The Z-track method is a method of administrating an IM injection that prevents the medication being tracked through the subcutaneous tissue, sealing the medication in the muscle, and minimizing irritation from the medication. Using the Z-track technique, the skin is pulled laterally, away from the injection site, before the injection; then the medication is injected, the needle is withdrawn, and the skin is released.
This method can be used if the overlying tissue can be displaced Lynn, To locate the ventrogluteal site, place the patient in a supine or lateral position on their side.
The right hand is used for the left hip, and the left hand is used for the right hip. Place the heel or palm of your hand on the greater trochanter, with the thumb pointed toward the belly button. Extend your index finger to the anterior superior iliac spine and spread your middle finger pointing towards the iliac crest. Insert the needle into the V formed between your index and middle fingers. This is the preferred site for all oily and irritating solutions for patients of any age.
Needle gauge is determined by the solution. An aqueous solution can be given with a 20 to 25 gauge needle. Viscous or oil-based solutions can be given with 18 to 21 gauge needles. The needle length is based on patient weight and body mass index. Children and infants will require shorter needles. Refer to the agency policies regarding needle length for infants, children, and adolescents. The vastus lateralis is commonly used for immunizations in children from infants through to toddlers.
The muscle is thick and well developed. The middle third of the muscle is used for injections. The width of the muscle used extends from the mid-line of the thigh to the mid-line of the outer thigh.
To help relax the patient, ask the patient to lie flat with knees slightly bent, or have the patient in a sitting position. The gauge of the needle is determined by the type of medication administered. Aqueous solutions can be given with a 20 to 25 gauge needle; oily or viscous medication should be administered with 18 to 21 gauge needles. A smaller gauge needle 22 to 25 gauge should be used with children. The length will be shorter for infants and children; see agency guidelines. Select needle length based on age, weight, and body mass.
In general, for an adult male weighing 60 to kg to lbs , a 25 mm 1 inch needle is sufficient. Refer to agency policy regarding specifications for infants, children, adolescents, and immunizations. The maximum amount of medication for a single injection is generally 1 ml. For immunizations, a smaller 22 to 25 gauge needle should be used. Consider the type of medication and the age, condition, and size of the patient when selecting an IM site. Rotate IM sites to avoid complications.
Potential complications include lingering pain, tissue necrosis, abscesses, and injury to blood vessels, bones, or nerves. If administering a vaccination, always refer to the vaccination guidelines for site selection.
Checklist 58 outlines the steps to perform an IM injection. Ensuring the sharps container is close by allows for safe disposal of the needle. Locate correct site using landmarks, and clean area with alcohol or antiseptic swab. Allow site to dry completely. Allowing the site to dry prevents stinging during injection. If blood appears, discard syringe and needle, and prepare the medication again.
Because the injection sites recommended for immunizations do not contain large blood vessels, aspiration is not necessary when immunizing. Cover injection site with sterile gauze, using gentle pressure, and apply Band-Aid as required.
Covering prevents infection at the injection site. Place a clean swab or dry gauze between your third and fourth fingers. Gauze between fingers 3 and 4 This allows for easy access to dry gauze after injection. Remove needle cap by pulling it straight off the needle. Hold syringe between thumb and forefinger on dominant hand as if holding a dart.
This prevents needle from touching side of the cap and prevents contamination. With skin held to one side, quickly insert needle at a degree angle.
After needle pierces skin, continue pulling on skin with non-dominant hand, and at the same time grasp lower end of syringe barrel with fingers of non-dominant hand to stabilize it.
Move dominant hand to end of plunger. If required by agency policy, aspirate for blood. If no blood appears, inject the medication slowly. Insert the needle with a dart-like motion. A quick injection is less painful. Once medication is given, leave the needle in place for 10 seconds. Avoid moving the syringe. Leaving the needle in place allows the medication to be displaced.
Movement of the needle can cause additional discomfort for the patient. Once medication is completely injected, remove the needle using a smooth, steady motion. Then release the skin. Using a smooth motion prevents any unnecessary pain to the patient. Do not massage site. Skip to content Chapter 7.
Paracentesis is a procedure to remove excess fluid from the abdominal cavity. This fluid buildup is called ascites. Learn about preparation, recovery…. Learn more. An abdominal film is an X-ray of the abdomen. This type of X-ray can be used to diagnose many conditions. Learn more here. The part of your body getting scanned and the number of images needed play a role in determining how long the MRI will take.
Here's what to expect. Health Conditions Discover Plan Connect. Ventrogluteal Injection. Medically reviewed by Debra Sullivan, Ph. Keep reading to learn about the benefits of ventrogluteal injections and how to administer them. Why are ventrogluteal injections used? How to prepare for a ventrogluteal injection. How to give a ventrogluteal injection. Important safety information. The takeaway. Read this next. It is the knobbly top portion of the long bone in the upper leg femur.
It is the size of a golf ball Find the posterior iliac crest. This is where X to insert the needle Stretch the skin tight Hold the syringe like a pencil or dart. Insert the needle at a right angle to the skin Up to 3ml of fluid can be given in this site The presence of major nerves and blood vessels, the relatively slow uptake of medication from this site compared with others and the thick layer of adipose tissue commonly associated with it, makes this site problematic.
Giving an IM injection into the deltoid site Find the knobbly top of the arm acromion process The top border of an inverted triangle is two finger widths down from the acromion process Stretch the skin and then bunch up the muscle Insert the needle at a right angle to the skin in the centre of the inverted triangle Caution: This is a small site — give only ml or less of fluid in this site It is important to limit volume of medication based upon size of muscle, ie.
Giving an IM injection into the ventrogluteal site Find the trochanter. It is about the size of a golf ball Find the anterior iliac crest Place the palm of your hand over the trochanter. Point the first or index finger toward the anterior iliac crest. The thumb should always be pointed toward the front of the leg.
These measures should ensure optimal nursing care for patients. Using the ventral gluteal site for intramuscular injection. Nursing Standard ; 18 29 : Small SP. Preventing sciatic nerve injury from intramuscular injection: literature review: J Advanced Nursing ; 47 3 : MacGabhan L. A comparison of two depot injection techniques. Intramuscular injections: a review of nursing practice for adults. Reviewing the big three injection routes.
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