip 2. AIM: draw a line between these 2 points, AIM ABOVE the line ****CAUTION: AVOID SCIATIC NERVE - - AIM HIGH!!!*** 3. INSERT & ASPIRATE at a 90 degree angle (Like a throwing Darts at a Dart Board) aspirate to avoid blood stream injection. 1.4 Vastus Lateralis Muscle Location NEEDLE Amount (ml) Common Meds? 1. LOCATE: LEGNTH: Max 4.0 ml Antibiotics: One hand above the knee One hand belwo the greater trochanter (femur neck) Locate middle of the outter thigh and middle of the side of the thigh. depends on size of your patient & hospital policy - Rocephin - Levaquin Physciatric Medications: Haldol Geodon 2. AIM Lateral area of the thigh 3. INSERT & ASPIRATE at a 90 degree angle (Like a throwing Darts at a Dart Board) aspirate to avoid blood stream injection. 5

6 Warning!!! Aspriate: Avoid penetrating & medicating a Blood Vessel!!! Nerves: Dorsal Gluteal, very common & dangerous mistake Over 5ml Ordered? Divided into 2 doses and injected into separate sites with a maximum of 2.5 cc per dose. Needle length: should NOT EXCEED 1 ½ inches A 1 ¼ inch needle is commonly used. **** Over View on Syringes & what they are used for! Remember, this is just a guide from personal experience and should never replace your nursing book! Medicine is constantly changing its rules & guidelines, so keep that in mind*** Needle SIZE? LENGTH Drug 18g - 21g BIGGEST OUCH!! Anibiotics gauge (Big Boy) For IM Normal Avarage Ouch Antibiotics or Pain meds (see gauge For IM below) 24 gauge Small Ouch Heparin 25 gauge For IM Vaccines: Hep, Flu, Chicken Pox 0.5 inches For SQ 28 gauge Super Small Ouch (small smally McSmalls Less than 0.5 inches Insulin TB tests (Tuberculosis) Page 6 of 9

7 2 Before You Give IM Injections (1) Allergies to EGGs? Ask the patient about any known allergies before you administer any medication. You should ask about specific allergic reactions such as penicillin, eggs, or horse serum to refresh his memory (2) Pregnant Patients: Ask females about the possibility of current pregnancy. Some medications can cause severe birth defects if given to the mother during pregnancy. If there is a possibility of pregnancy, do not administer the injection. Refer the patient to the physician or senior medical person. (3) Warn the Patient: Tell the patient about the injection procedure. Be sure to wake up a patient if he has been sleeping. If a patient is unconscious and you think he cannot understand what you are telling him, tell the patient anyway.. (Especially psychiatric patients) A patient may be frightened and/or violent. If this is the case, you must seek to contact your instructor & tell them that you were. ****Remember***** 5 RIGHTS OF MED. ADMIN. 1. Right PATIENT P = Please 2. Right DOSE D = Do 3. Right DRUG D = Da 4. Right ROUTE R = Right 5. Right TIME T = Thing 2.1 DICE Your Drugs D = Dose I = Integrity of package ( Is the Vial/ Ampule cracked? Your IV Medication bag torn? ) C = Clarity of medication ( Is it cloudy when it should be clear? Pharmacy could have messed up!) E = Experiation Date Page 7 of 9

8 3 Black Box Warnign Drugs This section presents the most common black box drugs. ( 2 R.N. verification (two signatures) NEEDED!!!!) DRUG Route REASON Insulin Subcutaneous (SQ) (fat portion of the skin) Anti-Diabetic Gets sugar into cells, drops actual sugar in the blood stream so LOW that patients can DIE & go into a hypoglycemic COMA!! OMG! Morphine, Fentanyl, Dilaudid, Demerol Intravenously (IV) (inside the vein) IM (intramuscular) (inside muscle) NOT SQ (subcutaneous) never!! Opioid Analgesic Depresses your CNS (central nervous system) Blocks pain receptors here. Its All good Right? NO!!!! CNS is where the breathing and heart rate of your Autonomic Nervous system (automatic system like heart & lungs) are controlled!!! BLOCK THIS TOO MUCH & HERES WHAT HAPPENS: 1. Breathing Stops 2. Heart Stops 3. DEATH Potassium Intravenously (IV) (inside the vein... NOT the artery, get it str8! Potassium Electrolyte: LEATHAL INJECTION Anyone? NEVER EVER IV PUSH!!! K+ ( blood value) Is an electrolyte Not made in the human body, comes from diet & food that helps muscle to contract GIVE TOO MUCH! 1. Heart contracts for good! 2. No more Oxygen to body 3. THIS IS CARDIAC ARREST. Aka heart 4. DEAD Page 8 of 9

9 Heparin IV SQ NEVER IM ANIT - COAGULANT Prevents blood from clotting Stabilizes Clots & prevents future clots from forming. Diagnosis s: DVT (deep vein thrombosis) PE (palmary embolism) Clot in the Heart Or just prophylactic for patients in Bed too long post surgery. Page 9 of 9

PIEDMONT ACCESS TO HEALTH SERVICES, INC.

PIEDMONT ACCESS TO HEALTH SERVICES, INC. Policy Number: 01-10-039 SUBJECT: I. M. Injections EFFECTIVE DATE: 3/2010 REVIEWED/REVISED: 7/21/2011, 07/27/2012, 10/7/2013, 10/27/2014, 05/16/2016 POLICY: I.