The intramuscular injection is most common type of drug administration. Because of a single mistake we can do harm to our patient. So, we should know about the right way to administer IM injection. Here, in this slides we discuss details about the topic. It will increase your skill proficiently. Thanks

1. WELCOME

2. Intramuscular injection
With drug calculation

3. Introduction
Since the 1920s,the health professionals have been
aware of the fact the intramuscular injection,which seems to
be easy to be administered,may lead to preventable
complications. Intramuscular injection, which was first
administered by the doctors and then the nurses with the
start of the use of penicillin in the 1940s is a frequently
administered nursing application. This is the most common
way of injecting medication directly into a patient. For rapid
absorption of the medicine this is a very useful process
because the medicine from this injection is inserted directly
into the muscle. This allows the medicine to gain easy access
to the blood stream and quickly begin its healing work.
Intramuscular injection are the best and safest way of
injecting medication into a patient.

4. Definitionof
intramuscular
injection An intramuscular injection is when
medication is injected deep into muscles.
or,
Intramuscular injection is the injection of a
substance directly into muscle.

5. Purposesof
intramuscular
injection
1) It is simple and accessible.
2) Adsorption of drug is more rapid.
3) Slightly irritant drug can be given.
4) Moderately large volume can be given(but
not more than 5 ml).
5) Intramuscular injection work faster and
systemic effect of the drug.

6. Sitesofintramuscular
injection
1. Deltoid:-
2 finger widths down from the acromion process; the
bottom edge is at an imaginary line drawn from the axilla.

7. 2.Ventrogluteal:-
With thumb toward the umbilicus, place palm of hand on the greater
trochanter, index finger on the anterior superior iliac & the middle finger
on the iliac crest.

8. Continue…
3.Vastus lateralis:-
Place one hand below the greater trochanter & one hand
above the lateral femoral condyle; mid-lateral thigh.

9. Continue…
4.Dorsal gluteal(greatest risk of injury):-
Draw an imaginary line between the greater trochanter & the
posterior superior iliac spine; at the middle of the imaginary line; go
up about one inch.

10. Continue…
5.Others:-
Quadricep site
Rectus femoral site
Tricep muscle

11. Anglesof
intramuscular
injection
 Intramuscular at 90 degree angle.
 Subcutaneous at 45 degree angle.
 Intradermal at 10-15 degree angle.

12. Intramuscular injection needle lengthPatient age Injection site Needle size
New born(0-28days) Anterolateral thigh muscle 5/8’’ (22-25gauze)
Infant(1-12months) Anterolateral thigh muscle 1’’(22-25guaze)
Toddler(1-2years) Anterolateral thigh muscle
Alternate site: Deltoid muscle
of arm if muscle mass is
adequate.
1-1 ¼’’(22-25gauze)
5/8 -1’’(22-25gauze)
Children(3-10 years) Deltoid muscle(upper arm)
Alternate site: Anterolateral
thigh muscle
5/8-1’’(22-25gauze)
1-1 ¼’’(22-25gauze)
Children &adults(11years &
older)
Deltoid muscle(upper arm)
Alternate site: Anterolateral
thigh muscle
5/8-1’’(22-25gauze)s
1-1 ¼’’(22-25guaze)

14. Calculating
dose
The nurse must be prepare the dose accurately.The
quantity for administration can be easily calculated
using a standard formula.
D X Q
 Drug calculation formula: -----------
H
Here,
D=Desired dose
Q=Quantity
H=dose on hand(supplied dose)

15. Exampleofdrug
calculation
 A physician order Tranal 50 mg given
intramuscularly to a patient. How will you
give it?
We know that,
Drug calculation formula is = DXQ
H
= 50 X 2
100
= 100
100
= 1 ml
 Here
D=50 mg
H=100 mg
Q=?
50 mg = 1 ml
1 mg = 1 ml
50
100 mg = 1 x 100 ml
50
=2 ml

16. Advantagesof
intramuscular
injection i. Rapid onset of action.
ii. Uniform absorption.
iii. Long duration of action.
iv. Suitable for vaccine.

17. Disadvantagesof
intramuscular
injection i. Painful.
ii. Chance of hematoma.
iii. Chance of neurovascular bundle injury.
iv. Large volume can not be administered.

18. Precautionsof
intramuscular
injection
1) Never use the same needle & syringe to inject more
than one person.
2) It is important to know what reactions a medicine
can produce & to take the recommended
precautions before injecting.
3) If any signs of allergic or poisonous reaction appear,
never give the same or similar medicine again.
4) Select the proper site & needle size according to
age, weight of the patient & medication viscosity.
5) Maintain sterile technique properly.

