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Summary
The administration of intramuscular (IM) injections is an important part of medication management and a common nursing intervention in clinical practice. A skilled injection technique can make the patient's experience less painful and avoid unnecessary complications.
Keywords
Clinical procedures; Drug administration; Injection technique
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THE NURSING and Midwifery Council's (NMC's) (2007) Standards for Medicines Management state that administration of medicines 'is not solely a mechanistic task to be performed in strict compliance with the written prescription of a medical practitioner (now independent/supplementary prescriber). It requires thought and the exercise of professional judgement.' Therefore, the administration of intramuscular (IM) injections requires the healthcare practitioner to possess the knowledge and rationale of the guiding principles that underpin these clinical skills. It is essential that all aspects of these techniques - anatomy, physiology, patient assessment, preparation and nursing interventions -are evidence based so that the nurse can perform safe and accountable practice (Shepherd 2002, NMC 2007). The aim of this article is to update the nurse's knowledge and skills on injection techniques. This article describes the practical, step-by-step approach for administering IM injections, which will assist nurses to perform this skill safely and competently.
Intramuscular injections
An IM injection is chosen when a reasonably rapid systemic uptake of the drug (usually within 15-20 minutes) is needed by the body and when a relatively prolonged action is required. The amounts of solution that can be given will depend on the muscle bed and range from 1-5ml for adults. Much smaller volumes are acceptable in children (Rodger and King 2000, Corben 2005).
The medication is injected into the denser part of the muscle fascia below the subcutaneous tissues. This is ideal because skeletal muscles have fewer pain-sensing nerves than subcutaneous tissue and can absorb larger volumes of solution because of the rapid uptake of the drug into the bloodstream via the muscle fibres. This means that IM injections are less painful when administered correctly and can be used to inject concentrated...