If you or your family have an illness that requires treatment with injections, you may need to learn how to give intramuscular (IM) injections. The doctor will determine it as a health care provider for you and your family. How to give an intramuscular injection that will be taught by the nurse is generally the same as the steps in this article.
Step
Part 1 of 3: Performing IM. Injections
Step 1. Wash your hands before starting
You must ensure hygiene to minimize the risk of infection.
Step 2. Calm the patient and explain the procedure you will perform
If the patient doesn't already know, tell him which part of the body you will inject and describe how he will feel after the injection.
There are some drugs that hurt or sting when injected, but not many. However, the patient must be aware of the possibility so that he does not feel the tension that may arise due to ignorance
Step 3. Clean the injection area with an alcohol swab
Before injecting, the area of skin over the muscle to be injected must be clean and sterile. This step is necessary to minimize the chance of infection after the injection.
Let the alcohol dry. Do not touch the area before the injection is given. If it is touched, you will have to clean it again
Step 4. Ask the patient to relax
Tense muscles will hurt during the injection, so the patient should be asked to relax so that he or she does not feel so sore during the injection.
- You can distract the patient before injecting him by asking a few questions about his life. When the patient's attention is distracted, the muscles tend to relax more.
- There are also people who choose to position their bodies in such a way that they do not see themselves being injected. Some people are afraid and depressed when they see a needle prick the skin, as a result not only increased anxiety, but also tense muscles. To relax the patient, suggest that he looks the other way if he is willing.
Step 5. Insert the needle into the injection area
First, remove the syringe cap, then insert it quickly and surely at a 90-degree angle into the skin. Fast needle puncture will make the pain less. However, if this is your first time injecting, be careful not to inject too quickly to avoid getting the injection in the wrong area or injuring the skin more than it should.
- After enough practice and getting used to the injection, you can increase the speed. The faster the needle is injected, the less pain it will cause. However, don't sacrifice security for speed.
- Before injecting, you can also stretch the skin around the injection site with your non-dominant hand (you will use your dominant hand to inject). This can help you mark the target and reduce the pain the patient feels when the needle is inserted into the skin.
Step 6. Pull the suction slightly before injecting
After inserting the needle and before injecting the medication, withdraw the suction. While this may seem counterintuitive, this step is important because if any blood enters the tube when the suction is pulled, you are puncturing a blood vessel, not a muscle. If this happens, you will have to repeat with a new needle and a new tube.
- The drug must be injected into the muscle, not into the bloodstream. So, if you see red when you pull on the sucker, you'll need to move the needle to another area before continuing. Prepare a new syringe and define a new injection area. Do not try to give the injection in the same place.
- Usually, the needle will go into the muscle on its own. It's rare for a needle to hit a vein, but caution is always better than regret.
Step 7. Inject the medicine slowly
To minimize pain, the needle should be inserted quickly, but the medication should be injected slowly. This is necessary because the drug will fill the space in the muscle and the surrounding tissue must stretch to accommodate the incoming drug fluid. Thus, the slow injection will provide the time needed for the muscle tissue to stretch and reduce the pain that the patient will feel.
Step 8. Pull the needle at the same angle as it entered
Do this once you are sure that all the medication has been injected.
Gently press the injection area with 5x5 cm gauze. After the injection, the patient may feel a bit uncomfortable, but that is normal. Ask the patient to hold the gauze while you remove the needle
Step 9. Dispose of syringes properly
Don't just throw it in the trash. Usually, you will receive a special hard plastic container for disposal of used tools and syringes. You can also use a soda bottle or another plastic bottle with a tight-fitting lid. Make sure the needle and syringe fit inside the container and don't go through the sides.
Ask your doctor or pharmacist about the rules for disposing of needles and syringes in your area or country
Part 2 of 3: Understanding Basic Knowledge of Injections
Step 1. Know the parts of the syringe
You will be able to give the injection if you understand the mechanism behind the injection.
- There are three main parts of the syringe, namely the needle, tube, and suction. The needle is inserted into the muscle, the tube displays a number next to the marker expressed in cm3 (cubic centimeters) or ml (milliliters), and a suction is used to draw the drug into and out of the tube.
- Drugs injected intramuscularly (IM) are measured in cm3 or ml. The amount of drug in cm3 is the same as in ml.
Step 2. Know which area to inject
There are several points in the human body that are highly receptive to drugs.
- Vastus Lateralis (Thigh) Muscle: To find this area, look at your thigh and divide it into three equal parts. The middle is the injection area you are looking for. The thighs are a good area if you are going to inject yourself because this area can be seen easily. The thigh is also a good injection site for children under three years of age.
