Intramuscular (IM) Injections

Definition

Introduction of an immunizing agent into the muscle.

Sites, needle size, and positioning for IM injections

•The IM site of choice for infants less than 12 months of age is the vastus lateralis (anterolateralthigh).

It should a lso be c onsidered f or o lder children w ith a small de ltoid m uscle msas.For c hildren 12 months of age or over and for adults, the preferred site is the deltoid muscle. When the deltoid muscle is used for children 12 months of age or over, first assess the adequacy of the muscle mass.

•Use a needle length sufficient to reach the largest part of the muscle.This is to prevent the biological being deposited in subcutaneous tissue and to decrease or prevent abscess formation.

• For i nfants a nd t oddlers, a 7 /8"–1"needle i s usually u sed, depending on t he muscle s ize a nd t he amount of subcutaneous tissue.

•For older children and adults, a 1"–1 1/2" needle is used.

•Use a 21-to25- gauge needle, depending on the viscosity of the biological product.

Description of Intra Muscular injection sites

Deltoid muscle

The deltoid muscle is the preferred injection site for adults and children 12 months of age or over; before the age of 12 months, this muscle is not sufficiently developed to be used.

Preferably, the professional should not inject more than 2 ml of immunizing agent into the deltoid muscle.

Vastuslateralis (externus) muscle

The vastuslateralis muscle is the preferred injection site for children under 1 year of age, because it is already well developed at birth and is far from any nerves or major blood vessels. This muscle can also be used for adults. In both children and adults, using this site can temporarily restrict movement of the leg.

The professional should never inject more than 5 mL of immunizing agent into the vastuslateralis muscle.

Dorsogluteal muscle

The dorsogluteal muscle should be used only for the administration of immunoglobulins. In adults, adolescents, and children ove r 2 years of age, I M injections can be given in the superoexternal qua drant of the butt ocks.

This injection site is less immunogenic for several vaccines, primarily hepatitis B and rabies vaccines.

The amount of agent that a muscle can absorb varies: 5 mL is normally the maximum dose for a largemuscle (such as the dorsogluteal). Babies, seniors, and persons who are thin cannot tolerate more than 2 mL. When the amount to be administered is greater than the recommended volume, the dose must be divided into portions and injected into different muscles; the vastus externus muscle and the deltoid can be used in adults whoequirer a large quantity of antirabies immune globulin

.

Intramuscular Injection Techniques

1.Clean s ite w ith analcohol swab, us ing a Allow the site to dry inorder to prevent the use from

3.Plunge t he needle i nto t he muscle at a 9 0° angel with a rapid, firm motion.

4.Release the skin.

7.Dispose of soiled equipment in the container provided for that purpose.