Overview
This video demonstrates the correct procedure for administering an intramuscular (IM) injection in the deltoid muscle, including preparation, technique, and post-injection steps.
Preparation and Verification
- Review facility protocols for medication administration.
- Confirm patient identity, medication, dose, timing, and route before beginning.
- Gather necessary supplies and use clinical judgment for selection.
- Choose the deltoid muscle for injections of 1–2 mL; use a larger muscle for bigger volumes.
- Select needle length (1–1.5 inches) based on patient's build and adipose tissue.
- Choose appropriate gauge; watery solutions typically use 20–25 gauge, thicker solutions 18–25 gauge.
Infection Control and Safety
- Perform hand hygiene before starting.
- Gloves are optional unless contact with infectious fluids or open wounds is likely.
- Explain the procedure to the patient and determine arm preference, using the non-dominant arm if possible.
- Patients anxious about needles should sit to reduce risk of fainting.
Landmarking and Injection Site
- Locate the deltoid by finding the acromion process and measuring two fingers below it.
- Cleanse the injection site with alcohol, starting from the center outward, and let it air dry.
Injection Technique
- Use the Z-track method to minimize pain and prevent medication from leaking into subcutaneous tissue.
- Pull the skin to the side with the non-dominant hand and inject at a 90-degree angle with the dominant hand.
- Steadily inject the medication (about 10 seconds per mL), then wait 10 seconds before withdrawing the needle.
- Engage needle safety, never recap a used needle, cover with gauze if needed, and do not massage the area.
- Dispose of the needle and syringe in a sharps container.
Post-Procedure and Documentation
- Perform hand hygiene after the procedure.
- Document the injection site, side, patient response, and amount of medication administered.
Additional Notes
- Aspiration before IM injection is no longer recommended, per CDC guidelines, as there are no major blood vessels at recommended sites.
- Do not massage the injection site to avoid medication entering subcutaneous tissue.