How to give an intramuscular injection (IM injection). (2023)

Medically checkedfrom Last updated on February 6, 2023.

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What is an intramuscular injection?

An intramuscular (IM) injection is an injection of a drug into a muscle. Certain medications must be delivered into the muscle to work properly.

What do I need to know about the syringe?

A syringe consists of 3 parts: the needle, the barrel and the plunger. The needle goes into your muscle. The barrel contains the medicine and has markings like a ruler. The markings are in milliliters (mL). The plunger is used to move the medication in and out of the syringe.

Where can I give an intramuscular injection?

  • Leg:Look at your thigh and divide it into 3 equal parts. The middle third is where the injection will go. The thigh is a good place to give yourself an injection as it's easy to see. It is also a good place for children under 3 years old.
  • Hips:Have the person receiving the injection lie on their side. To find the right spot, place the heel of your hand on the upper, outer part of your thigh where it meets your buttocks. Point your thumb to the bar and your fingers to the person's head. Form a V with your fingers by separating your first finger from the other 3 fingers. You will feel the edge of a bone at the tips of your pinky and ring finger. The injection site is in the middle of the V. The hip is a good injection site for adults and children 7 months and older.
  • upper arm muscle:Fully expose the upper arm. You will give the injection in the center of an inverted triangle. Feel for the bone going across the top of the upper arm. This bone is called the acromion process. The bottom forms the base of the triangle. The apex of the triangle is just below the center of the base, at about armpit level. The correct area for an injection is at the center of the triangle, 1 to 2 inches below the acromial process. This site should not be used if the person is very thin or the muscle is very small.

    How to give an intramuscular injection (IM injection). (1)

  • Buttocks (ventrogluteal side):The ventrogluteal site is the preferred site for an injection in the buttocks because there are fewer veins and nerves in this area compared to the dorsogluteal site. To locate the ventrogluteal site, expose one side of the buttocks and use one of the following methods:
    V method. Place the other hand on the hip of the person receiving the injection. If the injection is to be given in the right hip, use the left hand and vice versa. The thumb is placed toward the person's crotch. The tip of the index finger is placed on the iliac crest, which is the most prominent part of the hip. Spread your middle finger to form a V. The injection is inserted at the bottom of the V where the fingers meet. The V method is not reliable for people with a BMI over 30.
    G method. Draw imaginary lines from the main bone endpoints of the thigh and hip to create a triangle. Then draw imaginary center lines from each corner of the triangle. The injection is inserted where these lines meet. The G method is more reliable for people of any BMI.
  • Buttocks (dorsogluteal side):The dorsogluteal location is generally not recommended because of the proximity to the sciatic nerve, major blood vessels, and bone.
    To locate the dorsogluteal site, expose one side of the buttocks and draw a line from the top of the tear between the buttocks to the side of the body. Find the middle of that line and go up 3 inches. From this point, draw another line down and over the first line, ending about halfway up the buttocks. You should have drawn a cross. In the top outer square you will feel a curved bone. The injection is made in the upper outer square below the curved bone.

How to choose the best site for an intramuscular injection?

  • Track where the injections are given:Make a list of the websites you use. Record the date, time and injection site of each injection.
  • Switch injection sites:It is important that you use a different injection site for each injection. This prevents scars and skin changes. The injection sites should be at least 2.5 cm apart. Ask your doctor if you need to inject the medicine in a specific area.

What items do I need to give an injection?

  • An alcohol swab
  • A sterile 2 x 2 gauze pad
  • A new needle and syringe of the right size
  • Disposable gloves, if available

How do I give an intramuscular injection?

Wash your hands with soap and dry them completely. If necessary, put on gloves.

  • Open the alcohol wipe:Wipe the area where you want to give the injection. Allow the area to dry. Do not touch this area until you have given the injection.
  • Prepare the needle:Hold the syringe with your writing hand and pull the cap off with your other hand. Place the syringe between your thumb and forefinger. Rest the barrel of the syringe on your index finger.
  • Hold the skin around the injection site:With your free hand, gently press the skin and gently pull tight.
  • Insert the needle into the muscle:Hold the syringe barrel and use your wrist to inject the needle through the skin and into the muscle at a 90-degree angle.
  • Check the needle:Release the skin with the other hand. Hold the syringe pointing straight in. Pull the plunger back a little to make sure you haven't hit a blood vessel. If blood comes back, remove the needle immediately. Do not inject the medicine. Throw away both the syringe and the medicine. Get more medicine in a new syringe. When you give the second injection, give it on the other side.
  • Inject the medicine:Push the plunger down to inject the medicine. Do not force the medicine in. Some medicines hurt. You can inject the medicine slowly to reduce pain.
  • Remove the needle:Once the medicine is injected, withdraw the needle at the same angle that you inserted it. Place gauze over the area where you gave the injection.

How do I dispose of used syringes and needles?

It's important to dispose of your needles and syringes properly. Don't throw needles in the trash. You may be given a hard plastic container made specifically for used syringes and needles. You can also use a soda bottle or other plastic bottle with a screw cap. Make sure both the syringe and needle fit easily in the container and cannot break through the sides. Check with your health care provider or pharmacist about your state or local community requirements for disposal of used syringes and needles.

What are the risks of an intramuscular injection?

Intramuscular injection can cause infection, bleeding, numbness, or pain.

When should I contact my doctor?

  • After the injection, fever, sneezing or coughing occurs.
  • There is a lump, swelling, or bruise at the injection site that does not go away.
  • You have questions about the injection.

When should I seek immediate treatment or call 911?

  • A rash or itching develops after the injection.
  • Shortness of breath develops after the injection.
  • The mouth, lips or face swells after the injection.

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You have the right to be involved in planning your care. Find out about your health condition and how it can be treated. Discuss treatment options with your healthcare provider to decide what treatment you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for any individual condition or treatment. Talk to your doctor, nurse or pharmacist before using any medicine to see if it is safe and effective for you.

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