intramuscular injections

• 1.Inability to titrate agent
• 2. inability to rapidly reverse actions of drug

• 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***

• 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

• 1. Gluteal area
• 2. Ventrogluteal area
• 3. Vastus Lateralis
• 4.Mid-deltoid area

• 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

• 1. 1^o 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

• 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

• 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

• 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

If discomfort reqs more than mild analgesics (aspirin/acetamenophen), or persists for >7 days

• 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