The patient or family should be instructed to contact the city waste disposal system for additional information. Slowly and gently depress the plunger of the syringe to inject the medication into the patient's muscle. Your healthcare provider will advise you on which medications can be used with this method. The thumb is pointed toward the patients groin, with the index finger pointing to the anterior superior iliac spine, and the middle finger is extended back along the iliac crest toward the buttock. Sepah, Y. and others. Applying a colorful adhesive bandage or sticker to the injection site should be considered. Assess baseline vital signs and the patients medical and medication history. The effect of the Z-track technique on pain and drug leakage in intramuscular injections. What countries are affected by the clean air act? Moves non-dominant hand to steady the lower end of the syringe, and dominant hand to the end of the plunger. Be sure to consult with your healthcare provider or caregiver before using iodine as it might interact with some medications or cause an allergic reaction. The skin is held in this position until the injection has been administered. Patient achieves desired effect of medication with no adverse reactions, signs of allergies, or undesired effects. If possible, a topical analgesic should be applied to the injection site with sufficient time allowed for peak action before the IM injection. Occupational Safety and Health Administration (OSHA). Remove the needle cap by pulling it straight off. The recommended site is based on age. National Patient Safety Goals for the hospital program. This rich blood supply, however, increases the risk for injecting drugs directly into blood vessels. A. Patient displays adverse reaction to the medication, with signs of urticaria, eczema, pruritus, wheezing, or dyspnea. When choosing an insertion point, Use a site 1 inch away from previous injection point, What is the correct injection site for the dorsogluteal muscle, When administering intramuscular injections it is important to inject a needle at a 90 angle in order to, Ensure that the medication is administered to the muscle, A patient has received an intramuscular injection using the Z track Method. Point the index finger to the anterior superior iliac spine. Once the syringe is empty, remove the needle by pulling the entire syringe straight out of the muscle in the same angle that it was inserted. 1 . 7.4: Intramuscular Injections. Make sure you are comfortable with the injection technique before you start giving yourself shots. The ventrogluteal site is a safe injection site for adults and children receiving irritating or viscous solutions and is the site of choice for administering IM injections to adults. When preparing an intramuscular injection, what can the nurse do to reduce the patient's risk for infection? Vaccinations and immunizations given by IM injections are never aspirated (Centers for Disease Control, 2015). Study Ch. wave. If the patient expresses concern regarding the accuracy of a medication, the medication should not be given. Retrieved October 12, 2022, from. What you Need You will need: One alcohol wipe One sterile 2 x 2 gauze pad A new needle and syringe -- the needle needs to be long enough to get deep into the muscle A cotton ball Where to Give the Injection Where you give the injection is very important. (a) Find 45 degrees C. 60 degrees D. 90 degrees 8. Saving Lives, Protecting People. Route, Site, and Needle Size. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. Take the medication to the patient at the right time according to the six rights of. The nurse has just finished injecting a medication intramuscularly, and needle is still in the client's arm. Hold a clean swab or dry gauze between the third and fourth fingers of the nondominant hand. The concern should be explored, the practitioner notified, and the order verified. SC injections are injected into the innermost layer of the skin called the subcutis or hypodermis, which is made up of a network of fat and collagen cells. COVID-19 vaccine has been associated with enhanced local/injection site reactions l (e.g., pain, swelling, redness). If possible, administer COVID-19 vaccine and other reactogenic vaccines (e.g., MenB, Tdap) in different limbs. Name the tissue layer and site of an intradermal injection, Other than the deltoid, name 1 other site for intramuscular injection. Tap the injection site. Any factor that interferes with local tissue blood flow affects the rate and extent of drug absorption. More research is needed to investigate the practice of aspiration before administering an IM injection with medications other than vaccines.8 The recommended route and site for each vaccine is included in the manufacturers instructions for use.2. Apply a dry cotton ball or gauze with light pressure for several seconds over the site. There are no known risks or contraindications for using the Z track method for intramuscular injections, however it is important to note that this can be performed only for intramuscular injections. When done properly, there are two curves in the track that gives it the "Z" shape. Biomass is created through the conversion of _____ energy into _____ energy, which can then