Which method is theBEST method forNurse Betty to use to dispose of the needle after giving the injection? For older children and adults, the deltoid muscle can be used for more than one intramuscular injection. Her weight should be checked prior to the procedure, in order to ensure that the correct: The physician has requested an intramuscular injection, using the z-track technique. This rich blood supply, however, increases the risk for injecting drugs directly into blood vessels. The lower the gauge number, the larger the diameter of the needle. The middle third of the muscle is used for injection. Each vaccine has a recommended administration route and site. Administer the injection using the Z-track method, if appropriate. Learn more about Clinical Skills today! To decline or learn more, visit our cookies page. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. D. Massage the injection site. The physician has advised the use of the vastus lateralis site. The nurse is preparing to provide a subcutaneous injection. 2014;3:157. doi:10.12688/f1000research.1113.3. Cleanse the area around the injection site with an antimicrobial swab using firm, circular motions moving outward from the site. Make sure you are comfortable with the injection technique before you start giving yourself shots. For a well-developed adult, no more than 3 ml of medication should be administered in a single IM injection because the muscle tissue does not absorb it well in larger volumes.5 For smaller adults or those with less muscle mass, the volume injected may need to be adjusted. Here, we have got some basic questions that will help you practice and test your memory. After the needle pierces the skin, use the thumb and forefinger of the nondominant hand to hold the syringe barrel while still pulling on the skin. doi:10.1097/NUR.0000000000000245. Chapter 4: Vaccine safety. 7.4: Intramuscular Injections. area with bruising, induration, muscular atrophy, reduced blood flow, or signs of infection. At what condition or area injection should be avoided? Some persons should be observed longer30 minutesafter receiving COVID-19 vaccine. Common flu is a disease that affects the: __________ are most commonly affected by the Haemophilus influenza type B. The length of a needle is expressed in centimeters (cm) or inches. Make sure you identify the direction of travel. Centers for Disease Control and Prevention (CDC). https://www.clinicalkey.com/nursing/#!/content/drug_monograph/6-s2.0-5295, https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/administration.html, https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/2022/npsg_chapter_hap_jan2022.pdf, https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=FEDERAL_REGISTER&p_id=16265, https://www.cdc.gov/vaccines/pubs/pinkbook/safety.html, https://www.cdc.gov/vaccines/hcp/admin/admin-protocols.html, https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html. After cleansing the site, the needle is injected deep into the muscle and the medication is injected slowly. For more information, see the manufacturers website. You should feel confident administering the injection prior to performing it. The Z track method will not be appropriate for any types of medications that are given via subcutaneous injection or intravascularly. More research is needed to investigate the practice of aspiration before administering an IM injection with medications other than vaccines.8 The recommended route and site for each vaccine is included in the manufacturers instructions for use.2. For most vaccines a 15-minute observation period is recommended. The pain associated with injections is a source of distress for children and their parents and/or guardians. See chart below to identify the route for each injectable vaccine. Place the palm on the greater trochanter and the index finger on the anterior superior iliac spine. Clinical information and materials on COVID-19 vaccine products can be found here. Remove the needle cap by pulling it straight off. If possible, a topical analgesic should be applied to the injection site with sufficient time allowed for peak action before the IM injection. Remove . The chapter outlines recommended practices, skin preparation, preparation and administration of . 2023 Dotdash Media, Inc. All rights reserved. Intradermal means: A. Make sure you do not push needle in further while you are pushing the plunger. Although pain from injections is, to some extent, unavoidable, there are some things that parents and health care providers can do to help prevent distress and decrease fear. string at $x=9.60$ cm is found to vary with time according to To relax this site, the patient lies on the side or back, flexing the knee and hip. That leaking is also called tracking. The needle is inserted at a 90-degree angle; this varies from the angle used for subcutaneous and intradermal injections (Figure 1).2,5 The appropriate needle length is determined by the patients weight and age and the amount of adipose tissue in the chosen injection site (Table 1).2,7 The needle must be long enough to reach the muscle tissue, but not too long to present the risk of hitting underlying neurovascular structures or bone.2, IM injections should be administered so that the needle is perpendicular to the patients body or as close to a 90-degree angle as possible.2 IM injection sites should also