IM injection question

[srknurse]

Hi, everyone-

Can someone please tell me what the most current standard of practice is for IM injections? Specifically, I want to know, are we supposed to remove all air from the syringe before injecting the med or do we leave residual air so that the medication does not leak into the subcutaneous space? Also, what about aspirating the syringe back before pushing the med? Lastly, is "Z-Track" the current method? I have learned various ways, and it is interesting to see that every nurse I work with does a little something different.

Thanks,

srknurse

[srknurse]

Hello...anyone out there?

srknurse

[TazziRN, RN]

I use an airlock with all IM injections, and z-track all injections into the VG. Don't know if it's current practice, but I've been doing that for nearly 20 years.

[mandana]

I use an airlock with all IM injections, and z-track all injections into the VG. Don't know if it's current practice, but I've been doing that for nearly 20 years.

Your experience is right on track with current practice, to the best of my knowledge. I'm currently in nursing school and we've been taught to air lock, z-track, aspirate and always go with the VG unless it's small enough for the delt.

Amanda

[TazziRN, RN]

Something else I learned recently with a scared 10-year-old: I had to shoot him with Bicillin and he was freaked. I don't know what made me think of this, but it worked: I had him hold a chemical cold pack to his hip for five minutes, to the bare skin. I came in and injected him; of course he felt the bicillin, but he never felt the needle. I use the smalles gauge I can possibly get away with for IM's, but with bicillin you can't get away with anything smaller than a 22. The cold pack was a good idea and I will be using it in the future.

[superbratnurse]

I work in LTC, I have always used Z-track, mostly in the VG, but with agitated, combative patients, sometimes, you have to hit the biggest muscle you can reach easily...such as the quads, or delts in an emergency... mostly when we are giving behavioral meds, it is less than 1ml anyway, so the delts are relatively safe, even in the elderly. But when we are giving Rocephin, or any other Antibiotic injection, i always try to use the VG, in a rare case, if a person has multiple pressure ulcers, you would need to use the quadracep anyway.

or my 2 cents, anyhow...

~Brat