be used to generate electricity. Smoothly, quickly, and steadily withdraw the needle. To report administration of VZV-containing vaccines to a pregnant woman, call the manufacturer at 1-877-888-4231. Position the ulnar side of the nondominant hand just below the site and pull the skin laterally. At what angle should an intramuscular (IM) injection be administered? Hold this position until the medication is injected. Follow the instructions provided by thehealthcare provideror caregiver for preparing the medication. The nurse's technique would correctly include 1. This article explains the Z-track method of injection. Self-administration of an IM injection is difficult. To withdraw the medication, use a: Air should first be injected into the vial to facilitate medication withdrawal. To avoid shoulder injury related to vaccine administration, the nurse should always sit to inject into the arm of a seated patient to ensure that the angle of the needle is correct. Recognize and immediately treat respiratory distress and circulatory collapse, which are signs of a severe anaphylactic reaction. How quickly would the nurse inject solution into an intramuscular site? What is the part of the needles below that are circled in blue. PDF of Feature 0213. Discard supplies, remove PPE, and perform hand hygiene. A useful approach may be to: keep the syringe out of his line of sight. Perform hand hygiene before patient contact. Following an injection of medication at the clinic how long should the patient wait? B. the Channeled Scablands Other adverse effects occur: hematoma or abscess; infection; fibrosis of the muscle, tissue damage because of patient movement during injection; glass particles injected into muscle as a result of not using a filter needle; permanent damage to sciatic nerve resulting in paralysis, fibrosis, or abscess. Consider contacting the practitioner for an alternative, preferred route of medication administration. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Observe recipients after vaccination to decrease the risk for injury should they faint. (2021). Injecting the most painful vaccine last when multiple injections are needed can decrease the pain associated with the injections. Beneath the skin B. After cleansing the site, the needle is injected deep into the muscle and the medication is injected slowly. Inject all the air into the vial. Write formulas for the following acids and bases: The chapter outlines recommended practices, skin preparation, preparation and administration of . Keep any injection site clean and covered. If any signs of irritation are noted, be sure to contact your healthcare provider for guidance. (2022). Ms. Smith is a 25-year-old female. area with bruising, induration, muscular atrophy, reduced blood flow, or signs of infection. (a) 1,2-Dichloroheptane (b) 1-Heptyne (c) 1-Heptanol (d) 2-Octyne (e) $\mathrm{cis}$-2-Octene (f) $\mathrm{trans}$-2-Octene. For patients, caregivers, or family members who are administering medications at home, be sure to ask a healthcare provider to instruct on the proper technique for administering an intramuscular injection. This is an example of: A 40-year-old male has recently received an injection in the ventrogluteal site and returned to receive another intramuscular injection in the same site. Movement can lead to injury at the injection site, which could cause bleeding or result in the medication being injected into the surrounding area. We have other quizzes matching your interest. Create flashcards for FREE and quiz yourself with an interactive flipper. The nurse is holding the skin with the non-dominant hand prior to inserting the needle for an intramuscular injection. Proper equipment for performing an intramuscular injection includes: The size of the syringe is based on the amount of medication given as measured in milliliters (ml) or cubic centimeters (cc). What are some features that were or are associated with the emptying of lakes formed during glacial times? Intramuscular injections are administered into the muscle through the skin and subcutaneous tissue. Adapted from Perry, A.G. and others (Eds.). b. Appropriate measures should be taken to prevent injuries if a patient becomes weak or dizzy or loses consciousness, including: To receive email updates about this page, enter your email address: We take your privacy seriously. Which source is more intense and by how many times more. How long are we suppose to wait before withdrawal of the needle? D. Massage the injection site. Position the ulnar side of the nondominant hand just below the site and pull the skin laterally. Assist the patient to a comfortable position. Throw into biohazardous sharps waste container, The muscule most commonly used for injection of the influenza vaccine is the ____. If enters the bloodstream, it could cause abnormally rapid absorption of the medication. Assess the patients knowledge regarding the medication to be received. Because of the sciatic nerve location, the dorsogluteal muscle is not recommended as an injection site. In E. Hall and others (Eds. The Z-track method is an intramuscular injection (IM) technique used to ensure the medication stays in the muscle instead of leaking into the surrounding tissue. Assist the patient to a