intramuscular injections

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Author:
mexident82
ID:
83333
Filename:
intramuscular injections
Updated:
2011-05-02 20:12:04
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intramuscular
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Description:
intramuscular
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  1. Disadvantage of IM injections? (2)
    • 1.Inability to titrate agent
    • 2. inability to rapidly reverse actions of drug
  2. why IM?
    • 1. may be only available route of admin in an emergency.
    • 2. pt cooperation not essential
    • 3. to give SBE prophy
    • ***all dental personelle should be trained in IM technique***
  3. Recommended uses of IM route (3)
    • 1. Premed prior to IV sedation/ GA in disruptive pedo/ handicapped pt
    • 2. Admin of antiemetics and steroids
    • 3. admin of emergency drugs where IV route is unavailable
  4. Sites of IM admin? (4)
    • 1. Gluteal area
    • 2. Ventrogluteal area
    • 3. Vastus Lateralis
    • 4.Mid-deltoid area
  5. Gluteal area (5)
    • 1. Upper outer quad is most frequently used
    • 2. gluteus maximus is muscle injected
    • 3. anatomically sciatic nerve and superior gluteal arteriy are avoided
    • 4. skin is think and region will accept larg volume readily
    • 5. pt should be proned (lying face down) for muscular relaxation
  6. Ventrogluteal region (3)
    • 1. 1o used for bedridden patients or those who cannot lie face down
    • 2. index and middle fingers are spread forming a "v". ventrally placed figer is pressed down on skin overlying anterior iliac spine.
    • 3. needle puncture is made btwn fingers just below iliac crest
  7. Vastus Lateralis (5)
    • 1. Anterior aspect of thight is probably the safest area for IM
    • 2. accepts largest volume
    • 3. strongly recommended for children
    • 4. contains no important structures anatomically
    • 5 narrow rectangular band one hands breadth aove knee to the greater trochanter of femur
  8. Mid-deltoid region (6)
    • 1. readily accessible area of upper third of arm
    • 2. disrobing is minimal
    • 3. position is unimportant
    • 4. will not accommodate large volumes
    • 5. absorption is rapid
    • 6. injection is given btwn upper and lower portions of the deltoid to avoid radial nerve
  9. Technique of IM injection (10)
    • 1. select appropriate site
    • 2. appropriate disrobing/localization of external landmarks
    • 3. Isopropyl alcohol whipe (allow to dry)
    • 4. stabilize skin and limb
    • 5. grasp syringe in PEN or DART grasp and penetrate to depth in one motion
    • 6. Aspirate, rotate and reaspirate
    • 7. inject solution slowly
    • 8. maintain stabilization and w/draw syringe
    • 9. Place dry gauze over site for 2 mins
    • 10. apply bandage
  10. When should you seek consultation after giving IM?
    If discomfort reqs more than mild analgesics (aspirin/acetamenophen), or persists for >7 days
  11. Complications of IM (8)
    • 1. Nerve injury (paralysis, pareshtesia, hypersthesia)
    • 2. IV injection
    • 3. Air embolism
    • 4. Periostitis
    • 5. Hematoma
    • 6. Abscess
    • 7. Cyst or scar formation
    • 8. Necrosis and sloughing of skin

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