Definition
In an intramuscular injection, a drug is administered into a skeletal muscle using a syringe and cannula. From the muscle, it enters the bloodstream through the vessels and is distributed throughout the body.
Application sites
A common site of application for small volumes of up to 2 ml is the deltoid muscle of the upper arm. Furthermore, intramuscular injection is also possible on the outer thigh and buttock (gluteal muscle). The site of application depends on the drug. Not all drugs are suitable for all sites. This is also due to differences in pharmacokinetics.
Examples
Drugs that are administered intramuscularly (selection):
- Vaccines
- Painkillers
- Glucocorticoids
- Adrenaline, emergency drugs
- Vitamins
- Sedatives
- Neuroleptics
General procedure
The following is the general procedure. The procedure may vary depending on the drug, injection site and patient. Please refer to the appropriate professional and patient information and literature:
- Indication and medical clarification including contraindications and interactions.
- Refrigerated drugs passively allow to warm up to room temperature.
- Wearing gloves, skin disinfection.
- Providing the material, preparing the syringe.
- Visually inspect syringe contents for foreign particles and a change in appearance.
- Suspensions must be shaken before administration.
- Removal of air is required for some preparations.
- Disinfection of the skin site. Allow disinfectant to act. Allow skin site to dry.
- Spread skin site with two fingers.
- Hold syringe like a dart.
- Quickly insert syringe vertically (90°).
- Release the skin site.
- Aspiration to avoid injecting into a blood vessel. When drawing up blood, inject at another site. Aspiration may be omitted when injecting into the deltoid muscle.
- Inject syringe contents slowly into the muscle.
- Spread the skin site again.
- Quickly pull out the syringe.
- Stop any bleeding, light compression of the skin site with a sterile swab.
- Disinfection of the skin site.
- Apply plaster.
- Dispose of material, the syringe in a suitable disposal container.
- Monitor the patient for adverse effects.
Adverse effects
Common adverse effects of intramuscular injection include local discomfort such as pain and bruising, but these usually last only a short time. Improperly administered injections can lead to injury and infection. Side effects depend on the active ingredient administered. Injections may cause allergic reactions and very rarely anaphylaxis. An injection can cause unpleasant symptoms in some patients, such as pallor, sweating, lightheadedness, dizziness and fainting, see in the article Fear of injections. Injections also pose some risk to professionals. They can accidentally prick themselves with the syringe, injure themselves, and become infected with a disease.