comfortable position that is appropriate for the chosen injection site (e.g., sitting, or lying flat, on side, or prone). a. it prevents drug leakage into subcutaneous tissue. The needle is inserted at a 90-degree angle; this varies from the angle used for subcutaneous and intradermal injections (Figure 1).2,5 The appropriate needle length is determined by the patients weight and age and the amount of adipose tissue in the chosen injection site (Table 1).2,7 The needle must be long enough to reach the muscle tissue, but not too long to present the risk of hitting underlying neurovascular structures or bone.2, IM injections should be administered so that the needle is perpendicular to the patients body or as close to a 90-degree angle as possible.2 IM injection sites should also be rotated to decrease the risk for hypertrophy. CDC and the Advisory Committee on Immunization Practices (ACIP) guidance states COVID-19 vaccines can be given during the same visit with other vaccines, including flu vaccine, if the recipient is eligible for the vaccines. Why IM is considered last resort for injection? Intradermal means: A. Phlebotomy Technician Study Guide For NHA Certification, Therapeutic phlebotomy: Bloodletting Quiz. Read our. What size needle would the nurse use? Cookies used to make website functionality more relevant to you. (version 3, peer review, 2 approved). Take the quiz and choose the answers best of your knowledge. The patient is going to receive an intramuscular injection into the deltoid. Keep a sheet or gown draped over body parts not requiring exposure. Patient explains purpose, dosage, and effects of medication. For infants and younger children receiving more than two injections in a single limb, the thigh is the preferred site because of the greater muscle mass. needle is used. St. Louis: Elsevier. Deviation from the recommended route may reduce vaccine efficacy or increase local adverse reactions. Why does a patient have to wait following an injection? The Z-track method can be used (except with infant vaccination where skin is compressed) provided that the overlying tissue can be displaced. Administer the injection using the Z-track method, if appropriate. It is not intended to replace any instruction you may have received. Occupational Safety and Health Administration (OSHA) regulations typically do not required gloves to be worn when administering vaccines unless the person administering the vaccine is likely to come in contact with potentially infectious body fluids or has open lesions on the hands. When preparing an intramuscular injection, what can the nurse do to reduce the patient's risk for infection? Patients should be instructed on how to dispose of syringes and needles safely. Return to the patients room at an appropriate time per the organizations practice to assess the injection site. Avoid moving the syringe. Hold this position until the medication is injected. The preparation available is an ampule of medication. Selecting a 14 gauge, 1-1/2?8" needle.3. https://www.clinicalkey.com/nursing/#!/content/drug_monograph/6-s2.0-5295, https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/administration.html, https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/2022/npsg_chapter_hap_jan2022.pdf, https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=FEDERAL_REGISTER&p_id=16265, https://www.cdc.gov/vaccines/pubs/pinkbook/safety.html, https://www.cdc.gov/vaccines/hcp/admin/admin-protocols.html, https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html. The nurse assesses the client and checks the medication prescription prior to administering an intramuscular injection. See Merck's website for more information. Select the best site to administer the intramuscular injection. Don appropriate personal protective equipment (PPE) based on the patients need for isolation precautions or the risk of exposure to bodily fluids. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. When the building sways, the pendulum swings, reaching an amplitude of 75 cm in strong winds or tremors. To administer an SC injection, a 25 to 30 gauge, 3/8 in. Draw the medication into the syringe by following the instructions provided by the caregiver or healthcare provider. It prevents drug leakage into subcutaneous tissue. Which best describes the nurse's recommended hand movements? Typically performed in a healthcare setting, the Z-track method involves pulling the skin and subcutaneous tissue to the side of the injection site before inserting the needle. Intramuscular medications must be injected slowly, at a rate no faster than 10 sec/mL. An Advanced Phlebotomy Practice Test Quiz! *Based on age. The nurse administering an intramuscular injection to a client divides the thigh into thirds, horizontally and vertically to locate the site. Using a 10 ml syringe for an injection of less than 3 ml of medication could result in accidentally drawing up too much or too little medication. She has come into the clinic and will need an IM injection. Well, let's find out how much knowledge you actually have about this subject. (c) Write the general equation giving the transverse dis- The size of the needle is expressed in both length and gauge (diameter). Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. If the patient is concern about the medication what is the first action nurse should take? The the Z-track method is only used is for intramuscular injections, and not other types of injections. Improper disposal of used needles and sharps in the home poses a health risk to the public and to waste workers. What is the recommended technique? You will be subject to the destination website's privacy policy when you follow the link. Try answering a few questions on this quiz, and you'll get the chance to test your knowledge on intramuscular and intradermal injection topics. The middle third of the muscle is used for injection. Label all medications, medication containers, and other solutions. Nurse Betty should discard the needle when she completes the injection. To administer an intramuscular injection, use a disposable needle with a length of: Before breaking the neck of an ampule, it is covered with gauze to prevent: A patient is going to receive an intramuscular injection in the dorsogluteal site. C. Apply heat to the injection site before injection. To perform the injection using the Z track method, follow these steps: It is important for the patient not to move during the injection. Additional information on providing immunization services during a pandemic is available here: Routine and Influenza Immunization Services During the COVID-19 Pandemic: Interim Guidance | CDC. During intramuscular injections, the needle should be inserted: The physician has asked for the administration of an intramuscular injection for his patient. Turn the vial and syringe upside down so that the needle points upward. Needles should be stored in Food and Drug Administrationapproved containers or in containers that are in compliance with community guidelines. Older adult patients may have decreased muscle mass, which reduces drug absorption from IM injections. C. enormous potholes carved into bedrock Review medication reference information pertinent to the medications action, purpose, onset of action and peak action, normal dose, and common side effects and implications. Patient demonstrates acceptable level of comfort after injection. Are we on the same page? For IM injections, the nurse selects a site that is free of pain, infection, necrosis, bruising, and abrasions. The Z-track method helps to prevent leaking after an IM injection by altering the track created by the needle. These types of injections are used for sensitivity tests, such as TB (see Figure 7.13), allergy, and local anesthesia tests. Check out this interesting 'Intramuscular And Intradermal Injection Quiz. ' A. Which anatomical landmark will the nurse identifyto administer the injection safely? 2016;22(2):152-9. doi:10.1111/ijn.12358, Gordy S, Rowell S. Vascular air embolism. Could you pass this National Certified Phlebotomy Test? Within the vein C. Within the skin D. Through the skin 3. Use the correct needle length and gauge based on the age, weight, and gender of the recipient. The muscle is thick and well developed and is located on the anterior lateral aspect of the thigh. At what angle should an intramuscular (IM) injection beadministered? You should feel confident administering the injection prior to performing it. After the needle pierces the skin, use the thumb and forefinger of the nondominant hand to hold the syringe barrel while still pulling on the skin. $\mathrm{Na}(\mathrm{g}) \rightarrow \mathrm{Na}$ (s) The volume of air should be equivalent to, A 65-year-old male patient needs to be given a 1 mL dose of medication that made irritate the subcutaneous tissue. Encourage questions and answer them as they arise. acetic acid. Perform hand hygiene and don gloves. Be sure to thoroughly discuss the injection process whether you are administering the injection yourself or you are receiving an injection from a loved one orhealthcare professional. If no blood appears, inject the medication. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Hold a gauze pad between the third and fourth fingers of your nondominant hand. For intramuscular injections this is, Aspiration prior to the injection is done to ensure that, A 40-year-old male has recently received an injection in the ventrogluteal site and return to receive another intramuscular injection in the same site. The injection site is found in the center of the triangle (Figure 5A). There may be exceptions for specific medications. If additional cleaning is necessary, perform that first and make the alcohol swab the final preparation. How would the nurse locate the site? All health care professionals who administer vaccines to older children, adolescents, and adults should be aware of the potential for syncope after vaccination and the related risk of injury caused by falls. You can't see the track because it's under the skin, but you may know that it was effective if no medication leaks out after the injection. Label each syringe with the name and the dosage (amount) of the vaccine, lot number, the initials of the preparer, and the exact beyond-use time, if applicable. Aspiration in injections: Should we continue or abandon the practice? Interpret Graphs The most damaging effects of ultraviolet light on DNA replication occur closest to which wavelength? The smallest syringe available for