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How to administer intramuscular injections

Chadwick, AngelinaWithnell, NeilNursing Standard (2014+); London Vol. 30, Iss. 8,  (Oct 21, 2015): 36. DOI:10.7748/ns.30.8.36.s45

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Preparation and equipment

A clear prescription chart should be available.

This must be legible, signed and dated.

All appropriate equipment for administration of the intramuscular injection should be available including:

A clean tray or receiver.

Two sterile needles (of appropriate size).

A syringe (2-5mL).

The drug to be administered.

An alcohol-impregnated swab.

Gloves.

A sharps container.

The nurse should have knowledge of the intramuscular injection medication, and its normal dosage range, clinical use, contraindications, cautions and side effects.

Procedure

Undertake infection control measures, such as handwashing and using sterile equipment.

Undertake medication checks: ensure that the medication is correct against the prescription chart, including the dose and expiry date.

Confirm the identity of the patient and obtain consent for the procedure, ensuing that the patient is not allergic to the medication before administration.

Use an ampoule opener or cover the neck of the ampoule with some gauze to avoid injury when opening the ampoule.

Inspect the injectable solution for inappropriate appearance (cloudiness, fragments of glass). Prepare the injection before approaching the patient, if possible, on the tray or receiver.

Aspirate the contents of the ampoule using the needle and syringe, ensuring any air in the syringe is expelled.

Use a two-needle approach (changing needles after drawing up the injectable solution and before administration) to ensure the needle is clean, sharp and dry to avoid causing unnecessary pain to the patient during the procedure ( Agac and Gunes¸ 2010 ). Dispose of the first needle directly in the sharps container.

Resheathe the needle carefully using a one-handed scooping method ( Dougherty and Lister 2015 ), ensuring the contents remain sterile before administration ( Hunter 2008 ).

Put on gloves, according to local policy guidelines.

Select the appropriate intramuscular injection site (deltoid, dorsogluteal, ventrogluteal, rectus femoris, vastus lateralis) depending on the drug...