Step by Step Guide

An intramuscular injection, as illustrated in the figure below, delivers medication deep into the muscle tissue. This allows the medication to be quickly absorbed into the bloodstream for action. 

Step 1: Setting Up for the Injection

  1. Find a comfortable, well-lit working place
  2. Remove medication from the refrigerator and let it reach room temperature.
  3. Make sure it is the medication your doctor prescribed. Check the expiration date on the vial. Do not use a medication with an expired date. If the medication has particles or is discoloured, do not use it and check with your pharmacy.
  4. Ensire your working area is clean
  5. Wash your hands

Hand washing is one of the most important things you can do to prevent infection. Enusre to wash your hands at these times: 

  1. Before and after doing any procedure
  2. Before and after removing gloves
  3. After handling any contaminated waste or body fluid
  4. After personal hygiene (such as using the bathroom or blowing your nose),
  5. Before Eating

You will need an antibacterial soap or handwash , or you may use an antiseptic gel or hand rub that does not require water.   


  • Wet your hands and wrists under running water.
  • Scrub vigorously with an antibacterial soap for 15 seconds.  Work lather between fingers, under nails, over palms and on backs of hands and wrists. 
  • Rinse hands and wrists and dry with a clean paper towel.
  • Turn off tap with a paper towel.

Assemble supplies:

  • Medication
  • Disposable syringe and needle
  • Alcohol Swabs
  • Water proof plaster
  • Puncture proof disposal container i.e Sharp Bin

Step 2: Selecting and Preparing the Injection Site The following are sites for injections. Alternate the injection site each time you inject to avoid soreness at any one sight

The following are sites for injections. Alternate the injection site each time you inject to avoid soreness at any one sight.  


In the lower edge of the acromial process and the point on the lateral arm in line with the axilla. Insert the needle 1inch – 2inch below the acromial process, usually two or three finger breadths. 

Typical injection: 0.5 ml (range: 0.5 to 2.0 ml)

Use the lateral muscle of the quadriceps group, from a handbreadth below the greater trochanter to a hand breadth above the knee. Insert the needle into the middle third of the muscle parallel to the surface on which the patient is lying.

Typical injection: 1-4 ml

Vastus Lateralis


Inject above and outside a line drawn from the posterior superior iliac spine to the greater trochanter of the femur. Or, divide the buttock into quadrants and inject in the upper outer quadrant about 2inch – 3inch below the iliac crest. 

Typical injection: 1 to 4 ml (range: 1-5ml)

Step 3: Preparing the Dose

  • Take the cap off the vial. Clean the rubber stopper with one alcohol swab.
  • Check the package containing the syringe. If the package has been opened or damaged, do not use that syringe. Dispose of that syringe in the puncture-proof disposal container. If the syringe package is undamaged, open the package and remove the syringe
  • Pull the needle cover straight off the syringe. Then, pull back the plunger and draw air into the syringe. The amount of air drawn into the syringe should be the same amount (ml/cc) as the dose that is prescribed
  • Keep the vial on your flat working surface and insert the needle straight down through the rubber stopper. Do not put the needle through the rubber stopper more than once.
  • Push the plunger of the syringe down and inject the air from the syringe into the vial.
  • Keeping the needle in the vial, turn the vial upside down. Make sure that the liquid is covering the tip of the needle.
  • Keeping the vial upside down, slowly pull back on the plunger to fill the syringe with the medication to the number (ml/cc) that matches the dose prescribed.
  • Keeping the vial upside down, slowly pull back on the plunger to fill the syringe with the medication to the number (mL or cc) that matches the dose prescribed.
  • Keeping the needle in the vial, check for air bubbles in the syringe. If there are air bubbles, gently tap the syringe with your fingers until the air bubbles rise to the top of the syringe. Then slowly push the plunger up to force the air bubbles out of the syringe.
  • Keeping the tip of the needle in the liquid, once again pull the plunger back to the number on the syringe that matches your dose. Check again for air bubbles. The air in the syringe will not hurt you, but too large an air bubble can reduce your dose of medicine. If there are still air bubbles, repeat the steps above to remove them.
  • Check again to make sure that you have the correct dose in the syringe. It is important that you use the exact dose prescribed by your doctor. Remove the syringe from the vial but do not lay it down or let the needle touch anything.

Tips for Minimizing Injection Pain :

•    Inject medicine that is at room temperature

•    Remove all air bubbles from the syringe before injection

•    Wait until the topical alcohol has evaporated before injecting

•    Keep muscles in the injection area relaxed

•    Break through the skin quickly

•    Don’t change the direction of the needle as it goes in or comes out

•    Do not reuse disposable needles

Recommnded Dose

 2ml every 2 – 3 days for the loading up period of 2 weeks then come back every 4 to 8 weeks.


The client should not consume large amounts of alcohol prior or post treatment. The same applies for the first week after the injection.

Preparing for treatment

Make your client feel calm and comfortable.

This applies to everyone from Doctor to any practitioner entering the world of Needle work , working in any type of setting. It’s the same in a calm hospital setting as it is in the back of a bouncing ambulance, helicopter, or a busy clinic.

Some say to sit, some say to stand but it’s all about your preference. You need to be comfortable so spend some time and be able to be dexterous in the position you choose.

Remember, Take a deep breath, stay calm and relax. Talk to your patient, it will help and make it less stressful and tense for the both of you.

Now let’s proceed to the assessment you need to achieve 80% to successfully pass this course. Good luck!

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