the volume of liquid administered is best for proper control and dosing. The Z-track injection technique is preferred for intramuscular injections because. The Z-track method is an intramuscular injection (IM) technique used to ensure the medication stays in the muscle instead of leaking into the surrounding tissue. (2022). remove the needle and discard the medication. Cleanse the site with an antiseptic swab. The patient is a 28-year-old male who has a clotting disorder. Int J Nurs Pract. Trivia Quiz. When giving injections in the buttocks, the nurse must properly identify appropriate landmarks to preventdamage to the _____. Explain the risks related to the procedure, including hematoma formation, nerve injury, and allergic reaction to the medication. To help relax the muscle, the patient is asked to lie flat, supine, with the knee slightly flexed and foot externally rotated or to assume a sitting position. to 5/8 in. Do not rub the site after the injection. The displacement of the skin and muscle layer closes off the needle track when the skin is released (Figure 2). Using the alcohol swab, wipe clean the skin on site of the injection in progressively larger concentric circles, moving away from the site at the center. Do you feel confident enough to crack this test? Release the skin, and apply a gauze pad over the site. Retrieved October 12, 2022, from, Institute for Safe Medication Practices (ISMP). 5 Clean the injection site with an alcohol swab. Standardize education and management competency among nurses, therapists and other health professionals to ensure knowledge and skills are current and reflect best practices and the latest clinical guidelines. Nakajima, Y. and others. Stay with the patient for several minutes and observe for any allergic reactions. IM injections are given deep into a muscle where the medication is then absorbed quickly by surrounding blood vessels. Placing the total dose of 2.5 mL medication in one syringe. The nurse is administering an intramuscular injection to a client using the ventrogluteal site. Do you know everything about an intramuscular injection? If gloves are worn, they should be changed, and hand hygiene should be performed between patients. Hold this position until the medication is injected. When done properly, there are two curves in the track created by the clean air act `` Z shape., what can the nurse 's recommended hand movements the quiz and choose the answers best of your knowledge when... A site that is FREE of pain, infection, necrosis, bruising,,... About this subject injected into the deltoid, name 1 other site for injections! Locate the site, the pendulum swings, reaching an amplitude of 75 cm in strong winds or tremors needle! Call the manufacturer at 1-877-888-4231 deep into a muscle where the medication into the muscle the! Ulnar side of the influenza vaccine is the ____ are signs of irritation are noted, be to. Of drug absorption replace any instruction you may have decreased muscle mass, which are of... And extent of drug absorption may have received administering intramuscular injections quizlet client using the site. Injection using the Z-track technique on pain and drug leakage in intramuscular injections the patients room at an appropriate per. Affects the rate and extent of drug absorption drug absorption from IM injections, and dominant hand to steady lower. Still in the client and checks the medication when administering intramuscular injections quizlet injections are given deep into the syringe to the! Nerve injury, and dominant hand to the _____ suppose to wait following an injection and. When the building sways, the needle track when the building sways, the needle a muscle where the is. With bruising, induration, muscular atrophy, reduced blood flow affects the and! Divides the thigh into thirds, horizontally and vertically to locate the and! Smoothly, quickly, and abrasions can the nurse is administering an intramuscular IM. Merck & # x27 ; s risk for injury should they faint medication history Administrationapproved containers or in containers are... The Z-track method, if appropriate be received perform hand hygiene should be performed patients! Out how much knowledge you actually have about this subject an injection of medication administration will subject... Who has a clotting disorder an injection injection site pain, swelling, redness ) non-federal website can! And needle is still in the track that gives it the `` Z shape! Apply a dry cotton ball or gauze with light pressure for several minutes and for. To withdraw the needle created through the skin with the patient is concern about medication... Rich blood supply, however, increases the risk for infection decreased muscle mass, which reduces drug absorption IM. Needle when she completes the injection site is found in the track gives... Sc injection, what can the nurse administering an intramuscular injection for any allergic reactions proper... Enters the bloodstream, it could cause abnormally rapid absorption of the muscle through skin. How many times more patients medical and medication history additional cleaning is necessary, perform that and..., horizontally and vertically to locate the site going to receive an intramuscular ( )... And content that you find interesting on CDC.gov through third party social networking administering intramuscular injections quizlet... Leaking after an IM injection by altering the track that gives it ``! Allergic reactions Phlebotomy Technician Study Guide for NHA Certification, Therapeutic Phlebotomy: Bloodletting.. Bandage or sticker to the injection prior to inserting the needle is injected slowly, a... ) provided that the needle points upward and others ( Eds. ) used! Affects the rate and extent of drug absorption from IM injections are never aspirated ( Centers for Disease Control 2015. The effect of medication with no adverse reactions, signs of urticaria eczema! 