Intramuscular Injection “IM”

Document created by tfreiberg Employee on Dec 27, 2016Last modified by Mary Aycock on May 3, 2018
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For several medicines, injection is the best way to get the medication into the body so it can work. 


IM injections are used to administer medication into muscle tissue. Some medications must be injected into the muscle to work effectively.


Supplies you will need

  • Syringe with needle (provided by your nurse)
  • Disinfectant (alcohol swabs)
  • Sterile 2x2 gauze pad
  • Medication to be given
  • Proper needle disposal container


What to do 

Prepare the medication

  1. Wash your hands.
  2. Check the label for the correct medication and expiration date.
  3. Remove the soft metal or plastic cap protecting the rubber stopper on the medicine bottle.
  4. Clean the rubber top with an alcohol swab.
  5. Take the syringe out of the package and be sure the needle is screwed on tightly.
  6. With the cap still on the needle, pull back the plunger to fill the syringe with air equal to the amount of medicine that you want to give.
  7. Remove the cap from the needle – do not touch the needle.
  8. Lay the needle cap on its side to keep it clean.
  9. Have the bottle of medicine sitting on the table.
  10. Push the needle straight into the bottle of medicine (90 degree angle).
  11. Push the air in the syringe into the bottle.
  12. Turn the bottle of medicine upside down with the needle still in it.
  13. Be sure the tip of the needle is completely covered with medicine.
  14. Pull back on the syringe with the correct dose of medicine.
  15. Keep the bottle upside down – flick the syringe to move the major air bubbles to the top of the syringe so you can push them back into the bottle.
  16. Remove the needle from the bottle.
  17. Slide needle into the cap (nurse will demonstrate).
  18. Check again to be sure you have the correct dose of medicine in the syringe.


Now it is time to inject the patient

  1. Explain to the patient what you are going to do, even if you do not think they can hear you.
  2. Uncover the area to be injected.
  3. Clean the skin with an alcohol swab and allow to air dry.
  4. Take the cover off the needle.
  5. Hold the needle like a pencil or a dart.
  6. Grasp the skin between thumb and index finger.
  7. Quickly thrust needle all the way into the skin (like a dart action).
  8. Do not press down on the plunger while putting the needle through the skin.
  9. After the needle is all the way into the skin grasp the syringe near its base to stabilize it.
  10. Pulling back gently on the plunger and be sure no blood returns.  (If blood does return, pull the needle out of the skin, change needles and use a different site for the injection.)
  11. If no blood returns push the plunger in at a slow rate to inject the medicine.
  12. Pull the needle out of the skin.
  13. With one hand, press 2x2 gauze or alcohol swab over the site -- apply a little pressure.
  14. It is not unusual to see a drop of blood or a little clear fluid at the site.
  15. Do not recap the needle.
  16. Put the used syringe and needle into a proper disposal container. (Either a coffee can or other container that the needle cannot poke through – a bleach bottle can also work.)


Special instructions

  • ·Always be sure to have the correct medication.
  • ·Hold the needle (like a dart) at about a 90 degree angle unless on a child or very thin person - then use a 45 degree angle. 
  • Ask your nurse about suggested locations to give the intramuscular injections.
  • Sites that can be used for intramuscular injections are: 
    • Outer side of upper arm – into the deltoid muscle
    • The side of the thighs
    • The buttocks – upper outer quadrant
  • Choose a site that is not red or infected.
  • Do not give into a scar or into a very bony area.
  • Rotate where you give the injections. Move at least 2 inches away from where you gave the last injection. 
  • Report any unusual reaction or redness to your nurse.


Adapted from: Harkreader, H., & Hogan, M.A. (2007).  Fundamentals of nursing: Caring and clinical judgment. St. Louis: Saunders