How to administer intramuscular injections

Chadwick, Angelina; Withnell, Neil

doi:10.7748/ns.30.8.36.s45

Cited by 9 publications

(13 citation statements)

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“…The internally rotated foot and Z‐technique resulted in the patients feeling less pain (Table ). It was suggested that the Z‐technique makes the path of the needle to the injection site into a zigzag shape, which obstructs the return of the drug from the muscle to the SC tissue, thus minimizing irritation from the medication (Berman et al, ; Chadwick & Withnell, ; Nicoll & Hesby, ; Potter et al, ; Rodger & King, ; Wilkinson et al, ). In this meta‐analysis, in addition to the Z‐technique, the effects of different positioning, evaluation of the effect of muscle relaxation, and the air‐lock technique were added.…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta‐analysis: Physical‐procedural interventions used to reduce pain during intramuscular injections in adults

Zeyrek

Takmak

Kurban

et al. 2019

Journal of Advanced Nursing

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Aims To assess the effectiveness of physical‐procedural interventions in reducing pain during intramuscular injections. Design Systematic review and meta‐analysis. Method English keywords were used to search databases [MEDLINE (OVID, Ebsco), SCOPUS, Science Direct, COCHRANE and the reference lists from retrieved articles] from their inception to November 2017 and randomized and quasi‐experimental trials were selected based on inclusion and exclusion criteria. The standardized mean difference and random effects model were used. Results From 2,318 articles, 15 articles (1996–2017) met the criteria for the meta‐analysis. Physical‐procedural interventions described in the articles were included in this systematic review. The overall standardized mean difference was 0.595 (95% confidence interval (CI) = 0.417–0.773), indicating a moderate effect on pain levels. Generally, these interventions (two‐needle technique, acupressure, manual pressure, ShotBlocker, Z‐technique, air‐lock technique, injection site postinjection massage, and speed of injection) have been found to moderately reduce pain. Conclusion It seems difficult to conclude that a single intervention reduces pain in adults. However, we can state that the most effective interventions for reducing pain during intramuscular injections in adults involve the ventrogluteal site, the Z‐technique, and manual pressure. Impact The systematic review will provide guidance to clinicians, staff, and educator nurses and future studies. The systematic review will help nurses and educators apply techniques based on evidence in any setting. The systematic review will guide well‐designed and well‐reported studies to contribute to the accumulation of evidence in nursing research.

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Section: Discussionmentioning

confidence: 99%

Systematic review and meta‐analysis: Physical‐procedural interventions used to reduce pain during intramuscular injections in adults

Zeyrek

Takmak

Kurban

et al. 2019

Journal of Advanced Nursing

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“…A higher risk for cardiovascular toxicity of Chloroquine has been reported in volumedepleted and electrolyte deranged patients with gastroenteritis, and more so if the dose administered is inappropriately high for the patient's weight [21]. Chloroquine is safely administered as a slow intravenous infusion given over 30 minutes, but an inadvertent intravenous bolus could sometimes be given following failure to adhere to proper techniques of administering intramuscular injections [6,[22][23][24]. Any confirmed hypoglycemia in a patient with malarial fever that collapsed immediately after an intramuscular injection of appropriate dose of Chloroquine could well have been a consequence of reduced appetite and food intake as well as consumption of blood glucose by the malaria parasite [25].…”

Section: Discussionmentioning

confidence: 99%

Single Adult-human Equivalent Dose of Intramuscular Chloroquine did not Lower Blood Glucose Level in Fasted Wistar Rats

ED¹,

EC²

2016

Clin Exp Pharmacol

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Objectives: The 4-Aminoquinoline, Chloroquine is still indicated for treatment of malaria fever due to sensitive Plasmodium species. The hypoglycemic effects of Chloroquine have been sparsely reported in human and animal models of type 2 diabetes and a widely held perception among health caregivers in this part of the world is that administering Chloroquine intramuscularly to fasting malaria patients could be complicated by syncope, directly caused by hypoglycemia. This study investigated the effects of a single adult human intramuscular bolus of Chloroquine on the blood glucose level in fasting non-diabetic Wistar rats. Methods: Fifteen acclimatized adult male rats were randomly divided into three groups of 5 per group. Group I and II rats were fasted overnight and received 4.17 mg/kg of intramuscular Chloroquine in the morning. Group III rats were also fasted but received 1 ml of sterile water injection. Fasting blood sugar level was determined immediately after injection and at 2 h and 4 h intervals using Accucheck glucometer. Results: The results were recorded as Mean ± SEM. The mean sugar levels of the groups were compared with each other within a given time point as well as between the different time intervals within a given group, using the Student's t test of significance. There were no observable statistical significant differences between the Mean blood glucose levels of the groups. Conclusion: The results of this study suggested that intramuscular Chloroquine injection in fasted non-diabetic rats did not significantly lower their blood glucose level and syncope in fasting adult humans immediately following treatment by this route is unlikely to be related to a Chloroquine-induced hypoglycemic effect.

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“…• Drugs and necessary materials are prepared. [4,[26][27][28][29][30][31] • Site detection: If the left hip is used for injection, the right hand's palm; otherwise, the left hand's palm is placed on the greater trochanteric fracture protrusion of the femur. The index finger is placed on the anterior superior iliac spine while other fingers are opened as far back as possible to form a "V" region (the midpoint of the "V" region is the injection site) (Figure 2).…”

Section: Im Injection Administration Techniquementioning

confidence: 99%

“…[31] • The needle guard is taken off and the syringe is held like a pen/dart. [26][27][28]31] • The site determined is wiped with an antiseptic solution in circular movements from inside to outside with a diameter of about 5 cm, and allowed to dry for 30 seconds. [27,29,31] If the Z-technique is used,…”

Section: Im Injection Administration Techniquementioning

confidence: 99%

“…• The drug is injected into the skin in such a way that 1 ml of the drug is delivered at 10 seconds by pressing the plunger. [26,27,[29][30][31] • It is waited for 10 seconds after drug administration. [26,[29][30][31] • A dry cotton pad is pressed lightly on the site, and the needle is swiftly withdrawn without disturbing the injection angle.…”

Section: Im Injection Administration Techniquementioning

confidence: 99%

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