Giving an intramuscular injection

What is an intramuscular injection?

‘Intramuscular’ is another way to say ‘into the muscle’. An intramuscular injection is a dose of medicine given into a muscle of an arm, leg or bottom. The medicine is put inside a syringe, which has a needle attached to it. The needle needle goes through the skin and into the muscle. The medicine is then injected into the muscle by pushing the plunger of the syringe.

Why do I need an intramuscular injection?

You might need injections into your muscle because:

• the medicine you are having has to be given into the muscle for it to work.
• the amount of medicine needed is too much to take by mouth.
• you have had difficulty swallowing the oral medicine.

Things to check before giving the injection

Before giving the intramuscular injection, it is necessary to do a few checks first:

• always know the name of your medicine, and check it.
• always check the expiry date of the medicine (the last day that the medicine is safe to use).
• make sure that you know how much medicine is needed.
• check that there is no damage to the vial (small bottle or tube) containing the medicine.

How do I get the medicine into the syringe?

When you have done the checks above, it is time to put the medicine inside the syringe.

1. Make sure you have a clean and flat surface for the medicine, syringe and needles
2. Wash your hands and dry them completely
3. Sometimes a small amount of the medicine gets stuck in the neck (the top) of the vial – if this happens, gently tap or flick the top of the vial until the medicine drops down
4. Hold the bottom of the vial with one hand. With the fingers of your other hand, pinch the neck of the bottle and snap off the top. The bottle is often marked and scored to make it easier to snap
5. Place the vial on your clean surface, and attach a filter needle to your syringe. The filter needle is a special needle, and it stops any small pieces of glass from the vial getting into the syringe
6. Place the filter needle inside the vial. Hold the syringe with one hand, and use the other had to pull back the plunger to suck up the medicine (see diagram of syringe). When all the medicine is in the syringe, take off the filter needle
7. You now need to get rid of any air that is in the syringe. Carefully hold the syringe upright, so that the plunger is pointing towards the floor. Gently push the plunger up, until the medicine reaches the top of the hub (see diagram). Any bubbles of air will be pushed out of the syringe by doing this
8. Carefully push the needle (for giving the injection with) onto the syringe. When it is safely in place, and you are ready to inject, pull off the plastic case covering the needle
9. The injection is now ready to be given

Where do I give the injection?

You need to decide where you are going to give the injection. If you are giving a lot of medicine, you might want to give it in the leg or the bottom, rather than in the arm.

You will see your nurse before having to give an injection by yourself. They will make sure that you know how and where to inject, and that you are happy that you understand. If you have any worries or questions, please ask your nurse.

Thigh

Imagine that you are splitting the thigh into three parts, going up and down the leg between the hip and knee. The injection needs to be given in the middle section, as shown in the diagram below. Your nurse will show you how to do this.

Bottom

To give an injection in the bottom, you need to trace an imaginary cross on one of the buttocks as shown in the diagram. The injection should then be given in the upper outer quarter of the cross.

Arm

If you are injecting into the arm, you will first need to feel for the bone that runs across the top of the upper arm. Trace a square with your finger (see diagram). The injection needs to be given in the middle of the square.

How do I give the injection?

1. Wash and dry your hands thoroughly
2. Wipe the skin with an alcohol wipe, and allow to dry
3. Hold the syringe in the hand that you write with
4. Remove the cover from the needle
5. With your other hand, lightly hold the skin around where you will be giving the injection
6. Insert the needle at 90 degrees to the skin, keeping hold of the syringe (see diagram)
   
7. While holding the syringe, pull the plunger back slightly. This is to make sure that you have not put the needle into a vein. If you see blood when you pull back the plunger, do not give the injection and remove the needle
8. When all of the medicine has been injected, pull the needle out, keeping it at the same angle as when it went in
9. Carefully put the needle and syringe into a sharps bin