Intramuscular (IM) injection of drug can be an effective way to administer many medications. However, complications may occur if poor technique is used or care is not taken with certain patients.
Concerns:
(1) proper technique
(2) problem patients
Proper Technique
Risk
clean skin carefully prior to making the injection
cellulitis or abscess
use single dose medications
multi-dose vials may become contaminated
use disposable syringe
reduces contamination
rotate injections sites; avoid repeat injections into the same site
reduces inflammation and scarring
use a needle long enough to reach muscle
avoid injecting drug into fat
avoid injecting drug as the needle is advanced
avoid injecting drug into fat
be aware of anatomic landmarks
avoid injecting drug into a blood vessel or nerve
aspirate syringe prior to making injection
avoid injecting drug into a blood vessel
use a formulation designed for IM injection
reduces chemical damage to soft tissues; aqueous formulations may cause more muscle damage than those with an oily vehicles (Svendesen & Blom)
Problem Patients
Risk
coagulopathy or anticoagulation therapy
hematoma
morbid obesity
injection of drug into fat
malnutrition
little muscle to inject into
edema or lymphedema
leakage of drug into edema fluid
immunocompromised
injection site abscess or cellulitis
scar at injection site
difficult to penetrate and may limit volume of fluid that can be injected
To read more or access our algorithms and calculators, please log in or register.
