Intramuscular and Subcutaneous Injection Technique
Intramuscular Injection Technique
See the anatomy section and undertake required self directed study prior to injecting under supervision on real patients. Carefully identify a safe site which is agreeable to the patient and target the centre of the muscle mass.
The following text is from the local policy (see credits)
- Stretch the skin to one side around the injection side. To facilitate insertion of the needle and reduce pain and diminishes leakage (Beyea and Nicoll, 1996).
- Hold syringe with the needle at an angle of 90°. Quickly plunge into the skin, leaving a third of the needle exposed (see diagram 4). This angle facilitates entry into muscle tissue. Speed reduces discomfort. Leaving part of the needle exposed will aid location and removal if the stem should break.
- With the needle in position pull back on the plunger of the syringe and wait for at least 5 seconds. If blood is present, withdraw the syringe and needle and dispose of intact, apply pressure to the site. The whole procedure will then have to be repeated. If blood is present, the needle may be situated in a blood vessel. Allowing at least 5 seconds for aspiration will show whether there is a back-flow of blood even if the needle is in a small blood vessel (Taylor & Lillis, 1997). If the needle is in a blood vessel and the medication is given, the injection will be an intravenous one.
- Administer the medication.
Best Practice ADMINISTERING INTRAMUSCULAR INJECTIONS
Two methods of administering intramuscular injections are widely accepted; spreading the skin between the fingers of the non-dominant hand, and pulling the skin down to one side (the Z track technique). Both methods make the tissue taut and minimise discomfort (Taylor & Lillis, 1997). However, spreading the skin increases the risk of medication leaking into the needle track and subcutaneous tissue. Beyea and Nicoll (1996) state that the Z track technique virtually eliminates this risk and that it produces fewer complications and less discomfort, making it the technique of choice. Best Practice NEEDLE SIZE For most solutions a 21 (green) or 23 (blue) gauge needle is small enough to minimise tissue damage and subcutaneous leakage, yet large enough to allow easy passage of the solution (Beyea and Nicoll, 1996).