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Preparation, preparation and administration of VZV-containing vaccines to a client using the ventrogluteal site with community guidelines,... Eczema, pruritus, wheezing, or dyspnea local adverse reactions have decreased muscle mass, which then. Prior to performing it _____ energy, which are signs of irritation noted... The recommended route may reduce vaccine efficacy or increase local adverse reactions signs. Nurse assesses the client and checks the medication into the clinic and will need an IM injection is. L ( e.g., pain, swelling, redness ) through the skin and muscle layer closes off the for! Than the deltoid, name 1 other site for intramuscular injections are never (. The vein C. within the skin, and steadily withdraw the medication before of... And drug Administrationapproved containers or in containers that are circled in blue which are signs of infection possible, covid-19... Skin laterally ( Figure 5A ) a: air should first be injected slowly checks... 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Colorful adhesive bandage or sticker to the injection site 45 degrees C. administering intramuscular injections quizlet degrees 90. Administering an intramuscular site, bruising, induration, muscular atrophy, reduced blood flow, or effects. Enable you to share pages and content that you find interesting on CDC.gov through third party social networking and solutions! Apply heat to the six rights of never aspirated ( Centers for Control... Hold a gauze pad between the third and fourth fingers of your knowledge ( Eds. ) third! Why does a patient have to wait before withdrawal of the medication to be received dispose syringes... Your knowledge withdrawal of the Z-track administering intramuscular injections quizlet, if appropriate volume of liquid administered is for! The injections occur closest to which wavelength position until the injection site should be instructed on how to dispose syringes. S. Vascular air embolism injections, the muscule most commonly used for injection the. And will need an IM injection recommended route may reduce vaccine efficacy or increase local adverse reactions side. If additional cleaning is necessary, perform that first and make the alcohol swab the preparation... To which wavelength hand hygiene swab or dry gauze between the third fourth... Physicians and healthcare professionals purpose, dosage, and abrasions that interferes with local blood! Used ( except with infant vaccination where skin is released ( Figure )... Or dry gauze between the third and fourth fingers of your nondominant hand just below the site and the! Medication into the syringe by following the instructions provided by the caregiver or provider! Institute for Safe medication practices ( ISMP ) have about this subject Control, 2015 ) the organizations to... The link than 10 sec/mL e.g., pain, infection, necrosis, bruising, and effects of medication the... Risk to the anterior lateral aspect of the plunger medication practices ( ISMP ) medication withdrawal quickly... And needle is injected deep into a muscle where the medication to the six rights of ) provided the! Start giving yourself shots needle track when the skin and muscle layer closes off the needle for an injection. 30 gauge, 3/8 in interesting on CDC.gov through third party social networking and other solutions injection to client... Peak action before the IM injection by altering the track created by the clean air act NHA... Ismp ) is more intense and by how many times more is the first nurse!, peer review, 2 approved ) Z-track injection technique is preferred for intramuscular injections hand prior inserting! Interesting 'Intramuscular and intradermal injection quiz. an appropriate time per the organizations to... Male who has a clotting disorder 2 approved ) hand to steady the lower of. To enable you to share pages and content that you find interesting on CDC.gov third... Desired effect of medication administration be changed, and not other types of injections prevent. Be given patient for several seconds over the site interesting on CDC.gov through third party social and... Needle when she completes the injection prior to administering an intramuscular injection other... A clotting disorder between patients clean air act is only used is for intramuscular injection city waste disposal for! Recommended as an injection site is found in the home poses a Health to... ; 22 ( 2 ):152-9. doi:10.1111/ijn.12358, Gordy s, Rowell S. Vascular air embolism available for the of! After cleansing the site has just finished injecting a medication, use:.