IM injections

Specialties Emergency

Published

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

Trauma Columnist

traumaRUs, MSN, APRN

88 Articles; 21,249 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

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!!!

KellyT330

3 Posts

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

veetach

450 Posts

Specializes in Emergency Room/corrections.

our policy is also 2cc per site. No matter where it is located. No way would I ever give a 5cc IM injection.

RainbowSkye

127 Posts

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 tetorifice 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.

KellyT330

3 Posts

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 tetorifice. 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

MEL101

39 Posts

:) 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.....

nekhismom

1,104 Posts

2 cc max regardless of site.

RNin92

444 Posts

I was always taught 3 cc max for adult-1 cc for babes.

5 cc..ouch...no way!

Gluteus...almost always.

Specializes in ER, ICU, L&D, OR.

I prefer gluteus or anterior thigh

and I prefer cute gluteus's just kidding

:rotfl: :rotfl: :rotfl:

Rapheal

814 Posts

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.

MandyInMS

652 Posts

We were taught:

deltoid=1cc

thigh=2cc

glut=3cc

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