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Intramuscular Injection Home Instructions

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Your child needs to receive a medication at home that is given by an injection (shot) into the muscle. Your child’s doctor will give you prescriptions for the correct size syringes, needles and for the medication.

Discuss options for decreasing pain for this procedure with your physician or nurse. These are some ideas which may be helpful:

  • Apply ice to the site for 3-5 minutes before the injection.
  • Just before giving the injection, apply firm pressure next to the injection site with the thumb of your other hand. Ask your nurse to show you how to use a Shot Blocker™. This is a small device that provides pressure to the skin before and during an injection.
  • Distract your child during the injection. Have your child squeeze a ball, sing a song, hum, count or recite colors. Blowing bubbles or blowing on a pinwheel calms some children as this keeps them from holding their breath.
  • Ask your child’s doctor if you can use a numbing spray or ointment before giving the injection.

Supplies you will need:

  • Prescribed medication
  • Alcohol swab or 70% alcohol and a cotton ball
  • Syringe and needle
  • Container for disposal

Drawing up the medication

  1. Wash your hands with soap and water. Count to 15 while washing. Rinse and dry your hands with paper towels or a clean cloth towel.
  2. Check the medication bottle before using it. Look at the label and check that you have the correct medication and concentration. Make sure that the expiration date has not passed and that the top of the bottle is not damaged. Make sure the medication has not changed color and that there are no particles floating in the bottle. Follow the bottle instructions for reconstituting and mixing the medication prior to use.
  3. Clean the top of the bottle with an alcohol swab or cotton ball dipped in alcohol. Allow it to dry. Do not touch the top after you have cleaned it.
  4. Remove the needle cover from the syringe by pulling it straight off. Lay the cover on a flat surface. Do not touch the needle.
  5. Draw air into the syringe by pulling back on the plunger to the line that indicates the amount of medication to be given. (Figure 1)
  6. With the bottle standing upright, insert the needle into the small circle on top of the rubber stopper of the bottle and push down on the plunger to inject the air. (Figure 2) 
  7. Leaving the syringe in the bottle, turn the bottle over. Slowly pull the plunger down past the line that indicates the dose of medication you are going to give. Check for air bubbles.
    • No air bubbles: Push the plunger up to the line that indicates the exact dose of medication you need. The plunger has a rubber ring. Move the plunger until the top of the rubber ring is on the exact line for the medication dose. 
    • Air bubbles: Flick or tap the syringe with your finger. When you see the air bubbles move to the top of the syringe, push the plunger gently to release the air. Pull the plunger back to get the exact dose for injection. (Figure 3)
    • Remove the syringe from the bottle.
    • Put the cap back on the needle loosely to keep the needle clean.  

    Choosing the site

    The medicine needs to be injected into muscle tissue. Positioning your child as suggested below may relax the muscle. The most common areas for intramuscular injections are:

    • deltoid muscle – between the top of the shoulder and the armpit
    • vastus lateralis muscle – between the hip and the knee. Position: bend your child’s knee.
    • ventrogluteal muscle- on the side of the body just below the hip. Position: place your child on his/her side with the upper leg bent and placed over the thigh of the lower leg.

    Discuss the best site for your child with the nurse or physician.

    How to give an intramuscular injection

    1. Position your child so he/she is comfortable and remove clothing as needed.
    2. Get someone to help you hold your child as needed.
    3. Clean skin around the injection area with soap and water. Next, clean the area with alcohol using a circular motion. Allow to dry.
    4. Remove the needle cover by pulling it straight off. Hold the syringe like a pencil.
    5. Locate the correct landmarks for the site you have chosen using the pictures above.
    6. Grasp the muscle firmly between your thumb and fingers. This will help to steady the muscle and allow the medication to be given in the deepest part of the muscle.
    7. With one quick darting motion insert the needle straight into the skin at a 90 degree angle. The faster the needle goes in, the less it will hurt.
    8. Pull back on the plunger to see if there is any blood in the syringe.
      • If there is no blood: push the plunger down slowly until the syringe is empty. This should take 3-5 seconds.
      • If you see blood: Quickly remove the needle from the muscle. Carefully remove the needle from the syringe and replace it with a new sterile needle. Start over at step #3. Do not use the same exact spot, but you may use the same muscle.
    9. When all the medication has been injected, quickly remove the needle from the site and apply gentle pressure with a dry sterile pad or a clean tissue.
    10. Activate the needle safety device, if applicable. Discard the used needle and syringe. See below for instructions.
    11. Place a Band-Aid on the injection spot, if needed.
    12. Compliment, reward and comfort your child. It is important that your child does not think that the injections are punishment. If your child is old enough to understand, explain that the medicine will help him/her.
    13. Praise your child for helping you.
    14. Return the medication, needles, syringes and supplies to a safe place out of your child’s reach. Be sure to follow storage recommendations. Some medications must be kept in the refrigerator.
    15. If you have any questions, contact your physician’s office.

    How to discard syringes

    1. Do not recap syringes, you may stick yourself.
    2. Drop the used syringe into a hard plastic container with a screw top lid. Choose a container that you cannot see through. (Example, a liquid laundry detergent bottle)
    3. When the container is ¾ full, screw on the lid and secure it with tape. Discard the container in the trash. DO NOT put the container in the recycle bin. DO NOT bring the container to the hospital or your physician’s office.
    4. If you are using a sharps container from a medical company or from a pharmacy, DO NOT return it to the hospital or your physician’s office.
    5. You may want to call your local trash collection service for other suggestions.

Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.

Reviewed: 06/2008

(757) 668-7000