IM injections

  1. Hi,
    We are having a discussion at work about the maximum amount of cc that can be given in each muscle. I was always taught the following:
    Adults
    Gluteus- 5cc
    Thigh- 3cc
    Deltoid-up to 2cc depending on Pt's size, I prefer 1cc limit
    Pediatrics
    Thigh- 1cc
    I would appreciate hearing from others.

    Kelly Townsend RN
    Kayenta, AZ
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  2. 16 Comments

  3. by   traumaRUs
    Our policy for our hospital is 2cc IM no matter the site - its up to the nurse as to size of the patient. 5cc - that seems like an awful lot!!!
  4. by   KellyT330
    Hi,
    Most antibiotic injections are 3cc minimum for adults, do you give 2 injections. You can look up immunogloblin and it says over 5cc needs to be given in divided injections. I have rarely given 5cc in the gluteus, usually 2-3cc on adults. What is your limit for children given in the thigh. I have always gone with 1cc limit. What about a 4-5 yrs old?

    Thanks
    Kelly Townsend RN
  5. by   veetach
    our policy is also 2cc per site. No matter where it is located. No way would I ever give a 5cc IM injection.
  6. by   RainbowSkye
    I pretty much hold it to 3cc IM in adults, although I will occasionally do 4cc in a big person. And I very rarely give an IM in the deltoid unless it's a tetanus shot or the like.

    However, in the old days, a lot of drugs were given IM in really big volumes. I can remember giving Wycillin that had to be 4 or 5 cc and the poor patient had to get two of them. (The needle on that thing was huge, and the stuff was so thick you had to use the palm of your hand to push it in.) We also used to give something called paraldehyde IM for DTs and that was even bigger. It was a long time ago, but I think some patients got like 20cc at a time. I remember it had to be given in a glass syringe because it would eat through the plastic.
  7. by   KellyT330
    Hi,
    I hated giving Bicillin 2.4 mil units, it was definitely more than 3cc and the needle on the glass syringe is a 16 gauge 2 inch needle. I had one patient vagal after I gave the injection when she saw the needle. It has been more than 10 yrs since I have given immunogobulin, that was the main one that we exceeded 3 cc for. I never give injections in the deltoid except tetanus. I have had patients request it there but I refuse. I have seen too many reactions post injections of pain meds and antibiotics given in the deltoid.

    Thanks
    Kelly Townsend RN
  8. by   MEL101
    When I've given 2-3 cc per hip my patients were always recumbent! Never standing and never seeing my "equiptment". I'd go vagal on seeing a 16 or 18 guage needle too! Common sense tells you to insure patient safety and keeping them upright is asking for trouble....esp when injecting more than 2 cc in hip or whatever....treat every pt as tho' they'll faint irregardless! They may want to be brave but common sense should take over....remind them that if they topple you may not be able to hold them etc....do whatever it takes to insure their and your safety....besides your the "mother" in this situation!
    Kill 'em w love!

    An old and wise nurse...most of the time.....
  9. by   nekhismom
    2 cc max regardless of site.
  10. by   RNin92
    I was always taught 3 cc max for adult-1 cc for babes.

    5 cc..ouch...no way!

    Gluteus...almost always.
  11. by   teeituptom
    I prefer gluteus or anterior thigh

    and I prefer cute gluteus's just kidding

  12. by   Rapheal
    I never go more than 3 cc in the ventral gluteal (my prefered site) and 4 cc in the vastus lateralis. The vastus lateralis is the biggest muscle in the body. An injection there does make for a sore leg so I try not to use this site except when necessary.
  13. by   MandyInMS
    We were taught:
    deltoid=1cc
    thigh=2cc
    glut=3cc
  14. by   renerian
    Yep I agree 5cc would not feel good. 2 max is what I would go, maybe 2.5 in a split.

    renerian

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