Correct way to give IM injections?

MikeyBSN · Oct 28, 2009

I wouldn't base my practice on anything I saw on the news, especially if it was Fox "News".

justiceforjoy · Oct 28, 2009

I was taught 10 seconds per mL and two hands for stabilizing. Also, always landmark. I see them on TV not land marking properly and it makes me cringe!

sweetiepeas · Oct 28, 2009

I think it depends on what you are giving. The nurses that I have seen do it, go fast.

The way I was taught was to Z track with one hand and stabilize the needle with that hand while aspirating and giving the injection.

RNRyan · Oct 28, 2009

I've never given it with two hands. Like you said, dart it in, aspirate, then inject.

Black Jade, BSN, RN · Oct 28, 2009

With everything that is going on with the swine flu vaccine, the news show nurses giving it slowly. I think I am paying more attention on what I'm seeing than what I'm hearing. :icon_roll

katkonk, BSN, RN · Oct 28, 2009

I think it depends on what you are giving. The nurses that I have seen do it, go fast.
The way I was taught was to Z track with one hand and stabilize the needle with that hand while aspirating and giving the injection.

Why on EARTH would you Z track every injection? Do you understand rationale behind giving a Z track? That

is overkill to the -nth- degree as they say. There is no need to Z track a simple IM injection.

katkonk, BSN, RN · Oct 28, 2009

What 's the correct way to give IM injections such as Flu vaccines? In my Medical Assistant and Nursing Program I was taught to give it one hand and give it quick after aspirating. However, I've seen some of my Medical Assistants and on TV (news) giving their IM injections very slowly and using two hands. Am I doing it wrong?:uhoh21:

There is no one right way for an IM injection. It depends on what you are injecting! If it is thick and deep IM (like say, Rocephin or GG), it will be different than something simple like the flu vaccine. Thick =slower, larger amount = slower, deep IM is different than just a short needle, etc. There is even great debate in the scientific journals as to whether it is necessary to aspirate before giving meds....lengthy subject. Do some internet web searches, read up on it and find the "how to" sites with good instructions and some drawings. This will either reinforce what you were taught, or make you re-think it and perhaps modify your technique. It is also depended on your patient...an elderly emaciated pt. will be different than a robust/slightly obese young person. Muscle mass varies. Enjoy the research.

catshowlady · Oct 28, 2009

With everything that is going on with the swine flu vaccine, the news show nurses giving it slowly. I think I am paying more attention on what I'm seeing than what I'm hearing. :icon_roll

Yes! I noticed that too! I was also taught to dart it in, aspirate, and then give quickly. I was taught that poking the needle in slowly causes more pain. I have always darted in my SQ and IM injections, and many pts tell me that it hardly hurts when I give their shots.

It is harder to push in a thicker med like Ativan.

:paw:

DLS_PMHNP, MSN, RN, NP · Oct 28, 2009

[/i]
Why on EARTH would you Z track every injection? Do you understand rationale behind giving a Z track? That
is overkill to the -nth- degree as they say. There is no need to Z track a simple IM injection.

exactly! It's not like you are giving iron dextran or something similar that can leave a 'stain' under the skin.

sweetiepeas · Oct 28, 2009

[/i]
Why on EARTH would you Z track every injection? Do you understand rationale behind giving a Z track? That
is overkill to the -nth- degree as they say. There is no need to Z track a simple IM injection.

Actually, that is the way it is taught. Not necessarily the way it is done in the "real world"

katkonk, BSN, RN · Oct 28, 2009

Yes! I noticed that too! I was also taught to dart it in, aspirate, and then give quickly. I was taught that poking the needle in slowly causes more pain. I have always darted in my SQ and IM injections, and many pts tell me that it hardly hurts when I give their shots.

It is harder to push in a thicker med like Ativan.
:paw:

Yep, with the flu shots...it is dart-like. In and out.