Usually no more than 5 mL of medication is injected for an adult and 3 mL for
a child. If the prescriber orders a higher dose, divide the dose into two syringes.
Choose an injection site based on the size of the muscle with a minimum
number of nerves and blood vessels in the area. These sites are:
- Ventrogluteal (hip)
- Dorsogluteal (buttocks)
- Deltoid (upper arm)
- Vastus lateralis (front of thigh)
See Table 6-1 for more details.
Intramuscular injections use a 20 to 23-gauge needle that is 1 to 1.5 inches in
length and a 1 to 3 mL syringe that is calibrated with 0.5 mL to 1.5 mL.
Here’s how to administer medication intramuscularly:
- Check the prescriber’s medication order.
- Wash hands and then put on clean gloves.
- Properly identify the patient.
- Cleanse the area of the site in a circular motion, using using alcohol or
betadine as per the agency guidelines. - Flatten the skin at the injection site using your thumb and index finger.
- Insert the needle at a 90-degree angle into the muscle between your thumb
and index finger. - Release the skin.
- Slowly inject the medication.
- Quickly remove the needle.
- Gently massage the area (unless this is contraindicated by the medication).
Z-Track Injection Technique
The Z-Track inject technique is used to prevent medication from leaking back in
the subcutaneous tissue after the medication has been injected into the patient.
This technique is used whenever the medication—such as dextran (iron)—might
cause a visible and permanent skin discoloration. The gluteal muscle is the pre-
ferred site for a Z-Track injection.
Here’s how to administer medication using the Z-Track technique:
- Check the prescriber’s medication order.
- Wash hands and then put on clean gloves.
CHAPTER 6 Route of Administration^107