What happens if an IM injection misses the muscle? Missing IM injection can cause nerve damage, a frozen shoulder, a limited range of motion, and chronic pain. The sciatic nerve injury is the most common injury of a wrong IM injection. Ensure that blood is not present in the syringe, and inject the medication slowly into the muscle.
What Are IM Injections?
Intramuscular injection, often known as IM injection, is the injection of a drug into muscle tissue. It is one of the various ways of administering medications intravenously in the medical field. As a result of the more blood arteries found in muscles, IM injections may be favored for their speed of absorption.
Deltoid and gluteal muscles of the upper arm and buttock are two common injection sites. The large lateral muscles of the thigh are frequently employed to support the weight of a newborn. Before injecting, clean the injection site, and the injection is delivered in a rapid, darting motion to minimize pain.
Equipment Required For IM injection
No. | Equipments |
---|---|
1 | Needles |
2 | Syringe |
3 | Medicines administration chart/prescription; |
4 | Receiver or tray to carry the drug |
5 | Drug for administration |
6 | Sharps container. |
Complications of poorly performed IM injection include:
-
Pain
-
Muscle fibrosis
-
Injuries to nerves and blood vessels
-
Inadvertent intravenous
-
Bleeding
-
Abscess formation
-
Cellulitis
Note: Depending on the injection location, the maximum volume injected into the muscle is generally 2–5 milliliters. It would be best if you did not use an infected or atrophying area. Patients with myopathies or clotting issues should not get intramuscular injections.
How to Administer an Intramuscular Injection?
Training in good intramuscular injection techniques should be required for anybody who gives injections. It’s important to know that several factors will influence the size and location of the needle and injection site. These factors include the patient’s age, weight, dosage, and kind of drug.
You’ll get precise instructions from your doctor or pharmacist on what needle and syringe to deliver your medicine. The needle length can safely access the nerves and blood vessels below. To ensure a safe intramuscular injection, follow these steps:
1. Wash your hands
To avoid infection, use soap and warm water to wash your hands between your fingers and on the backs of your hands, and thoroughly clean beneath your fingernails. Lathering for 20 seconds, or the time it takes to sing “Happy Birthday” twice, is the recommended amount.
2. Gather all the needed supplies
Get the following supplies:
-
Needle and syringe with medication
-
Gauze
-
Puncture-resistant container
-
Alcohol pads
-
Bandages
3. Locate the injection site
Spread the skin at the site with two fingers and target the area where the injection will be administered. Get into a comfortable posture that allows simple access to the injection site. Keep the muscles relaxed for the individual getting the injection.
4. Clean the injection site.
Clean the injection site and let the skin air dry after each injection.
5. Prepare the syringe with medication
Clean the rubber stopper with alcohol. Please take off the needle cap and place it inside the vial’s top rubber stopper. Fill the vial with air. To keep the needle clean, do not touch it. To get rid of any air bubbles, tap the syringe, then gently depress the plunger to remove them.
6. Self-inject with a syringe
Holding the needle like a dart, inject it into the muscle at a 90-degree angle to the surface of the muscle. Inserting the needle should be done in a swift yet controlled way. Do not press the plunger.
7. Inject the medication
Pushing the plunger carefully into the muscle will allow the drug to be injected.
8. Remove the needle
Remove the needle as fast as possible. Do not put the needle’s cap back on. You may purchase a red container called a sharps container at any drugstore.
9. Apply pressure to the injection site
Apply mild pressure to the injection site using a piece of gauze. Massage the affected area to absorb the drug into the muscle tissue. A small amount of bleeding can be seen. A bandage can be used if needed.
Note: Needles and syringes and other medical trash are collected in this bin. Needles may be dangerous to anybody who handles waste, so do not dispose of them with ordinary rubbish.
Everything You Need To Know About IM injections.
Needles
IM injections should be performed using a safe needle to minimize the danger of needle injuries. Measurement of needle size is done in gauges diameter. However, the viscosity of the injected liquid dictates that you should use a 21G needle.
The needles must be long enough to reach the muscle and administer the medication.
-
Muscle mass;
-
Patient’s weight;
-
Amount of subcutaneous fat.
When treating obese individuals, it may be necessary to use longer needles because women have more subcutaneous fat than males.
Nurses have traditionally been instructed to leave a few millimeters of skin to avoid needle breakage when administering an injection. It might result in subcutaneous fat delivery. Single-use needles have eliminated the necessity for this procedure.