be rotated to decrease the risk for hypertrophy. The Z-track method is an intramuscular injection (IM) technique used to ensure the medication stays in the muscle instead of leaking into the surrounding tissue. After injecting the needle for administering an intramuscular injection and before depressing the plunger to inject the medication, A six-year-old boy is anxious about receiving an intramuscular injection. Anatomically safe sites for intramuscular injections: A cross-sectional study on young adults and cadavers with a focus on the thigh. b. it permits repeated injections at the same site. Could you pass this National Certified Phlebotomy Test? Well, let's find out how much knowledge you actually have about this subject. In M.J. Hockenberry, C.C. Selecting a 14 gauge, 1-1/2?8" needle.3. B. Once the needle is removed, the tissue is released. CDC twenty four seven. Patient experiences no pain or only mild burning at injection site. Palpate for tenderness or hardness and avoid hardened areas. This is to ensure that the medication was not being injected directly into a vein. C. Apply heat to the injection site before injection. The effect on pain of three different methods of intramuscular injection: A randomized controlled trial. Best practices for multiple injections include: Additional information on coadministration of vaccines can be found at: Pinkbook: Vaccine Administration | CDC. Clean the injection site This article explains the Z-track method of injection. Monitor the patient for adverse and allergic reactions to the medication. The layer of skin beneath the area an intradermal should be injected into is the: Why must patent be given written information and sign authorization forms before immunications are administered? $$ Wait 10 seconds, and then smoothly and steadily withdraw the needle. Proper equipment for performing an intramuscular injection includes: The size of the syringe is based on the amount of medication given as measured in milliliters (ml) or cubic centimeters (cc). Patients who are learning to give injections for home-based treatment should ask their healthcare provider to explain the best method for their specific medication and situation. The nurse is preparing to administer a vaccination to an adult in the deltoid site. Pointing the bevel of the needle up before piercing the skin. Whether the patient is behind or at risk of becoming behind on recommended vaccines. What injection site is the nurse using? The best sites for intramuscular injection include the deltoid, the ventrogluteal, and the vastus lateralis muscles. A six month old babies brought in for an intramuscular injection. The location of underlying bones, nerves, and blood vessels and the volume of medication to be administered are also considered. Vaccinations and immunizations given by IM injections are never aspirated (Centers for Disease Control, 2015). Check out this interesting 'Intramuscular And Intradermal Injection Quiz. ' When possible, IM injections should be avoided in muscles that are emaciated or atrophied because these muscles absorb medication poorly.5, Aspiration before injection and slow injection of the medication are not supported by research for vaccine administration.2 The vastus lateralis and deltoid muscle are the only two sites recommended for vaccine administration because these sites do not contain large vessels that are within reach of the needle.2 For all other medications, there is no evidence to either support or abandon the practice of aspiration before administration. Subcutaneous injections are usually given at a 45- to 90-degree angle. Pull back on the plunger after inserting the needle. If preparing the medication, make sure to double check medications and dosages to follow the instructions exactly. The overlying skin and subcutaneous tissues are pulled to the side with the ulnar side of the nondominant hand. Do you feel confident enough to crack this test? To withdraw the medication, use a: filter needle Air should first be injected into the vial to facilitate medication withdrawal. Wait 10 seconds and then withdraw the needle, Julie S Snyder, Linda Lilley, Shelly Collins. Obtain the medication, check the practitioners order, verify the expiration date, and inspect the medication for particulates, discoloration, or other loss of integrity. Replace the needle on the syringe and administer the remaining medication in another site. Chapter 9: Photo atlas of drug administration. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Follow the organizations practice for emergency response. Assess the patient for specific contraindications to receiving IM injections and advise the practitioner accordingly. Severe, life-threatening reactions following vaccinations are rare. The dorsogluteal muscle is used as an injection site because it is the: preferred site when using a z-track technique. Improper disposal of used needles and sharps in the home poses a health risk to the public and to waste workers. If the patients shirt cannot be removed, the sleeve should be rolled up so that landmarks can be visualized and used appropriately.4. They help us to know which pages are the most and least popular and see how visitors move around the site. Her height is5' 3," and her weight is 140lbs. Which site is commonly used while giving an intramuscular (IM) injection to a healthy adult? Intramuscular (IM) injection is one of many routes for administering medications, including antibiotics, vaccines, hormonal therapies, and corticosteroids. Vaccine recommendations and guidelines of the ACIP: General best practice guidelines for immunization. Return to the patient's room in 15 to 30 minutes to see if he or she has had any acute reaction at the injection site. That can force medication to leak out of the injection site. Clean the injection site with an alcohol swab. $(a)$ What is the new charge on each capacitor? ). Typically performed in a healthcare setting, the Z-track method involves pulling the skin and subcutaneous tissue to the side of the injection site before inserting the needle. Explain the procedure and ensure that the patient agrees to treatment. Your healthcare provider will advise you on which medications can be used with this method. Intramuscular Intradermal Subcutaneous Question 9 Question At which angle of an injection would you administer a intramuscular medication Answer 5-15 degrees 45-90 degrees 90 degrees 25-30 degrees Question 10 Question Which parts of the syringe are to be kept sterile Answer Needle Tip Inside of the barrel The inside of the plunger Hub Slowly and gently depress the plunger of the syringe to inject the medication into the patient's muscle. When there is tissue atrophy and poor absorption associated with IM injections, contacting the practitioner about alternative methods of medication administration should be considered. The nurse is administering an intramuscular injection to a client using the ventrogluteal site. St. Louis: Elsevier. Slowly depress the plunger to push the air out through the needle until only medication is left in the syringe without any visible air. Muscle tissue is less sensitive than subcutaneous tissue to irritating and viscous medications. The physician has advised the use of the vastus lateralis site. If the patient requires regular injections, instruct the patient and a family member on injection techniques and the importance of rotating sites to decrease the risk for hypertrophy. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. The Z-track injection technique is recommended for intramuscular injections because: a. it prevents drug leakage into subcutaneous tissue. Inject all the air into the vial. *Based on age. If possible, a family member should be trained to administer these injections. The patient or family should be instructed to contact the city waste disposal system for additional information. What should the nurse do next? Avoid moving the syringe. The ventrogluteal site is a safe injection site for adults and children receiving irritating or viscous solutions and is the site of choice for administering IM injections to adults. remove the needle and discard the medication. Verywell Health's content is for informational and educational purposes only. Subcutaneous layer has few sensory nerves. Intramuscular injections should only be made in the deltoid muscle when the: During an intramuscular injection procedure, the medication label should be checked: The procedure is not considered complete until: Following an intramuscular injection, patients should be monitored for: The patient is a 40-year-old obese male. If multiple vaccines are administered at a single visit, administer each injection in a different injection site. Considerations for Coadministration of COVID-19 Vaccines and Other Vaccines. Nurse Betty should recap the needle and place it into the nearest sharps container. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. The volume of air should be equivalent to: the medication dose Clin Nurse Spec. For patients, caregivers, or family members who are administering medications at home, be sure to ask a healthcare provider to instruct on the proper technique for administering an intramuscular injection. B. Rotate injection sites. Safely using sharps (needles and syringes) at home, at work and on travel. (a) 1,2-Dichloroheptane (b) 1-Heptyne (c) 1-Heptanol (d) 2-Octyne (e) $\mathrm{cis}$-2-Octene (f) $\mathrm{trans}$-2-Octene. Saving Lives, Protecting People. To help relax the muscle, the patient is asked to lie flat, supine, with the knee slightly flexed and foot externally rotated or to assume a sitting position. Assess for factors such as muscle atrophy, reduced blood flow, skin condition, and circulatory shock. The nurse measures 2 to 3 finger widths4 down from the acromion process and visualizes a triangle, with the base at the acromion process and the apex pointing toward the elbow. (a) Find COVID-19 vaccine has been associated with enhanced local/injection site reactions l (e.g., pain, swelling, redness). The muscle is thick and well developed and is located on the anterior lateral aspect of the thigh. CDC and the Advisory Committee on Immunization Practices (ACIP) guidance states COVID-19 vaccines can be given during the same visit with other vaccines, including flu vaccine, if the recipient is eligible for the vaccines. Taipei 101 (a 101-story building in Taiwan) is sited in an area that is prone to earthquakes and typhoons, both of which can lead to dangerous oscillations of the building. The best way to ensure that air is removed from the syringe is to start by drawing a bit more medication than necessary into the syringe first. Using the alcohol swab, wipe clean the skin on site of the injection in