19. Procedureof
intramuscular
injection
Equipment:-
1) Sterile container/kidney tray.
2) Cotton.
3) Gloves.
4) Antiseptic solution.
5) Sterilized syringe & needle-3cc,5cc,10cc according
amount of medication.
6) Required medicine(in vail or ampoule).
7) Ampoule of sterile water.
8) Gauze pieces if needed.
9) Forceps.

20. Continue…
Procedure:-
1) Check patients name & medication order, including
rights of administration of oral medication to the
patient:-
i. Right patient.
ii. Right dose.
iii. Right drug.
iv. Right time.
v. Right route.
vi. Right assessment.
vii. Right approach.

21. Continue…
vii. Right education.
viii.Right prescription.
ix. Right nurse clinician.
x. Right principle of care.
xi. Right evaluation.
xii. Right documentation.

22. Continue…
2)Explain procedure to the patient.
3)Perform hand washing.
4)Withdraw medication from an ampoule or vial.
5)Do not add air to the syringe.
6)Provide for the privacy. Have the patient assume a
position appropriate for the site selected.
7)Ensure that the area is not tender & is free of lumps or
nodules.
8)Clean the area thoroughly with an alcohol swab, using
friction. Allow alcohol to dry.
9)Quickly dart the needle into the tissue at a 90 degree
angle.

23. Continue…
10)As soon as the needle is in place, use non-dominant hand to
hold the lower end of the syringes. Slide dominant to the tip of
the barrel.
11)Aspirate by slowly(for last 5 seconds)pulling back on the
plunger to determine whether the needle is in a blood vessel. If
blood is aspirated, discard the needle, syringes & medication,
prepare a new sterile set up & inject at another site.
12)If no blood is aspirated, injected the solution slowly.
13)Remove the needle slowly & steadily.
14)Assist the patient to a position of comfort.
15)Remove gloves & dispose of the properly. Perform hand
hygiene.

24. Continue…
16)Chart the administration of the medication,
include the site of administration.
17)Evaluate the patients response to the
medication within an appropriate time frame.
Assess the site, if possible, within 2 to 4 hours
after administration.

25. Complicationof
intramuscular
injection
Early(days to weeks)
 Swelling
 Redness
 Pain
 Bruising/ecchymosis
 Itching
 Infections
 Allergic reaction/hypersensitivity
 Inflammation
 Solid nodules
 Lumps caused by misdistribution
 Tissue necrosis
 Embolism with blindness

26. Continue….
Delayed(weeks to years)
 Granulomatous inflammation/foreign body reaction
 Nodules, erythematous or not
 Migration of the implanted filler
 Scarring
 Asymmetry

27. Nursingcareplan
Nursing
diagnosis
Goal Nursing
intervention
Evaluation
1) Fear & anxiety
due to
administration of
intramuscular
injection.
To reduce fear &
anxiety.
i. Explain the procedure to
the patient.
ii. Psychological support to
the patient.
iii. Maintain patient privacy.
Minimize fear &
anxiety.
2) Risk for
developing
complication.
To prevent
complication.
i. Proper hand washing.
ii. Put sterile gloves.
iii. Use sterile needle.
iv. Pushing injection in the
safe area.
Gradually reduce
complication.

28. Continue….
Nursing
diagnosis
Goal Nursing
intervention
Evaluation
3) Deficit
knowledge about
intramuscular
injection.
Increase
knowledge by
providing
information about
intramuscular
injection.
i. Encourage the
patient.
ii. Explain the
patient about
complication of
intramuscular
injection.
Patient acquire
knowledge about
intramuscular
injection.

29. Summary Intramuscular injection is the injection of a substance directly
into muscle. In medicine, it is one of the several alternative methods
for the administration of medications. Intramuscular injection is a
parenteral technique that maintains several advantages over enteral
techniques, making it potentially useful in the management of pain
& anxiety.When giving intramuscular injection a nurse must be
remembered that-----
‘’Save one life you are a hero,
Save one hundred lives &
You are a nurse’’
So responsibility is the vital points for giving intramuscular injection.

30. References
Dr.Md.Mokbul Hossain MMBS;M phil(pharmacology),A handbook of easy
pharmacology.
Hesperian Foundation,1993,516p;WhereThere Is No Doctor-A village Health
Care Handbook.
Sk-Md.ZahirulAlam;RN(BNC),BSN(DU),MPH-Hospital management &
Nutrition; Fundamental of nursing and Health Assessment.
Correspondence to:
• www.alfa.saddle.back.edu
• www.immunize.org/catd/p2020.pdf
• www.sciencedirect.com
• www.pharmatips.in
• Knowledge concering.com

31. Thanks