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 |
Purpose: To make an intramuscular drug injection with a low risk of complications.
Specialty: Toxicology, Emergency Medicine, Critical Care
Objective: adverse effects, prevention
ICD-10: T80.9,