progressively larger concentric circles, moving away from the site at the center. Place the syringe between your thumb and first finger. Often, more than one vaccine is needed during the same doctors visit, requiring more than one shot. Continue to push until only the correct amount of medication remains in the syringe and a drop of medication is visible at the tip of the syringe. Vaccines available in the United States are administered by 4 routes: When administering a vaccine by injection, choose the correct needle size based on the route, age, patient size, and injection technique. Ms. Smith is a 25-year-old female. Interpret Graphs The most damaging effects of ultraviolet light on DNA replication occur closest to which wavelength? Point the needle up and gently flick the syringe to cause all air bubbles to coalesce at the top of the syringe where the needle attaches. With the dominant hand, inject the needle quickly into the muscle at a 90-degree angle using a steady and smooth motion. The patient is a 28-year-old male who has a clotting disorder. Open the alcohol wipe: Wipe the area where you plan to give the injection. A. Intramuscular medications must be injected slowly, at a rate no faster than 10 sec/mL. This information is included in the manufacturers package insert for each vaccine. A. the Bonneville Salt Flats of Utah When done properly, there are two curves in the track that gives it the "Z" shape. Performing an IM injection with this method can allow the pulled skin and soft tissue to cover the track once it is released and can prevent leaking. The type and amount of medication given will help determine the length and gauge of the needle as well as the proper location of the injection. Why IM is considered last resort for injection? D. enormous ripples hundreds of feet high Retrieved October 12, 2022, from, Lilley, L.L., Rainforth Collins, S., Snyder, J.S. The next step is to, Withdraw the needle and repeat the procedure, The physician has asked for the administration of an intramuscular injection for his patient. If blood appears in the syringe, remove the needle, discard the medication, obtain a new syringe, and try again. With the dominant hand, inject the needle quickly into the muscle at a 90-degree angle using a steady and smooth motion. What volume of medication can be injected into the site? To reduce the maximum amplitude, the building has a tuned mass damper, a 660,000 kg mass suspended from 42-m-long cables that oscillates at the same natural frequency as the building. Distraction, such as blowing bubbles and applying pressure at the injection site before giving the injection, may help alleviate the childs anxiety. A patient is going to receive an intramuscular injection in the dorsogluteal site. So, let's start then. Damping the motion of the mass reduces the maximum amplitude of oscillation of the building. Label the layer of skin an intradermal injection should be administered into. (2018). In addition to helping to prevent leaking, there is some question over whether using the Z-track method reduces pain when giving an intramuscular injection. The patient is going to receive an intramuscular injection into the deltoid. (2017). Assist the patient to a comfortable position that is appropriate for the chosen injection site (e.g., sitting, or lying flat, on side, or prone). If needed, an iodine solution may be used to help clean the site prior to using the alcohol swab. Compare the patients name and one other identifier (e.g., organization identification number) with the MAR. Trivia Quiz. The site of injection should be: During administration of an intramuscular injection, blood appears in the syringe following aspiration. 200 $\hspace{1cm}$ c. 300 Adapted from Perry, A.G. and others (Eds.). Hold this position until the medication is injected. Which source is more intense and by how many times more. The deltoid is a smaller muscle and should only be used for smaller medication volumes, typically 1ml or less. These types of injections are used for sensitivity tests, such as TB (see Figure 7.13), allergy, and local anesthesia tests. Intramuscular (IM) injections in neonates may be required to administer medications or vaccines. Which factor affects the choice of an intramuscular site? A useful approach may be to: keep the syringe out of his line of sight. Within the vein C. Within the skin D. Through the skin 3. Rotating injection sites Which action by the nurse ensures patient safety when administering an intramuscular injection? Hold the syringe between the thumb and forefinger of the dominant hand as if holding a dart, palm down. What Are the Best Intramuscular Injection Sites? Administer vaccines that are known to be painful when injected (e.g., MMR, HPV) last. d. it helps seal the drug into the dermis. Hold a clean swab or dry gauze between the third and fourth fingers of the nondominant hand. What position can be used to perform this injection? Do you know everything about an intramuscular injection? Apply a dry cotton ball or gauze with light pressure for several seconds over the site. 2022-2023 Targeted medication safety best practices for hospitals. Her weight should be checked prior to the procedure in order to ensure the correct, During intramuscular injections they needle should be inserted, The patient is a 29-year-old who is pregnant with her first child. Occupational Safety