Skin preparation
Alcohol-impregnated swabs for cleaning injection sites are controversial. Swabbing the skin isn’t necessary if the patient is healthy and clean.
Skin pretreatment using a 70% isopropyl alcohol-impregnated swab may be indicated for elderly or immunocompromised individuals. Abide by the rules in your area.
Aspiration
After the needle is placed, it is customary to draw back on the syringe to see if it is in a blood artery. The gluteal artery is close to the DG muscle location; thus, aspiration is necessary, but not for other IM injection sites.
Gloves
No gloves are required for this treatment, provided the health care professional and the patient’s skin are undamaged. According to the study, gloves do not protect against needlestick injuries. Individual patient risk assessments and knowledge of local rules on glove usage are critical to ensuring the safety of nurses.
What are intramuscular injections used for?
Modern medicine uses intramuscular injections. Drugs and vaccinations are delivered through them. Other distribution techniques are not indicated in the case of intramuscular injections. Among them are:
-
Swallowed into the stomach.
-
Injected into the vein.
-
Injected into the fatty tissue.
Because some medications irritate veins or a suitable vein cannot be discovered, intramuscular injections may be used instead of intravenous injections. Because certain medications are destroyed by the digestive system when swallowed, you may utilize them instead of administering them.
It takes longer for intramuscular injections to be absorbed than for subcutaneous injections. It is true since muscular tissue has a better blood supply than skin-deep tissue.
Where to Give the IM Injection?
Choosing the right place to administer the injection is critical to its success. Muscle is where the medication needs to go. Nerves and blood vessels can be life-threatening targets, so be careful not to injure yourself. So show your doctor so that he can choose a safe place to insert it.
Thigh:
-
The thigh is an excellent location if you’re injecting yourself or a kid under 3.
-
Look at the thigh and divide it into three equal portions in your mind.
-
Inject the medicine into the thigh muscle near the midline.
Hip:
-
Adults and toddlers over seven months can receive an injection through the hip.
-
Put them on their side. With your hand, hold yourself into this spot between the thigh and lower back. Thumbs and fingers should be pointing toward each other.
-
V-shape with your index finger by pulling it away from the other fingers. You may feel the bone’s edge on the first finger.
-
Between your first and middle fingers, inject the solution.
The biceps:
-
If you can feel the muscle in your upper arm, you can utilize it. Only utilize this site if you’re skinny or have very little muscle.
-
The upper arm may now be seen. This muscle creates an upside-down triangle at the bone that runs across the upper arm.
-
The triangle’s apex is located just below the level of the armpits.
-
This should be 2.5 to 5 centimeters (about 1 inch) below the tibia or femur.
Buttocks:
-
Children should not use this site since it lacks sufficient muscle. If an injection is administered in the wrong spot, it might harm a nerve or blood artery.
-
Draw a line upward in a straight line to the top of the hip from the bottom of the buttocks. Draw a line to the side of your hip from the top of the buttock crack. This box is split into four halves by these two lines.
-
Inject the drug just beneath the curved bone on the outside of the buttocks.
The Importance of Injecting Vaccines into Muscle
One should administer most vaccinations intramuscularly into the deltoid or anterolateral thigh. It improves vaccination immunogenicity and reduces injection site responses. The needle length and gauge used in clinical practice must be considered to ensure that people vaccinated acquire the immunological advantage of the vaccinations.
A standard needle size does not ensure effective intramuscular injection. Health care practitioners should have access to various non-fixed needles (pre-filled syringes with a needle fixed to the barrel).
Injecting vaccines into the layer of fat is a cause of vaccination failure. It leads to shoulder injury related to the vaccine. Subcutaneous hepatitis B vaccine injection had lower seroconversion rates and faster antibody degradation than intramuscular injection.
When To Call Doctor After IM Injections?
An intramuscular injection is usually followed by some soreness, which is expected. On the other hand, specific symptoms may indicate a more severe problem. You need to know what happens if you give an IM injection wrong. Contact your doctor or health care professional immediately if you encounter any following symptoms.
No. | Symptoms |
---|---|
1 | Pain at the injection site |
2 | The injection site is redness, edema, or warmth. |
3 | Tingling or numbness in the hands or feet |
4 | Drainage at the injection location |
5 | Allergic reactions, |
6 | Prolong bleeding. |
Summary
You may have anxiety before administering or getting an intramuscular injection. Read through the instructions numerous times until you are familiar with the technique, and take your time with the process overall.
