IM injections

Question 1

What three sites are recommended for use for IM injections?

Answer 1

Ventrogulteal
Deltoid
Vastus Lateralis

Question 2

What things must be checked before starting to draw up the drug?

Answer 2

Right patient
Right dose
Right drug
Right route
Right time

Check if any allergies
Check clotting if IM injection

Question 3

Outline the steps involved in preparing the drug

Answer 3

Wash hands
Clean tray with a clinnel wipe
Gather equipment and drug
Check expiry dates, signs of contamination, intact packaging, bath numbers if any warnings
A second check of the drug must take place- check dose, amount and expiry date

Prepare the drug
Clean the top with a wipe
Draw up with a blunt needle
Remove any air
Swap to the needle for IM injection (green or blue)

Question 4

When should the second check of the drug be carried out?

Answer 4

Before drawing it up have someone check to see if it is the right drug, right dose, expiry date and if it is intact

Question 5

Why might IM delivery of a drug be indicated?

Answer 5

Rapid absorption and quick onset of action
PO route CI if N and V
IV access not obtainable

Question 6

What is important to check before IM injections?

Answer 6

INR and Platelet count

Question 7

What drugs might be given via the IM route?

Answer 7

Narcotic
Sedatives
Anti-psychotics
Anti-biotics
Anti-emetics

Question 8

What is a pro of the ventro-gluteal site?

Answer 8

Minimal risk of injury to neurovascular structures

Large volumes may be given- 1-5mls

Question 9

What volume of drug can be given ventro-gluteal site?

Answer 9

1-5mls

Question 10

What must be done every time before injecting anything IM?

Answer 10

Aspirate

Question 11

What are some advantages to the deltoid site?

Answer 11

Easily accessible

Rapid absorption as greatest blood supply

Question 12

What is a disadvantage of the deltoid site?

Answer 12

Only smaller volumes can be given upto 2ml

Question 13

What site might be best for repeated IM injections?

Answer 13

Vastus lateralis- a fist up from knee and a fist down from the greater trochanter and then inject into the middle third

Question 14

Why is it important to have the patient lying down for gluteal injections?

Answer 14

To ensure the gluteal muscles are relaxed- injections into tense muscles causes more pain

Question 15

What should you do if you aspriate blood prior to giving an IM injection?

Answer 15

Withdraw

Dispose of everything and start over

Question 16

At what point do you release the z-track technique?

Answer 16

Before withdrawing the needle

Question 17

What colour of needle is used to draw up the desired drug?

Answer 17

Red

Question 18

What important things must you check before every procedure?

Answer 18

Patient ID- Name, DOB
Check against their wristband
Any allergies or sensitivities
That there is a clinical indication for the procedure