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Intramuscular Injections Review • • • • • • • Definition of parenteral Equipment Aseptic technique Personal protective equipment 3 “checks” 6 “rights” Proper disposal of sharps Intramuscular • Given into the muscle layer beneath the dermis and subcu tissue • Intermediate absorption rate • 3 mL syringe • 19 – 25g needle • 1 to 3 inch needle length Land marking for IM • • • • Deltoid Ventrogluteal Vastus lateralis or rectus femoris Dorsogluteal Deltoid • Small muscle with little subcu fat • Absorbed quickly • Smaller volume of medication (no more than 1 mL) • Anatomical risk: radial nerve and brachial artery Vastus Lateralis • • • • Absorption rapid Site of choice for infants and children 1 inch needle for children Lift muscle from bone and administer at right angle to the muscle Ventrogluteal • Lateral hip; free of major blood vessels, nerves and fat • 90 degree angle • Least painful Dorsal Gluteal • Site is close to sciatic nerve and superior gluteal artery so accurate landmarking is critical • Not used on infants and toddlers Z-Track Method • IM injection where solution will irritate subcu tissue • Allows medication into muscle with no tracking to subcu tissue • 0.2 mL of air used as airlock to prevent leak into subcu tissue