Help me w/ IM injection, maybe a good visualization or picture?

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I did a custom search on here first, but haven't found anything that shows in picture detail WHERE to give an IM.

In school, I was great on the tests, but now that I've faced IM's in real life, I feel very very insecure.

All of the IM's I've had to give were Rocephin or Ivanez (?), which requires 3ml of lidocaine.....so had to use the hip.....I have made both men and women cry, they both had tears rolling out of their eyes. One patient, I went to push in the needle and it bounced off his skin! He still had tears rolling down his face.

I HATE GIVING IM'S and don't wanna do it anymore!!! Nothing else has bothered me, I can do other procedures and not worry too much about the patients discomfort because I know some things just can't be helped, but there has GOT to be a better to give IM's.

I felt horrible, and no one at the job I was working would help me. Oh wait, there was a nurse who went in and showed me the bruises on the mans hip and said, "try to go where the bruises are, that's where they been giving them". (I recently ran from that place)

I looked in my books, but it's too cut and dry....does anyone have a really good way to know where to inject? Or a really good diagram? Some of the patients were very heavy, some are very thin, so the pictures in my books are not very useful.

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Specializes in Med Surg/Tele/ER.

this is the site i use, unless its a child or needs to be given in the deltoid. hope this helps. i googled it & came up with a lot of sites.

hip (ventrogluteal) site for im injection

  1. [color=#ffffff]injection8.jpg[color=#ffffff]
  2. find the trochanter. it is the knobby top portion of the long bone in your upper leg (femur). it is about the size of a golf ball.
  3. find the anterior iliac crest. the nurse will help you find the bone landmarks.
  4. place the palm of your hand over the trochanter. point the first or index finger toward the anterior iliac crest. spread the second or middle finger toward the back, making a 'v'. the thumb should always be pointed toward the front of the leg. always use the index finger and middle finger to make the 'v'.
  5. give the injection between the knuckles on your index and middle fingers.
  6. stretch the skin tight.
  7. hold the syringe like a pencil or dart. insert the needle at a right angle to the skin (90 degrees).
  8. you may give up to 3 ml. (cc) of fluid in this site.

htmwww.steroidsource.net/injection.htm

www.drugguide.com/ddo/ub/view/davis-drug-guide/109502/5/medication_administration_techniques

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This is the type of diagram I always followed, but it's probably the same as in your book:

http://medicalcenter.osu.edu/pdfs/PatientEd/Materials/PDFDocs/medicatn/geninfo/intrainj.pdf

What gauge & length needle are you using? Maybe that's the problem. How quickly do you insert it? Did you hit a bone?

I've given mostly deltoid injections (flu & pneumo vacs), so I could get away with a 23 gauge, 1 inch needle. No complaints with that. I try to make my injections quick & steady (avoid lots of movement when it's in), but not so fast & hard that it freaks the pt out. Hard to explain...

Wish I had more suggestions to help you out!!

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