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Painful IM

SammyCT SammyCT (New) New

Hi. I'm beggining to be very sad everytime i have to give im injections in the gluteus. We all give on dorsogluteal site and there's no way at giving at ventrogluteal because there's no current pratice anywhere i live. All the patients ask for STANDING position. It seems as i'm throwing the needle i'm hurting a lot most of the time :(. What i'm doing wrong? I choose correctly the site and test before assepsia with my fingers, confirming a soft spot. Can someone help me? I'm creating a lot lot lot of anxiety everytime i have to give im injections there... In the arms i'm excellent though... Please give me your advices. I'm really needing help.

Sour Lemon

Has 9 years experience.

I've received a lot of IM injections, both self-administered and given by others. They sting quite a bit when the alcohol is not allowed to completely dry before the injection is given. They're also less comfortable when the giver is slow or hesitant. A super-fast, dart-like motion is best.

I agree with Sour Lemon about letting the alcohol dry and not going too slowly. Also, in my experience, most IM injections just plain hurt!

Thanks for your answers. We do not use alcohol at all. I'm sad because i'm getting afraid of hurting... i watched youtube videos also and still i dont figure out what i'm doing wrong.

Are you making sure the bevel is up? Don't "throw it" but use a quick dart like motion. Just some other ideas


Specializes in ICU, LTACH, Internal Medicine. Has 7 years experience.

Seconding with Sour Lemon. No ethanol, 90 degrees to the skin, QUICK IN, QUICK OUT. And, if not standing, then sitting is better.

P.S. smaller needle makes absolutely no difference in term of where the drug goes into. Unless patient is a professional bodybuilder or cachectic, people have pad of fat of at least 2 inches at that place. So, it is de facto SQ, not IM, and thinner, shorter needle makes no difference except it stings less... kind of.

Pull the skin taut between thumb and first finger. You are wanting it to go into muscle so pinching up is not required, yet I see people doing that all the time. It's counterproductive.

While I can't speak for everyone, I know I would be more likely to tense up with a needle to the behind vs arm or leg... that would make it hurt more.