How to Give an IM Injection: 10 Intramuscular Injection Steps

If you’ve ever gotten a flu shot, then you’ve received an intramuscular injection (aka IM injection). These shots must be given directly into the muscle in order to work properly. Below, we explain how to choose between the three main IM injection sites and how to give an IM injection in just 10 steps.

IM Injection Sites

There are three main sites that may be used for intramuscular injections. Each of them offers its own pros and cons and may be appropriate for different types of patients or shots. All of these sites avoid major blood vessels and nerves, a major requirement for IM injection.

For patients receiving multiple injections, you should rotate these sites to avoid irritating and scarring the tissue. Avoid giving injections in areas that are already bruised, tender, swollen or scarred as the injection can aggravate it further.

Upper arm: Find the middle of the bone that goes across the top of the upper arm, which is called the acromion process. Drop down one to two inches, to the level of the person’s armpit, and this is the injection site. Many common injections, such as the annual flu shot, are given in this area due to its easy accessibility, since patients don’t have to disrobe for the shot. However, it should not be used in patients who are very thin or if the muscle is very small.

Thigh: The intramuscular injection should be administered in the middle third of the thigh. If you ever have to give yourself an injection, this is a good site to choose because you can easily reach it and you don’t have to pinch or hold the muscle in any particular way. The thigh is also a good site for children under the age of three, whose arms may not be large enough to support an injection.

Hip: The side hip area also offers a good injection site. To find the site, place the heel of your hand on the hip bone with your fingers facing towards their head and your thumb pointing towards their groin. The injection site sits between the V made by your index and middle fingers. The hip is a good place for injections for adults and children older than seven months.

How to Give an IM Injection in 10 Steps

Some patients are afraid of needles, so performing an IM injection quickly and competently can go a long way towards reducing their worries and giving them a “good” injection experience. If you work with younger patients in pediatrics, wearing some fun Tooniforms scrubs can help distract them from the injection and give you something to chat about as you prep them.

Here are the 10 steps you need to know to give an IM injection:

  • 1. Gather your nursing supplies. You’ll need an alcohol wipe, one sterile 2x2 gauze pad, disposable gloves and, of course, a new needle and syringe in the correct size.
  • 2. Wash your hands and dry them completely. Put on the disposable gloves.
  • 3. Open the alcohol and swab the chosen injection site. Let the area air dry. Do not touch the injection site until you are ready to give the IM injection.
  • 4. As the site dries, hold the syringe in your dominant hand and pull off the cover. Firmly grasp the syringe between your thumb and first finger and let the syringe rest on your second finger.
  • 5. Use your other hand to gently press on and pull the skin around the injection site so it becomes taut.
  • 6. Insert the syringe into the muscle at a 90-degree angle. Let go of the skin while holding the syringe steady.
  • 7. Pull back on the plunger a little. If blood enters the tube, you’ve hit a vessel and must remove the needle immediately without injecting the medication. If this happens, dispose of the needle and syringe and prepare a new injection on the other side.
  • 8. If no blood appears, press down on the plunger to inject the medicine. Injecting the medicine slowly can reduce pain.
  • 9. Remove the needle at the same angle you inserted it. Cover the injection site with gauze to stop any bleeding that may occur.
  • 10. Dispose of the used needles in a sharps container or other safe receptacle.

Administering injections is one of the most important and most common jobs that nurses do. Follow these 10 steps to give an IM injection to your patient.

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