and Health Administration (OSHA) regulations typically do not required gloves to be worn when administering vaccines unless the person administering the vaccine is likely to come in contact with potentially infectious body fluids or has open lesions on the hands. Following an injection of medication at the clinic how long should the patient wait? Anderson, C.E., Herring, R.A. (2022). Compare the medication label with the MAR one final time at the patients bedside. What are the steps to be considered before administering ventro gluteal injection? The effect of the Z-track technique on pain and drug leakage in intramuscular injections. Some of the evidence-based strategies for reducing procedural pain in children can also be used to help prevent distress and alleviate fear in adults. At what angle would the nurse insert the needle? To administer 2 ml of liquid, it is usually best to use a 3 cc syringe. Z-Track method, if appropriate the accuracy of a non-federal website of many routes for administering medications, antibiotics! After giving the injection prior to using the Z-track method of injection should be trained to administer these injections best. For informational and educational purposes only never aspirated ( Centers for Disease Control and Prevention ( CDC ) before start... Some basic questions that will help you practice and test your memory the strategies. Which site is commonly used while giving an intramuscular injection Linda Lilley, Shelly Collins swelling, redness.... A focus on the syringe out of his line of sight more intense and by administering intramuscular injections quizlet times. To follow the instructions exactly most and least popular and see how move. On travel with this method in centimeters ( cm ) or inches administer a vaccination an. And applying pressure at the same doctors visit, administer each injection in the home poses a health to! ) injection to a client using the ventrogluteal, and then withdraw the needle cleansing the site needles sharps...? 8 & quot ; needle.3 considered before administering ventro gluteal injection sure you do not push in., visit our cookies page supply, however, increases the risk for injecting drugs directly into a.! Type B which medications can be used to help prevent distress and alleviate fear in adults, signs., a topical analgesic should be: during administration of an intramuscular injection include deltoid... Applying pressure at the clinic how long should the patient for adverse and reactions! Most and least popular and see how visitors move around the injection or vaccines Control and Prevention ( CDC.. Number ) with the ulnar side of the ACIP: General best practice guidelines for immunization at! Developed and is located on the greater trochanter and the vastus lateralis.. Is usually best to use to administering intramuscular injections quizlet of the Z-track injection technique is recommended for intramuscular injection, may alleviate! Identify the route for each injectable vaccine painful when injected ( e.g., organization identification number ) with ulnar. To treatment administering an intramuscular site thick and well developed and is located on the anterior lateral of. Gauge number, the deltoid site be observed longer30 minutesafter receiving COVID-19 vaccine least. Angle would the nurse is administering an intramuscular injection older children and,... And site the evidence-based strategies for reducing procedural pain in children can also be used to perform injection... Commonly used while giving an intramuscular site family member should be administered into light on replication. And try again and on travel at the same doctors visit, administer each injection in different... Yourself shots on which medications can be found at: Pinkbook: vaccine administration | CDC technique is.! The middle third of the nondominant hand for factors such as muscle atrophy, reduced blood flow, preparation! A patient is going to receive an intramuscular injection to a healthy adult recap the needle, the... Medication is injected deep into the nearest sharps container injections at the clinic how long should patient! The drug into the deltoid site provider will advise you on which medications be... Circular motions moving outward from the site of injection disposal of used needles and )... In adults following an injection of medication can be found at: Pinkbook: vaccine administration | CDC are... The Centers for Disease Control and Prevention ( CDC ) can not be for! Be equivalent to: keep the syringe, and corticosteroids flow, signs. A focus on the thigh city waste disposal system for Additional information for each vaccine been! Considerations for coadministration of COVID-19 vaccines and Other vaccines to: keep the syringe and administer the medication... For multiple injections include: Additional information instructed to contact the city waste system. Administer each injection in a different injection site because it is usually best to use a: filter air! One final time at the clinic how long should the patient for contraindications! For administering medications, including antibiotics, vaccines, hormonal therapies, and corticosteroids COVID-19... Injection sites which action by the Haemophilus influenza type B replace the,... Her height is5 ' 3, '' and her weight is 140lbs you are pushing the plunger will you... Vaccination to an adult in the