Alternatively, you may request that your doctor or pharmacist walk you through the procedure in advance. They’re more than happy to assist you in learning how to administer a safe and effective injection procedure.
Frequently Asked Questions - FAQs
People asked many questions about the side effects of wrong IM injections. We discussed a few of them below:
1 - What happens if you do an intramuscular injection under the skin?
It takes longer for intramuscular injections to be absorbed than for subcutaneous injections. This is because muscular tissue has a higher blood supply than skin-deep tissue. On the other hand, subcutaneous tissue may have a lower concentration of the medication.
2 - What if you make an IM injection mistake?
Injecting it into the wrong place can result in significant harm. The buttocks, thighs, or upper arm muscles are commonly injected with anabolic steroids and testosterone. Smaller doses are needed if the muscle being injected is smaller. Small muscles are more susceptible to damage and discomfort after an injection. Large muscle is less tricky for IM injections.
3 - What hurts the most when it is subcutaneous or intramuscular?
One can expect minimal pain from the needle used for subcutaneous injection. Because the needles are smaller and don’t need to puncture as much tissue, subcutaneous injections are less painful than intramuscular injections.
4 - What happens when air is injected into the subcutaneous tissue?
That’s not the reason why most people believe this way. If an insulin syringe has an air bubble, it is not dangerous. If you inject insulin into the fat layer under your skin, not into a vein, you won’t die.
5 - Does massage after intramuscular injection good?
The medicine can seep out of the subcutaneous tissue if you massage the injection site afterward. Thus You should avoid this with intramuscular injections.
6 - What if you accidentally inject air into your muscles?
Injecting a tiny air bubble into the skin or muscle is generally safe. However, you will not be able to obtain your entire medicine from the syringe.
7 - Can an injection affect a nerve?
Injection under the deltoid muscle can damage the radial nerve, whereas a far-off injection can impact the axillary nerve. An acute burning sensation occurs when a nerve is damaged, which might lead to paralysis or neuropathy that doesn’t always go.
8 - What happens if an injection hits a nerve?
Direct needle injury, chemical irritation, injection fluid toxicity, and neuritis cause post-injection nerve damage (fibrotic changes). When a needle causes nerve injury, most patients, including our patients, experience pain shortly after the injection.
9 - Is aspiration essential during an intravenous injection?
The lack of significant blood arteries causes increased discomfort in babies during aspiration.
10 - What causes a lump after an injection?
Abnormal fat buildup under the skin is known as lipohypertrophy. Patients with type 1 diabetes can suffer from this condition. When insulin is repeatedly injected into the same place, scar tissue and lumps can develop.
11 - What will happen if the injection gets into a vein?
Once an injection is made into an individual’s body via an injection site, it travels through their cardiovascular system and thins their blood clots before reaching their tissues. Swelling and agonizing pain might result from an injection into an artery, which carries the chemical straight to the tissues.
12 - How do I measure injection sites?
The injection site is typically 2.5 to 5 cm in the center of the deltoid muscle during the acromion process. To locate this location, place three fingers on the deltoid muscle during the acromion procedure. In the center of the muscle, the three fingers below are the typical injection location.
13 - Is aspiration a part of your injection procedure?
Aspiration is frequently carried out after intramuscular (IM) or subcutaneous (SC) injections to ensure that the needle tip does not enter a blood vessel.
14 - How do you give an IM injection?
If the patient is young or old, intramuscular injections are given at a 90-degree angle to the skin into the anterolateral side of the thigh or the deltoid muscle of the upper arm. Intramuscular injection needles typically have a gauge of 22-25.
15 - What is the purpose of IM injection?
Medication can be injected directly into the muscles, deep inside the muscles. Due to this, rapid absorption of the drug into the bloodstream is caused. Intramuscular injections are used for vaccines, such as flu shots, and you may have had one in the past.
Conclusion
Now, you must know what happens if an IM injection is missed. Pain, redness, and swelling are common side effects of intramuscular injections (IMs). There are rare adverse effects that persist for more than a few days and are usually moderate.
Sometimes, the injection site might cause significant pain or paralysis because of nearby nerves or blood vessel injury. Some nations no longer prescribe aspiration on the syringe before injecting.
Related Articles
Deep Tissue Massage
How much are lip injections
Botox Lip Flip