![]() Refer to the "Safety Checks for Acquiring Medications from a Medication Dispensing Device" video. Upon entering the medication preparation area (this area may be in a secured room or in a secured portion of the nurses' station), complete the first safety check of the five "rights" of medication administration. Vigorous friction for at least 20 s should be applied while washing the hands with soap and warm water or while applying hand sanitizer.ĥ. ![]() To learn about these five "rights" in detail, please refer to the video entitled "Safety Checks for Acquiring Medications from a Medication Dispensing Device." Remember to wash or sanitize your hands before and after each patient encounter. ![]() Adherence to the five "rights"-right patient, right medication, right dose, right route, right time-at the three checkpoints of the safe medication administration process is imperative to prevent patient injury and harm. Avoid administering IM injections into the dorsogluteal muscle, because this location is associate with an increased risk of hitting a blood vessel, nerve, or bone.Ĥ.Infants should receive all IM medications in the vastus lateralis because it is the largest muscle at that developmental age.Many providers consider the ventrogluteal muscle to be the preferred site for IM injections, due to the large muscle mass and the increased absorption when volumes larger than 2 mL are injected in the area. The gluteal site is commonly used to administer antibiotics, or any medication with a volume exceeding 2 mL but less than 3 mL for an adult. However, up to 1 mL of any medication may be administrated to this muscle (the maximum volume should never exceed 2 mL). The deltoid site is mostly commonly used for immunizations. Injections sites in the hip area, such as the gluteal muscles, are preferred for the administration of larger volumes of medications, while small volumes can be given to the arm, in the deltoid muscle.Select the most appropriate site for IM injection depending, upon the type of medication being delivered. In the case of IM injections, you should be particularly aware of the patient's preference for an injection site and administration process ( i.e., whether the patient prefers a particular site and whether he/she prefers you to count down to administration or to swiftly administer the medication).ģ. All this information can be obtained through discussion with the patient and by reviewing the Medication Administration Record (MAR) at the patient bedside.Ģ. Similar to any other route of administration, preparing and administering IM medications requires the nurse to be knowledgeable about the patient's medical history, medication allergies, and preferences, as well as on the previous administration times, adverse effects, and purpose of the medication. This video will focus on the essential steps that every nurse should follow in order to correctly prepare and administer an IM injection.ġ. It is best to avoid administering IM injections into the dorsogluteal muscle, because this location is associated with an increased risk of hitting a blood vessel, nerve, or bone. The sites that are most commonly utilized for IM injections include the deltoid muscle of the shoulder the vastus lateralis of the thigh and the ventrogluteal, gluteus medius, or dorsogluteal muscles of the hip. Also, if the patient has already received this injection, it is necessary to verify the injection site that was previously used and to ensure that the previous dose did not result in any adverse reactions. In addition, specifically for IM injections, it is important to assess the patient's muscle mass to determine the appropriate needle size. Some examples of medications that are commonly delivered by IM injections include antibiotics, hormones, and vaccinations.Īs in any other route of administration, the nurse must consider if the medication is appropriate, given the patient's medical conditions, allergies, and current clinical status. IM injections are recommended for patients unable to take oral medications and for uncooperative patients. Skeletal muscles have fewer pain-sensing nerves than subcutaneous tissue, which allows for the less painful administration of irritating drugs ( e.g., chlorpromazine, an anti-psychotic). Since muscle fibers are well perfused, this route of administration provides quick uptake of the medication and allows for the administration of relatively large volumes. Intramuscular (IM) injections deposit medications deep into the muscle tissue. Source: Madeline Lassche, MSNEd, RN and Katie Baraki, MSN, RN, College of Nursing, University of Utah, UT
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