- Ventrogluteal (Hip) Muscles: To find the right area, you need to place the base of your hand on the outer thigh, where the thigh and buttocks meet. Point your thumb toward the groin while the other fingers toward the head. Separate your index finger from your other three fingers to form a V. You should feel a bony edge along the tips of your ring and little fingers. The injection area is in the middle of the V that you formed earlier. The hips are a good area for injecting adults and children over seven months of age.
- Deltoid Muscles (Upper arm muscles): Watch the arm all the way to the base. Feel the bone crossing the upper arm. This bone is called the acromion process. The bottom is triangular in shape. The tip of this triangle is right in the middle of the base, roughly parallel to the armpit. The injection area you are looking for is in the center of the triangle, 2.5–5 cm below the acromion process. If the patient is very thin or does not have sufficiently large muscles, these areas should be avoided.
- Dorsogluteal (Buttocks): Pay attention to one side of the patient's buttocks. Take an alcohol swab and use it to draw a line from the top of the cleavage between the buttocks to the sides of the body. Find the midpoint of the line and move up 7 cm. From there, draw a line downward across the first line and ending in the middle of the butt. You will see a plus sign. You will feel the curved bone in the outermost part of the rectangle. The injection should be given under the curved bone in the outermost part of the rectangle. Do not choose this area for injecting infants or children under the age of three because their muscles are not fully developed.
Step 3. Know who you are going to inject
Everyone has the best area to receive the injection. So, consider the following before you inject someone:
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The age of the person to be injected. The best injection site for children and infants under the age of two is the thigh muscle. Meanwhile, children aged three years and adults should receive injections in the thigh or deltoid. You should choose a needle size between 22 and 30 (depending on the thickness of the medication, your doctor will determine which size to use).
Note: very young children need smaller needles. In addition, the thigh is better able to withstand larger needles than the arm
- Consider the injection area beforehand. If the patient has just received an injection in one area, administer the injection in another area of the body. Thus, scars and skin changes can be avoided.
Step 4. Know how to fill a needle with medication
Some syringes are already filled with medicine. However, many drugs are provided in bottles and must be put in a tube. Before loading the medication from the vial, make sure that you are taking the correct medication, that it is not expired, and that it has not changed color or has visible particles floating in the bottle.
- Sterilize the top of the bottle with an alcohol swab.
- Hold the syringe with the needle facing up, with the cap still on. Pull the suction to the line indicating the dose so that the tube is filled with air.
- Insert the needle through the rubber cap of the bottle and press the suction so that the air in the tube is pushed into the bottle.
- With the vial upside down and the tip of the needle in the medication, pull the plunger again to the correct dose mark (or slightly over if there are air bubbles). Tap the jar to move the air bubbles up, then push them into the bottle. Make sure the drug dose is correct.
- Remove the needle from the bottle. If you don't plan on using the injection right away, make sure you cover the needle with the cap.
Part 3 of 3: Alternative Way: Z-Track
Step 1. Understand the advantages of the "Z-track" method
When giving an IM injection, the act of inserting a needle creates narrow channels, or tracks, in the tissue. This raises the possibility of the drug seeping out of the body. The Z-track technique will reduce skin irritation and allow for effective absorption because this method is able to lock the drug in the muscle tissue.
Step 2. Repeat the steps for washing hands, filling the tube, and selecting and cleaning the injection area
Step 3. Tighten the skin and stretch 2 cm with your non-dominant hand
Hold firmly to keep skin and subcutaneous tissue from moving.
Step 4. Insert the needle at a 90° angle into the muscle layer with your dominant hand
Pull on the sucker slightly to check for blood, then push gently to inject the medication.
Step 5. Hold the needle for 10 seconds
This 10 second time allows the drug to spread evenly into the tissue.
Step 6. Pull the needle in a quick motion and remove the skin
A zigzag path is created that closes the trail left by the needle and ensures that the drug stays within the muscle tissue. As a result, the patient's discomfort will be reduced, as will the lesion at the injection site.
Do not massage the injection site as this can cause the medication to seep out and irritate it
Tips
- It will take you some time to get used to giving IM injections. At first you may feel doubtful and awkward. Remember, you will become more skilled after some practice, and over time you will be able to inject more easily. To practice, you can inject water into the citrus fruit.
- Your doctor or pharmacy can explain the correct way to dispose of used needles and syringes. Tools that have been used must be disposed of properly for safety. Do not throw it in the trash because it will be very dangerous.
