W5: Medication via Intramuscular route

Question 1

Why parenteral route?

Answer 1

• Faster acting
• Oral route unavailable
  o Nausea/vomiting
  o Fasting, dysphagia
  o Trauma, ICU, Operating theatre
• Specific drugs (for some drugs the parenteral route is the only one possible –
  insulin)

Question 2

Disadvantages of parental route

Answer 2

• Irretrievable nature
• Adverse reactions more rapid
• Pain and discomfort to patient
• Risk of infection
• Risk to health personnel
• Nerve and bone damage

Question 3

What are key sites

Answer 3

Could be a portal of entry for
microorganisms to colonise the
patient.

Includes wounds, IMI or IV sites.

Question 4

what are key parts

Answer 4

Any parts of the equipment
which come into contact with
procedural equipment or the
patient.

Includes needles, forceps, sterile gauze to clean a wound.

Question 5

what are the Intramuscular
injection sites

Answer 5

o Ventrogluteal
o Vastus lateralus
o Deltoid
o Dorsogluteal

Question 6

Knowing the landmarks and
locating the deltoid site

Answer 6

✓ Fully expose the upper arm and shoulder; ask
the patient to relax their arm by bending it at
the elbow
✓ Locate the acromion process (Knobby part of
shoulder)
✓ Position fingers as shown in image; the top
one on the acromion process the bottom 3-5
cm down
✓ The lower of the 4 fingers forms the upper border of
the deltoid injection site
✓ Draw an imaginary line from the axilla across the
upper arm. This line is the lower border of the
deltoid injection site.
✓ Draw an imaginary upside down triangle between
these 2 borders.
✓ The injection site is within this triangle

Question 7

Knowing the landmarks and
locating the vastus lateralis site

Answer 7

✓ Divide the area between the greater
trochanter of the femur and the lateral
femoral condyle into thirds
✓ Identify the middle third
✓ The injection is given on
the anterolateral aspect
of the thigh

Question 8

Locating the
ventrogluteal site

Answer 8

✓ Heel of hand on the greater
trochanter
✓ Thumb pointing toward the
persons groin
✓ Point index finger to the
anterior superior iliac spine
✓ Stretch middle finger toward
on the iliac crest
✓ Area between two fingers,
about knuckle length, is the
injection site
he area between the two fingers is the
injection site
Note: If your hand is small and your finger
does not reach the anterior superior iliac
spine or the iliac crest, slide you hand up until
your fingers are in the correct position.

Question 9

Dorsogluteal considerations

Answer 9

o Thick gluteal muscles of the buttocks
o Not recommended due to risk of striking the sciatic
nerve, major blood vessels or bone
o Not suitable for older patients, emaciated, very obese
patients

Question 10

Why parenteral route?

Answer 10

• Faster acting
• Oral route unavailable
  o Nausea/vomiting
  o Fasting, dysphagia
  o Trauma, ICU, Operating theatre
• Specific drugs (for some drugs the parenteral route is the only one possible –
  insulin)