Presentation Transcript

1. Intramuscular Injections

2. Goal: • -After giving this review session student/co-worker will be able to confidently administer an intramuscular injection, know sites used for injections, and demonstrate different techniques of giving an intramuscular injection. • -Perform giving IM injections. • -Demonstrate correct technique for giving IM injections. • -Identify equipment used for giving IM injections. • -Demonstrate and explain: Z track method and Air lock technique. • -Demonstrate correct disposal of used needle. • -Explain and be able to identify how the patient tolerated the IM injection.

3. -In this session learner will be educated in IM injections- • -Where to give an IM injection. • -Technique for giving IM injection • -Demonstrate different method for giving an IM injection. • -Equipment needed to perform an IM injection.

4. -Equipment needed to perform an IM injection- • -Syringe 1-2 inches in length. • -Medication to be administered. • -Gloves • -Band-Aid • -Alcohol swab • -Patient • -Muscle where medication will be administered

5. -Choosing the site to administer medication- -There are several different sites an IM injection can be given.- Site determination- • -Stage of patients development. • -Body build • -Physical condition • -Amount of the medication to be given

6. -Sites- • Mid Deltoid- common site, upper arm, 3 fingers width. • Dorsalgluteal- look out for sciatic nerve, given in the butt. • Rectus femoris- right on top of the thigh. • Ventrolgluteal- side of the butt, or on the hip. • Vastislateralis- outer thigh, in the middle.

7. How to find sites-

8. Mid Deltoid- • -Is on the upper arm. • - Take 3 fingers and place them at the top of the shoulder. • -At the end of the third finger in the middle of the muscle is where the injection can be made.

9. - Dorsalgluteal- • -Injection is in the butt. • -Watch out for the sciatic nerve. • -Have patient stand or lay face down with toes pointing inward. (relaxes muscle) • -Divide the buttocks into 4 quadrants; give the injection in the outer, upper quadrant toward the hip. • -DO NOT give to children who are not walking yet. (Muscles are not developed enough)

10. Ventrogluteal- • -Good for adults and small children. • - Find the upper part of the hip. • -Place palm on hip (greater trochater), with fingers point to the ground, and make a very large “V” with your pointer finger and middle finger. • -In the middle of the “V” is where the injection can be done.

11. Rectus Femoris • -On the anterior thigh, above the knee. • -Used mostly by people who have to get themselves injections. • -This is painful, because the muscles in the anterior thigh are tense when given.

12. VastusLateralis- • -Most preferred site. • -Given to children under 5 years of age. • - Patient should be sitting when this injection is to be given. • -On the outer thigh about half way between the knee and the hip.

13. -Technique of Giving an Intramuscular Injection- • -Check the 5 rights of medication administration. • -Choose the site the IM injection. • -Check the patient for any allergies. • -Gather you supplies needed to perform IM injection. • -Wash your hands. • -Put on gloves. • -Open alcohol swab and in a circular motion, clean area in a 2 inch diameter at the site of the intended IM injection. • -Let fully dry.

14. Continued… • -Pull skin around the clean site taut. • - take needle in dominate hand between the thumb and the index finger. • - At a 90 degree angle, plunge the needle into the skin in a dart like motion. • -Depending on the site and the condition of the patient, determine how far the needle is going to have to go into the skin to be in the muscle. • -Stabilize the needle with the non dominate hand. • -Use dominate hand to pull back on the plunger and aspirate or blood. (If there is blood aspirated back into the needle, remove and dispose in a sharps container. start from the beginning.) • -Push the medication at a slow and steady pace. Remember to hold the needle as steady as possible.

15. Continued.. • To take the needle out, quickly pull up at a 90 degree angle. • -Make sure to cover the needle immediately after withdrawing it from the skin. • -Apply some pressure at the site with the alcohol swab that was used to clean the site. • -Message the site to help disperse the medication that was just given. • -Cover site with Band-Aid. • -Dispose of needle into a sharps container. • -Throw away gloves and wash hands. • -Observe the patient for signs of any allergic reaction, N&V, or any other adverse reactions that may go along with the medication. • - Always remember to document.

16. -Different Methods of Giving IM injections- • -Just giving IM injection and massaging site- • - Z track • - Air lock

17. Just giving IM injections and messaging site- • -Just dose of medication given. • -Message site after to help disperse medication in to the muscle.

18. Z track method- • -Used for medications that can cause irritation, can be used for all IM medications. • -Pull skin at the site to the side. • - Still give the injection at 90 degree angle. • -When shin is let go and needle removed the needle track is cut off and the medication can not leak out. • -This will decrease irritation and bruising of the skin.

19. Air lock Technique- • -Medication is drawn up. • -0.2mL of air can be added to the medication. • -This will ensure that all the medication has been pushed though the needle. • - Still given at a 90 degree angle. • -Make sure medication is given first and the air lock second. • -Seals needle track so medication will not go into the subquncaneaus tissue, which can cause pain, soreness and bruising.

20. Review- • -Always remember 5 rights of medication administration. • -Right dose • -Right patient • -Right time • -Right route • -Right medication • -Choosing an IM Injection site that works best for your patient. • (Ex: Infants can not have injections in the dorsal gluteal (butt), In determining a site take into account the patients body build, try to avoid flabby tissue.) • -Different techniques of giving an IM injection: Z track, Air lock.

21. Evaluation:

22. 1.) Name the site that should not be used for children who are not walking yet?

23. Dorsal gluteal.

24. -Describe Z track method:

25. pullingskin to the side, then giving the shot, cutting off the needle track.

26. 2.) How do you clean a site for injection?

27. Alcohol swab, 2inches around the site in diameter, let dry completely.

28. 3.)How do you determine where to give a mid deltoid IM injection?

29. Upperarm, 3 fingers down from the top of the shoulder. In the middle of the arm. Use patients non dominate arm.