ADMINISTERING AN INTRAMUSCULAR INJECTION

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1. Assemble equipment and check physician’s order.
2. Explain procedure to patient.
3. Perform hand hygiene.
4. If necessary, withdraw medication from ampule or vial.
5. Do not add air to syringe.
6. Identify the patient carefully. There are three ways to do this.
   1. Check the name on the patient’s identification badge.
   2. Ask the patient his or her name.
   3. Verify the patient’s identification with a staff member who knows the patient.
7. Provide for privacy. Have patient assume a position for the site selected.
   1. Ventrogluteal – Patient may lie on back or side with hip and knee flexed.
   2. Vastus lateralis – Patient may lie on the back or may assume a sitting position.
   3. Deltoid – Patient may sit or lie with arm relaxed.
   4. Dorsogluteal – Patient may lie prone with toes pointing inward or on side with upper leg flexed and placed in front of lower leg.
8. Locate site of choice (vastus lateralis, ventrogluteal, deltoid, dorsogluteal) and ensure that the area is not tender and is free of lumps or nodules. Don disposable gloves.
9. Clean area thoroughly with alcohol swab, using friction. Allow alcohol to dry.
10. Remove needle cap by pulling it straight off.
11. Displace skin in a Z-track manner or spread skin at the site using your nondominant hand.
12. Hold syringe in your dominant hand between thumb and forefinger. Quickly dart needle into the tissue at 72- to 90- degree angel.
13. As soon as needle is in place, move your nondominant hand to hold lower end of syringe. Slide your dominant hand to tip of barrel.
14. Aspirate slowly (for at least 5 seconds), pulling back on plunger to determine whether the needle is in a blood vessel. If blood is aspirated, discard needle, syringe and inject in another site.
15. If no blood is aspirated, inject solution slowly (10 seconds per mL of medication).
16. Remove needle slowly and steadily. Release displaced tissue if Z-track technique was used.
17. Apply gentle pressure at site with small sponge.
18. Do not recap used needle. Discard needle and syringe in appropriate receptacle.
19. Assist patient to a position of comfort. Encourage patient to exercise extremity used for injection if possible.
20. Remove gloves and dispose of them properly. Perform hand hygiene.
21. Chart administration of medication, including the site of administration. This may be documented on the CMAR.
22. Evaluate patient response to medication within an appropriate time frame. Assess site, if possible, within 2 to 4 hours after administration.

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