Any person who administers intramuscular injections should receive training and education on proper injection technique. The needle size and injection site will depend on many factors. These include the age and size of the person receiving the medication, and the volume and type of medication. Your doctor or pharmacist will give you specific guidelines about which needle and syringe are appropriate to administer your medication.
The needle should be long enough to reach the muscle without penetrating the nerves and blood vessels underneath. Generally, needles should be one inch to one and a half inches for an adult, and will be smaller for a child. They will be 22 gauge to 25 gauge thick (noted as 22g on the packaging).
Follow these steps for a safe intramuscular injection:
1) Wash your hands. Wash your hands with soap and warm water to prevent potential infection. Be sure to thoroughly scrub between fingers, on the backs of hands, and under fingernails. The Centers for Disease Control and Prevention (CDC) recommends lathering for 20 seconds – the time it takes to sing the “Happy Birthday” song twice.
2) Gather all needed supplies. Assemble the following supplies:
needle and syringe with medicationalcohol padsgauzepuncture-resistant container to discard the used needles and syringe (typically a red, plastic “sharp’s container”)bandages
3) Locate injection site. To isolate the muscle and target where you will place the injection, spread the skin at the injection site between two fingers The person receiving the injection should get into a position that’s comfortable, provides easy access to the location, and keeps the muscles relaxed.
4) Clean injection site. Clean the site selected for injection with an alcohol swab and allow the skin to air dry.
5) Prepare syringe with medication.
Remove the cap. If the vial or pen is multi-dose, take a note about when the vial was first opened. The rubber stopper should be cleaned with an alcohol swab.
Draw air into the syringe. Draw back the plunger to fill the syringe with air up to the dose that you’ll be injecting. This is done because the vial is a vacuum and you need to add an equal amount of air to regulate the pressure. This also makes it easier to draw the medication into the syringe. Don’t worry; if you forget this step, you can still get the medication out of the vial.
Insert air into the vial. Remove the cap from the needle and push the needle through the rubber stopper at the top of the vial. Inject all of the air into the vial. Be careful to not touch the needle to keep it clean.
Withdraw medication. Turn the vial and syringe upside down so the needle points upward and pull back on the plunger to withdraw the correct amount of medication.
Remove air bubbles. Tap the syringe to push any bubbles to the top and gently depress the plunger to push the air bubbles out.
6) Insert needle. Hold the needle like a dart and insert it into the muscle at a 90-degree angle. You should insert the needle in a quick, but controlled manner. Do not push the plunger in.
Check for blood/blood vessel. Using the hand that is holding the skin at the injection site, pick up your index finger and thumb to stabilize the needle. Use your dominant hand (the one that did the injection) to pull back on the plunger slightly to look for blood in the syringe.
If you see blood going into the syringe, it means the tip of the needle is in a blood vessel. If this happens, withdraw the needle and begin again with a new needle, syringe with medication, and injection site. It’s rare to have this happen.If you don’t see blood going into the syringe, the needle is in the correct place and you can inject the medicine.
7) Inject medication. Push the plunger slowly to inject the medication into the muscle.
8) Remove needle. Withdraw the needle quickly and discard it into a puncture-resistant sharps container. Do not recap the needle. A sharps container is a red container that you can purchase at any pharmacy. It is used to collect medical waste, like needles and syringes. You should not put any of these materials into the regular garbage, as needles can be hazardous to anyone who handles the trash.
9) Apply pressure to the injection site. Use a piece of gauze to apply light pressure to the injection site. The dorsogluteal muscle of the buttocks is the site most commonly selected by healthcare providers. It’s difficult to use this site for self-injection.
Divide the buttock into four equal quadrants, halfway down from top to bottom and halfway across. The injection should always go into the upper, outer quadrant of the buttock, towards the hip bone.
If you will be giving the injection more than once, make sure to rotate injection sites to avoid injury or discomfort to the muscles.