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SC IM Injection

This document provides guidance on subcutaneous and intramuscular injection procedures and sites. It discusses that subcutaneous injections are usually less than 0.5 mL and administered at a 45 degree angle. Common subcutaneous injection sites include the abdomen, upper arms, and thighs. Intramuscular injections can administer up to 5 mL in certain muscle sites and are injected at a 90 degree angle. The deltoid, dorsogluteal, vastus lateralis, rectus femoris, and ventrogluteal sites are described as options for intramuscular injections along with guidance on patient positioning and injection technique.

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Muhammad Abukhater
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333 views16 pages

SC IM Injection

This document provides guidance on subcutaneous and intramuscular injection procedures and sites. It discusses that subcutaneous injections are usually less than 0.5 mL and administered at a 45 degree angle. Common subcutaneous injection sites include the abdomen, upper arms, and thighs. Intramuscular injections can administer up to 5 mL in certain muscle sites and are injected at a 90 degree angle. The deltoid, dorsogluteal, vastus lateralis, rectus femoris, and ventrogluteal sites are described as options for intramuscular injections along with guidance on patient positioning and injection technique.

Uploaded by

Muhammad Abukhater
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Medication Administration Review

Subcutaneous Injection
? Volume

usually less than 0.5 mL ? Administered through a - or 5/8-inch, 23or 25-gauge needle

Figure 9-9

SC Injection Common Sites

Figure 9-10

Subcutaneous Injection Procedure


? Choose

the injection site ? Elevate subcutaneous tissue by pinching injection site ? With needle bevel up, insert needle at a 45degree angle in one quick motion

Figure 9-9

Subcutaneous Injection Procedure


? Pull

back slightly on plunger (aspirate) to ensure needle placement ? After the injection, withdraw needle at same angle it was inserted ? Use alcohol swab to massage site

Intramuscular Injection
? Route

used when a drug is too irritating to be given subcutaneously or when a greater volume or faster absorption is desired Up to 5 mL may be given by IM injection (buttocks) although more than 3 ml can be painful Deltoid up to 1 ml

Intramuscular Injection
? Type

of needle used depends on: Site of the injection Condition of the tissue Size of the patient Nature of the drug to be injected ? 1 inch, 19 or 21-gauge needle usually used

Intramuscular Injection
? Procedure

for IM injection same as those previously described, but the needle is inserted at a 90-degree angle and the skin is held taut, not pinched

Figure 9-9

IM Injection - Deltoid
?

Used primarily for vaccinations with small volumes (up to 1ml) because the muscle is small ? Can use 1 needle ? Avoid hitting radial nerve ? Patient should be sitting upright or lying flat and should be told to relax the arm muscles
Figure 9-11

Dorsogluteal Method 1
? Divide

buttocks on one side into imaginary quadrants ? Administer medication into upper outer quadrant

Figure 9-12 A

Dorsogluteal Method 2
? Locate

posterior superior iliac spine and greater trochanter of femur ? Draw an imaginary line between the two landmarks
Injection given up

and out from this line


Figure 9-12 B

IM Injection Dorsogluteal
? Large, well-developed muscles can

accommodate an injection up to 5 mL
But anything over 3 mL may be

uncomfortable for the patient


? Patient

should lie prone with toes pointing inward to promote muscle relaxation

IM Injection - Vastus Lateralis and Rectus Femoris


? Up

to 5 mL may be injected into a well developed adult


although more than 3 ml may

be painful
? Acceptable

volumes for injection vary with patient age and muscle size ? Vastus lateralis is preferred injection site for children (up to 2 ml)
Figure 9-13

IM Injection Ventrogluteal
? Accessible

when patient lies in a supine or lateral recumbent position ? Site is free of large nerves and fat tissue ? In the adult, may accommodate up to 5 mL of a drug
although more than 3 ml

may be painful
Figure 9-14

Z track IM Injection
Displace subcutaneous tissue prior to injection Once tissue released, Z track results

Figure 9-9

References
? Nasrawi,

C.W. & Allender, J.A. (1999). Quick & Easy Dosage Calculations. W.B. Saunders Co., Philadelphia. ? Sanders, M.J. (2007). Mosbys Paramedic Textbook (Revised 3rd Ed.). Mosby. St. Louis, MO.

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