intramuscular injections
DESCRIPTION
Intramuscular Injections. Injection of substance directly in muscle, for forms of medicine used delivered in small amounts. Indications: Where IV administration is not available. Drugs with specific actions on muscles. A longer half life is needed eg. Morphine for anaesthesia. - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/1.jpg)
Intramuscular Injections
![Page 2: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/2.jpg)
Injection of substance directly in muscle, for forms of medicine used delivered in small amounts
Indications: Where IV administration is not available. Drugs with specific actions on muscles. A longer half life is needed eg. Morphine for
anaesthesia
![Page 3: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/3.jpg)
Complications & contraindications
Damage to the sciatic nerve. (Upper outer quadrant) Injection fibrosis - causes inability to flex muscle drug
is administered to. Thrombocytopenia (low platelets) and coagulopathy
(bleeding) can lead to hematomas. Local sepsis Arterial/IV injection Infection
![Page 4: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/4.jpg)
Equipment List
![Page 5: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/5.jpg)
Method Check identity of patient and contents and expiry date of drugs Insert needle into syringe, and fill with the required amount of
drug. Tap syringe to bring any air bubbles to the top and push the air out.
Choose a suitable injection site and inspect for signs of inflammation, swelling, infections or lesions
5 main sites: ▪ Upper arm (deltoid) – vaccines▪ Dorsogluteal (gluteus maximus)▪ Ventrogluteal(gluteus medius)▪ Vastus lateralis (quadriceps femoris) outer side of femur▪ Rectus femoris (anterior quadriceps) – self administration or
infants
![Page 6: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/6.jpg)
Method continued... Swab site with alcohol and let it dry (bactericidal and decreases
pain) Pull skin laterally and insert needle in one swift motion at 90°,
aspirate to avoid an intravenous placement, if blood is drawn in, restart with new medication and slowly inject the drug.
Remove needle and apply a pressure gauze and observe for signs of an adverse reaction.
Moving the skin may distract from the intended needle destination, therefore visualise and aim for the underlying muscle about to receive the injection.
http://www.youtube.com/watch?v=nA8i9eYW0_M
![Page 7: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/7.jpg)
Subcutaneous Injections
![Page 8: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/8.jpg)
Injection of substance into the subcutaneous tissue – layer of skin directly below the dermis and epidermis.
Indications When drug is desired to have a slow, sustained
absorption effect Local anaesthesia Administration of vaccines
and medicines such as insulin and morphine
![Page 9: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/9.jpg)
Complications & Contraindications
Avoid using the same site repetitively which can cause lumps or dents (lypodystrophies – loss or degeneration of fat) from forming.
Accidental IV, ID, IM injections
![Page 10: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/10.jpg)
Equipment List
![Page 11: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/11.jpg)
Method Check identity of patient and contents and expiry date of
drugs Insert needle into syringe, and fill with the required amount
of drug. Tap syringe to bring any air bubbles to the top and push the air out.
Choose a suitable injection site and inspect for signs of inflammation, swelling, infections or lesions
4 main sites: ▪ Upper arm outer area▪ Abdomen – above and below waist, except around navel▪ Anterior thigh – midway of outer side▪ Upper area of butt – behind hip bone
![Page 12: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/12.jpg)
Method continued ... When repeated injections are needed use a hidden site
to cover bruises – but the same area at the same time each day to reduce changes in the action of the insulin
Swab site with alcohol and let it dry (bactericidal and decreases pain)
Gently pinch skin to elevate subcutaneous fat and separate it from underlying muscle.
Insert the needle at a 30° angle and inject the drug – aspiration before injecting the drug is unnecessary as can increase the risk of local hematoma formation for heparin.
http://www.youtube.com/watch?v=bxdYGXKz1iA
![Page 13: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/13.jpg)
Local Anaesthesia Injections
![Page 14: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/14.jpg)
Used when performing invasive medical procedures except in life saving procedures.
Contraindications Patient refusal – but many can be persuaded Allergy – rare DO NOT USE adrenaline containing LA on digits or penis
– vasoconstriction can lead to ischaemia and necrosis. Anticoagulated patients have a tendency to bleed if a
vessel is punctured. Infection at intended site may make it more painful and
spread. Broken needles Acute systemic toxicity – CNS, CVS – when plasma
conc., exceeds toxic limit.
![Page 15: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/15.jpg)
Mechanism of action LA block fast sodium channels in nerve axons
preventing propagation of nerve impulse Pain nerves are usually smaller and non myelinated
fibres so are blocked faster than larger myelinated fibres (motor, proprioception, touch)
![Page 16: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/16.jpg)
Parenteral LA
Injected subcutaneously Onset of effect is 2 minutes, but duration
varies depending on the drug. LA solutions are alkaline pH 10/11
therefore are more painful A less painful approach would be ID
(instant anaesthesia) Avoid intra vascular injection, so aspirate
first.
![Page 17: Intramuscular Injections](https://reader033.vdocuments.net/reader033/viewer/2022061604/568165d0550346895dd8ddae/html5/thumbnails/17.jpg)
Have a good rest of your degree!!