IM Z track question

Nurses General Nursing


We are learning about the Z track Method of IM. Just wondering if most nurses use this? & Is the ventrogluteal site used most often? Thats what we were taught, but wanted to know if that is the case in practice. We were also told no Z track in the deltoid and PEDS.

any thoughts.................


1,024 Posts

We were taught that ventroglut was the only place to give this. Also, I have never seen it done at work or clinical, so I don't know how common it is.


Specializes in Med-Surg.

We were taught to Z-track, and usually see it listed on the MAR as the method to use for drugs like promethazine. We were taught that we can use the method in any IM site, but it's easier to do gluteal because there is more to work with. I haven't had the pleasure of doing one yet though...I have only given one IM.


2,719 Posts

Yes indeed it is used in real life I am surprised you ask. Also, surprised that some of you responding have not used it.

Anything irritating should be given by this method with airlock. (ie air in the needle to prevent tracking though subq tissue.)


2,099 Posts

Specializes in Corrections, Psych, Med-Surg.

Yep. Any IM spot will do, so long as there's enough flesh to manipulate.


951 Posts

Specializes in Hospice, Critical Care.

Have used z-track with iron injections. Haven't given one in a while. Most of my stuff (ICU) is given IV.


1,041 Posts

Today, when all my injection lab skills were tested, I went to give my IM, VG, 23 gau, 1",1.2cc saline shot and guess what?? I was trying to remember everything...including the Z-track with my non-dominent hand that wuld also hold the syringe stead while I injected all the "saline" because they required us to retract it from the end of the shot, and not pull out, then retract. We have to do each other, which sets up another dynamic.

Anyway, I had it all correct....figuring and dosing the med, doing it all sterile, greeting, site, Z-track..........but after i Z-tracted i went to do it, and got stopped butt-cold by the instructor because I didn't wipe with a alcohol swap.

There I was, reduced to a failure in 0.01 seconds.

Z-tract is a always right to do for IM and it's logical.


1,244 Posts

ooopsie :imbar

doncha hate when that happens :rolleyes:


1,041 Posts

I hate not knowing my technique. I don't know whether to use my push or pull method yet for creating a Z-track. Plus, not everyone looks anatomical, so when I try to imagine where a persons iliac crest and greater trochanter are, sometimes I don't see it. Even though my imagination is on.

Dayray, RN

700 Posts

I always use Z-track and airlock allthough in school I was taught not use air lock as it can cause a dry abces. I think the dry abces risk is much smaller then the risk of leaking into the sub Q tissue so I use it anyway.

I always use the VG site unless the patient has been reciveing a large amount of IMs. My second choice is the aterior lateral thigh (forgot the technical name). The only time I give shots in the deltoid is when patients insist on it. Allot of my patients say "in the doctors office they always give it to me in the arm" I try to explain that its becuse MA's are not allowed to use anyother site for IM's but sometimes I just give in.

I work in 2 hospitals and even nurses that went to school before z-track was taught use it.


153 Posts

Thank you Thank you Thank you, I know where to come if I have any more questions.......and i'm sure there will be many.:) :)


255 Posts

Personally, I can't remember the last time I gave an IM med period, much less z-track. We do pretty much everything IV -- less invasive and much less painful.

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