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Intramuscular Injection Home Instructions

(757) 668-7000

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 medication.

Discuss different ways to decrease pain for this procedure with your healthcare provider . Below are some ideas that may be helpful:

  • Apply cold pack to injection site for a few minutes before the injection. Wrap cold pack so that the pack feels cool but not uncomfortable. (Cold applications are not recommended for infants.)
  • 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™ which is a small device that provides pressure to the skin before and during an injection.
  • Distract your child during the injection by having your child squeeze a ball, sing a song, hum, count, blow bubbles or a pinwheel .
  • Ask your child’s healthcare provider if a numbing spray or ointment may be used.


  • Prescribed medication
  • Alcohol pad or 70% alcohol and gauze
  • Syringe and needle
  • Strong, plastic container with screw top lid for disposal

Drawing up the medication:

  1. Wash hands with soap and water. Count to 20 while washing. Rinse and dry hands with clean paper towels or clean cloth towel.
  2. Check medication bottle before using it.
    • Look at the label making sure it is the correct medication and concentration.
    • Check the expiration date. Do not use if expired.
    • Inspect top of bottle for damage. Do not use if damaged.
    • Make sure medication color has not changed and there are no particles in the bottle.
    • If medication needs to be mixed, follow bottle instructions.
  3. Clean top of bottle with alcohol pad or gauze wet with alcohol. Allow to dry. Do not touch the top after cleaning it.
  4. Remove needle cover from syringe by pulling it straight off. Lay cover on 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.
  6. With bottle standing upright, insert needle into the small circle on top of the rubber stopper of the bottle and push down on the syringe plunger to inject air into the bottle.
  7. Leaving the syringe in the bottle, turn the bottle upside down. Slowly pull the plunger down past the line indicating medication dose. Check for air bubbles.
    • No air bubbles: Push the plunger up to the line that indicates the exact dose of medication you will be giving.
    • Air bubbles: Tap the syringe with your finger to move the air bubbles to the top of the syringe , and then push the plunger gently to release the air. Pull the plunger back to the line indicating the exact dose of medication you will be giving.
  8. Remove the syringe from the bottle.
  9. Put the cover back on the needle loosely to keep needle clean.

Choosing the site:

The most common muscles for intramuscular injections are:

  • Deltoid ( between the top of the shoulder and the armpit)
  • Vastus Lateralis (between the hip and the knee) Bending your child’s knee may relax the muscle.
  • Ventrogluteal ( just below the hip on the side of the body)To relax this muscle, place your child on his/her side with upper leg bent and positioned over top of the lower leg.
  • Discuss with your child’s healthcare provider the best site for your child.

Giving the injection:

  • Position your child so he/she is comfortable and remove clothing as needed.
  • Have someone help hold your child as needed.
  • Clean the injection site with alcohol using a circular motion. Allow to dry.
  • Remove needle cover by pulling it straight off. Hold the syringe like a pencil.
  • Locate the correct landmarks for the medication injection site.
  • Hold the muscle firmly between your thumb and fingers to help steady the muscle and to allow the medication to be given in the deepest part of the muscle.
  • Quickly insert the needle straight into the muscle at a 90 degree angle. (The faster the needle goes in, the less it will hurt).
  • Pull the plunger back to check for blood in the syringe.
    • If no blood, push the plunger down slowly over 3- 5 seconds until the syringe is empty.
    • If blood, immediately 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.
  • After injecting all the medication, quickly remove the needle and apply gentle pressure to the site with a dry, clean gauze
  • Use the needle safety device (if applicable) and discard the used needle and syringe per below for instructions.
  • Place adhesive bandage over injection site, if needed.
  • 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.
  • Return the medication and supplies to a safe place out of your child’s reach. Follow storage recommendations(Some medications must be kept in the refrigerator.)

Discarding needles and syringes

  • To reduce risk of sticking yourself, do not recap used needles.
  • Place the used needle and syringe into a strong, plastic container with a screw top lid, and screw lid onto container. Use a container that you cannot see through such as a liquid laundry detergent bottle.
  • When the container is ¾ full, put the lid on, seal it with duct tape, and label “Do Not Recycle”. Put the container in the household trash. DO NOT take the container to the hospital or your doctor’s office even if it’s a sharps container from a medical company or pharmacy. Contact your local trash collection service if you have further questions.

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: 05/2018

(757) 668-7000