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Administration of im injections

IM INJECTIONS

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Administration of im injections

  1. 1. ADMINISTRATION OF INTRA MUSCULAR INJECTION
  2. 2. ◦ PRESENTED BY, LEKSHMY RAJAGOPAL.G. Ist YEAR MSc NURSING, SGNC,VJMD.
  3. 3. INDICATIONS • Muscles have more blood supply ,so quicker action of drugs. • More amount of drug can be administered than the intradermal and subcutaneous tissue.
  4. 4. CONTRA-INDICATIONS • Avoid sites of lesions, lumps, tissue injury,presence of nodules other pathology. •Avoid sites near to large blood vessels, nerves and bones.
  5. 5. SITES OF IM INJECTIONS • VENTRO GLUTEAL •DORSO GLUTEAL •VASTUS LATERALIS •DELTOID •RECTUS FEMORIS SITE
  6. 6. 1.VENTROGLUTEAL SITE ◦It is the site where the gluteus medius muscle lies over the gluteus minimus
  7. 7. ADVANTAGES OF VENTROGLUTEAL SITE 1.No large nerves or blood vessels in this area. 2.Provides greatest thickness of gluteal muscles. 3.It is sealed off by bone. 4.Contains less consistency fat than buttock area. 5.Most suitable for adults and children over 1 yr
  8. 8. PROCEDURE-VENTRO GLUTEAL 1.Place patient on side-lying position, bent the knees and raise it slightly to chest.(use alternate hands for hips). 2.Place the nurses heel of hand over the greater trochanter of patient with fingers pointing towards head of patient. 3.Index finger should rest on anterior superior iliac spine, middle finger stretched dorsally. 4.Midpoint of triangle formed between index finger ,middle finger and iliac crest is the site.
  9. 9. VENTRO - GLUTEAL
  10. 10. VENTROGLUTEAL SITE
  11. 11. DORSO GLUTEAL SITE ◦It is composed of the thick gluteal muscles of the buttocks. ◦CONTRA-INDICATION ◦Not used for children below 3 years ,because these muscles are developed by walking.
  12. 12. PROCEDURE FOR DORSOGLUTEAL 1.Patient is positioned in prone position with toes facing inwards or side-lying position with upper knee flexed and in front of the lower leg. 2. Palpate the posterior superior iliac spine and draw an imaginary line to the greater trochanter.(This line is parallel and lateral to the sciatic nerve ). 3.Injection site is parallel and superior to this site.
  13. 13. DORSOGLUTEAL SITE
  14. 14. VASTUS LATERALIS ◦It is thick and well developed in both adults and children. ◦The area is divide into 3 parts from the greater trochanter of femur and lateral femoral condyle. ◦The middle third is injection site.
  15. 15. VASTUS LATERALIS
  16. 16. DELTOID SITE ◦It is found in the lateral aspect of the upper arm.
  17. 17. PROCEDURE FOR DELTOID SITE 1.Place 4 fingers over the deltoid muscle,first finger over the acromion process. 2.Top of axilla is the line that marks the lower border. 3.Triangle formed between these boundaries is the site for injection.
  18. 18. DELTOID SITE
  19. 19. RECTUS FEMORIS ◦IT BELONGS TO THE QUADRICEPS GROUP OF MUSCLES.IT IS SITUATED IN THE ANTERIOR ASPECT OF THE THIGH
  20. 20. RECTUS FEMORIS
  21. 21. STEPS OF IM INJECTION ◦ASSESSMENT 1.Assess any drug allergy 2.Specific drug’s action, side-effects and adverse reactions 3.Client knowledge about the medication. 4.Client’s age and weight to determine the site and needle size.
  22. 22. PLANNING 1. PATIENT FILE WITH PHYSICIAN’S ORDER
  23. 23. 2. STERILE MEDICATION ( AMPULE,VIAL,PREFILLED SYRINGE).
  24. 24. 3.SYRINGE AND NEEDLE OF APPROPRIATE SIZE
  25. 25. 4.ANTISEPTIC SWABS AND CLEAN GLOVES
  26. 26. IMPLEMENTATION-preparation ◦PEFORM THE 3 CHECKS:-Read the label 1.When medicine is taken from cart or cupboard. 2.Before withdrawing the medicine . 3.After withdrawing and before giving the medicine.
  27. 27. ◦Confirm the correct dose and organize the equipment near the patient. ◦Also check the expiry date of the drug.
  28. 28. PERFORMANCE. 1.Perform hand hygiene and wear a clean glove. 2.Prepare medication from the ampule or vial . 3.Change the needle after drug withdrawal. 4.Invert syringe to upside and expel the air . 5.Provide client privacy 6.Introduce yourself and explain procedure
  29. 29. Continued……… 7.Position the patient according to the site. 8.Locate and clean the site –clean site in a circular movement- start from centre and move outward about 5 cm . 9.Transfer and hold the swab between the third and fourth finger of your non-dominant hand .
  30. 30. 10.Remove needle cover without contaminating needle. 11.Use the Z track method- use ulnar side of non dominant hand to pull skin approximately to the side (2.5 cm).
  31. 31. 12.Holding the syringe between thumb and forefinger pierce the skin to muscles quickly and smoothly at 90* angle. 13.Aspirate by holding barrel of syringe with non- dominant hand(for 5 to 10 sec) 14.If blood doesn’t appear inject the medicine.
  32. 32. 15.After injection wait for 10 sec to permit the drug to disperse and remove the needle at the same angle. 16.Apply gentle pressure with dry sterile gauze/cotton. 17.Discard all items as per protocol 18.Document in drug chart and nurses notes. 19.Look for effectiveness of medication.

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