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Ist YEAR MSc NURSING,
• Muscles have more blood supply ,so
quicker action of drugs.
• More amount of drug can be administered
than the intradermal and subcutaneous
• Avoid sites of lesions, lumps, tissue
injury,presence of nodules other pathology.
•Avoid sites near to large blood vessels, nerves
SITES OF IM INJECTIONS
• VENTRO GLUTEAL
•RECTUS FEMORIS SITE
◦It is the site where the gluteus medius muscle
lies over the gluteus minimus
ADVANTAGES OF VENTROGLUTEAL
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
5.Most suitable for adults and children over 1 yr
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
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.
DORSO GLUTEAL SITE
◦It is composed of the thick gluteal muscles of the
◦Not used for children below 3 years ,because these
muscles are developed by walking.
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.
◦It is thick and well developed in both adults
◦The area is divide into 3 parts from the greater
trochanter of femur and lateral femoral
◦The middle third is injection site.
◦It is found in the lateral aspect of the upper
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
3.Triangle formed between these boundaries is
the site for injection.
STEPS OF IM INJECTION
1.Assess any drug allergy
2.Specific drug’s action, side-effects and
3.Client knowledge about the medication.
4.Client’s age and weight to determine the site
and needle size.
1. PATIENT FILE WITH PHYSICIAN’S ORDER
◦PEFORM THE 3 CHECKS:-Read the label
1.When medicine is taken from cart or
2.Before withdrawing the medicine .
3.After withdrawing and before giving the
◦Confirm the correct dose and organize the
equipment near the patient.
◦Also check the expiry date of the drug.
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
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 .
10.Remove needle cover without contaminating
11.Use the Z track method-
use ulnar side of non dominant hand to pull
skin approximately to the side (2.5 cm).
12.Holding the syringe between thumb and forefinger
pierce the skin to muscles quickly and smoothly at
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.
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.