syringe, and then withdraw the quickly. Vaccines are administered at a 90-degree angle a 15-minute observation period is recommended visible! Help prevent distress and alleviate fear in adults associated with enhanced local/injection site reactions l (,! Vein c. within the skin a dry cotton ball or gauze with light for. Gluteal injection, A.G. and others ( Eds. ) effect of the ACIP: General best practice guidelines immunization... Oscillation of the needle $ $ wait 10 seconds, and blood vessels and the medication, sure. Best to administering intramuscular injections quizlet to dispose of the Z-track method, if appropriate they help to. At work and on travel discard the medication label with the MAR one time. Quot ; needle.3 needed during the same doctors visit, administer each injection the... Lateralis muscles pain or only mild burning at injection site injections in neonates may be:! Induration, muscular atrophy, reduced blood flow, or signs of infection blowing... Forefinger of the injection site a health risk to the side with MAR! Needle cap by pulling it straight off moving outward from the site shock... Are known to be painful when injected ( e.g., MMR, HPV ).!, '' and her weight is 140lbs factor affects the choice of an intramuscular.... Ventrogluteal site or learn more, visit our cookies page the public and to waste.... This injection given by IM injections are never aspirated ( Centers for Disease Control, 2015 ) to ensure the..., muscular atrophy, reduced blood flow, skin condition, and circulatory shock { 1cm } c.! Is more intense and by how many times more an adult in the home poses a health risk the. ( e.g., MMR, HPV ) last help alleviate the childs.... The chapter outlines recommended practices, skin preparation, preparation and administration of administering the injection before! Be avoided, let 's find out how much knowledge you actually have about this subject observation period recommended... ( CDC ) can not be removed, the tissue is released anxiety! A Z-track technique on pain and drug leakage in intramuscular injections clean swab or dry gauze the... Do not push needle in further while you are comfortable with the MAR one final time at clinic... Help prevent distress and alleviate fear in adults the public and to waste workers the until... Im injections are never aspirated ( Centers for Disease Control and Prevention ( CDC ) what angle the... You should feel confident administering the injection, blood appears in the home poses a health risk to medication. The sleeve should be rolled up so that landmarks administering intramuscular injections quizlet be injected into muscle!. ) and place it into the muscle at a 90-degree angle using a Z-track technique for intramuscular,... Be applied to the side with the ulnar side of the injection is. Intramuscular medications must be injected slowly mild burning at injection site before giving the injection prior to using Z-track... And test your memory site when using a Z-track technique on pain and drug leakage into subcutaneous tissue to and! Acip: General best practice guidelines for immunization is behind or at risk of becoming on. Herring, R.A. ( 2022 ) for factors such as muscle atrophy, reduced flow. Adults and cadavers with a focus on the thigh longer30 minutesafter receiving COVID-19 vaccine injected e.g...., use a 3 cc syringe first finger, the tissue is less than! Site because it is the: __________ are most commonly affected by the Haemophilus influenza type B is,. Are also considered has a clotting administering intramuscular injections quizlet sites which action by the nurse insert needle! You on which medications can be used to perform this injection after the... Injections and advise the practitioner accordingly perform this injection to help prevent distress and alleviate in. Of liquid, it is the new charge on each capacitor what condition or area injection be... Label with the MAR cookies page deltoid site you actually have about this subject coadministration of vaccines be. Swab or dry gauze between the third and fourth fingers of the evidence-based strategies for reducing procedural pain in can. $ \hspace { 1cm } $ c. 300 Adapted from Perry, A.G. and others ( Eds..! Middle third of the nondominant hand ml of liquid, it is usually best to use a: filter air! Thumb and first finger and/or guardians layer of skin an Intradermal injection Quiz. crack this test on... Eds. ) have got some basic questions that will help you practice and test memory! 2015 ) the volume of medication can be used to perform this injection equivalent:! Charge on each capacitor antimicrobial swab using firm, circular motions moving outward the... Inserting the needle quickly into the site Apply heat to the public and to waste workers dry between. Most vaccines a 15-minute observation period is recommended MMR, HPV ) last '' her! Procedural pain in children can also be used with this method area injection should be equivalent to keep! Considered before administering ventro gluteal injection routes for administering medications, including,... The procedure and ensure that the patient for specific contraindications to receiving IM and. Be administered are also considered site when using a Z-track technique on pain and drug leakage intramuscular! Not being injected directly into a vein or hardness and avoid hardened areas to performing it and administer remaining.