Intramuscular Injection in Deltoid Muscle with Z-Track Technique

Summary

This video demonstrates the proper technique for administering an intramuscular (IM) injection in the deltoid muscle. The process includes reviewing facility protocols, ensuring the right patient, medication, dose, and route, as well as preparing necessary supplies. The video explains key steps such as selecting the correct needle size, finding the deltoid muscle using landmarks, cleaning the injection site, and performing the Z-track technique for less pain and proper medication delivery. The video also discusses safety precautions, including the importance of hand hygiene, gloves, and accurate documentation.

Takeaways

• 😀 Always review your facility's protocol before administering any medication, including IM injections.
• 😀 Verify the right patient, medication, dose, time, and route before proceeding with the injection.
• 😀 The deltoid muscle is a small muscle, capable of holding only 1-2 milliliters of solution for an IM injection.
• 😀 Choose a needle length of 1 to 1.5 inches for deltoid injections, depending on the patient's body composition.
• 😀 Use a 20-25 gauge needle, with a 23 gauge being optimal for most vaccines.
• 😀 Gloves are optional unless there is a risk of exposure to body fluids, but it's recommended to wear them for safety.
• 😀 Explain the procedure to the patient, and ask if they are right- or left-handed to minimize post-injection discomfort.
• 😀 Always relax the patient's arm to prevent muscle tension and reduce injection pain.
• 😀 Use anatomical landmarks (like the acromion process) to identify the correct injection site in the deltoid.
• 😀 Clean the injection site with an alcohol swab, moving from the center outward, and allow it to air dry before injection.
• 😀 Employ the Z-track technique to decrease pain and ensure the solution stays in the muscle, not in the subcutaneous tissue.
• 😀 Inject the medication slowly, taking about 5-10 seconds per milliliter, and wait a few seconds after injection to ensure proper absorption.
• 😀 Never recap used needles and always engage the safety mechanism after use to avoid accidental injury.
• 😀 After the injection, apply gauze to the site and dispose of the needle and syringe properly in a sharps container.
• 😀 Document the injection details, including the muscle used, the amount administered, and how the patient responded.
• 😀 Aspiration (pulling back on the syringe plunger) is no longer required for IM injections as per CDC guidelines.

Q & A

What is the first step before administering an intramuscular injection?

The first step is to review your facility's protocol to ensure you're following the correct procedures for administering the medication.

What are the key factors to verify before giving the injection?

You should verify that you have the right patient, the right medication, the correct dose, and the right time and route of administration.

Why is it important to assess the patient's body type before administering an injection?

The patient's body type determines the needle length to use. For example, if the patient has more fatty tissue, you may need a longer needle to ensure the medication reaches the muscle.

How do you determine the correct needle size for a deltoid injection?

Generally, a 1-inch needle is recommended, but if the patient has more adipose tissue over the deltoid, a 1.5-inch needle may be necessary.

What gauge needle is typically used for deltoid injections?

A 23-gauge needle is commonly used for deltoid injections, though a 20-25 gauge can also be appropriate depending on the viscosity of the solution.

Is it necessary to wear gloves when administering an intramuscular injection?

According to CDC guidelines, gloves are not required when administering vaccines unless you may come into contact with potentially infectious body fluids or have open cuts on your hands. However, wearing gloves is recommended for added safety.

What is the Z-track technique, and why is it used?

The Z-track technique involves pulling the skin to the side before injecting the needle. This technique prevents the medication from leaking into the subcutaneous tissue and reduces discomfort for the patient.

What angle should you insert the needle for a deltoid injection?

The needle should be inserted at a 90-degree angle to the skin to ensure proper placement into the muscle.

How long should you wait after injecting the medication before withdrawing the needle?

You should wait about 10 seconds after injecting the medication to allow the fluid to fully absorb into the muscle.

Why is aspiration not recommended before administering a deltoid injection?

Aspiration is no longer recommended because large blood vessels are not present at the recommended injection sites like the deltoid. Aspiration can also increase discomfort for patients.