Intra Muscular Injection Techniques

Intramuscular (IM) Injections

Intramuscular injections are the medicines injected in to the muscles through a hollow needle

Sites of giving intramuscular injection

 1. Deltoid – it is located at the upper and outer aspects of the upper arm. It is a safe injection location. This location is about three fingers (1”-2”) below the shoulder joint.  Or make a ‘V’ shape just below the deltoid muscle and injection should go in the half outer side of the ‘V’ shape. We can inject maximum 2 ml only in this area.

 2. Thigh (Vastus Lateralis muscle)

It is located on the outer lateral aspect of the thigh. Location is one hand width above the knee to one hand width below the groin or hip joint. When injecting lift the Vastus Lateralis muscle away from the bone. Maximum amount to be injected is 2-4ml only. This site is safe for infants and children.

 3. Hip (Ventro-Gluteal) site

The Ventro gluteal site is located between the hip and the head of femur.

How to locate this site?

First place the heel of your hand over the patient’s greater trochanter and feel for the anterior superior iliac spine with your index finger. The middle finger then slides across up to iliac crest and the injection site is at the middle of this.

Or

Place the palm of your hand on the greater trochanter with your thumb pointing towards the patient’s abdomen. Extend your index finger up to the anterior superior iliac spine then spread your other finger back along the iliac crest. Insert the needle in the ‘V’ formed between your index and third fingers.

 4. Buttocks (Dorso Gluteal or Gluteal Maximus muscle)

Divide one buttock in to four quarters and injection should be given in the upper outer quarter.

This site is high risk of hitting sciatic nerve, blood vessel (superior gluteal artery). To avoid this injury divide the upper outer quadrant again in to four equal parts and give injection to the upper outer quarter of that portion.

Thickness of fat in this area is greater than the length of standard needles in fatty patients. This may cause decreased absorption and deposition of medicines under the subcutaneous layer. Later this may be an injection abscess.

Practice a ‘Z-track’ technique, by stretching the skin downwards or sideways at the site before injection. The track is closed when the skin is released, preventing leakage.