How to Give an Intramuscular Injection
Master the step-by-step technique for administering an intramuscular injection safely using clinical landmarking, 90-degree insertion, and a practice pad.
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🧰 Required Tools & Equipment
- ✓ IM injection practice pad
- ✓ 3 mL syringe with 22G 1.5-inch safety needle
- ✓ Sharps disposal container
- ✓ Non-sterile exam gloves
- ✓ Alcohol prep pads
📦 Materials & Supplies
- ✓ Practice vial (saline or water)
- ✓ 2x2 inch sterile gauze pad
- ✓ Adhesive bandage
⚠️ Safety Checkpoints & Warnings
- • Verify the six rights of medication administration before drawing up fluid.
- • Never recap a contaminated or exposed needle with two hands; engage the built-in safety guard immediately after withdrawal.
- • Always maintain a strict 90-degree angle to ensure delivery into deep muscle tissue.
📋 Step-by-Step Guide (5 Steps)
Draw Medication and Expel Air
Don clean gloves and scrub the practice vial rubber stopper with an alcohol wipe for 15 seconds. Inject an equal volume of air into the vial, invert it, and withdraw the exact required volume. Tap the syringe barrel to float air bubbles to the top and gently push the plunger to expel them.
- • Syringe barrel contains clear liquid with meniscus aligned to the target dosage line.
- • Zero air bubbles visible in the liquid column or needle hub.
- • Failing to inject air first, creating vacuum resistance inside the vial.
- • Touching the needle shaft or hub against non-sterile surfaces.
Identify Anatomical Landmarks and Disinfect
Locate the targeted anatomical site on the practice model (such as the center of the deltoid muscle or the ventrogluteal triangle). Clean the skin in a circular motion starting from the center and moving outward 2 inches. Allow the skin to air-dry completely for 30 seconds.
- • Cleaned circular sheen on the practice surface directly over the anatomical center.
- • Pad surface fully dry without pooling alcohol.
- • Blowing on or fanning the wet alcohol to speed up drying.
- • Cleaning from the outside edge inward, dragging contaminants into the target zone.
Anchor the Skin and Position the Syringe
Uncap the needle by pulling straight off. Use your non-dominant hand to spread the skin taut or apply the Z-track technique by displacing the skin 1 inch laterally. Hold the syringe like a dart between the thumb and index finger of your dominant hand directly above the site.
- • Skin surface visibly taut or laterally displaced by non-dominant hand.
- • Needle shaft positioned perfectly perpendicular (90 degrees) to the pad surface.
- • Holding the syringe at an oblique 45-degree angle.
- • Pinching the skin upward instead of spreading it flat, which raises subcutaneous tissue.
Insert Needle and Administer Solution
Insert the needle smoothly and quickly at a 90-degree angle all the way to the hub. Stabilize the syringe barrel with your non-dominant hand's thumb and index finger. Depress the plunger slowly and steadily at a rate of roughly 1 mL every 10 seconds.
- • Needle shaft fully buried to the hub at 90 degrees.
- • Plunger rod smoothly moving downward to the zero line without jerking.
- • Hesitant, slow pushing of the needle into the skin.
- • Rapidly slamming the plunger down, causing tissue trauma.
Withdraw, Activate Safety, and Apply Pressure
Withdraw the needle smoothly along the same 90-degree path while placing a gauze pad lightly over the site. Immediately activate the needle safety device using a single-handed technique against a firm surface or thumb latch, and drop the syringe into the sharps container. Apply gentle pressure to the injection site with gauze.
- • Needle safety shield audibly/visibly locked over the full length of the needle.
- • Used syringe fully inside the sharps container opening.
- • Gauze pad pressed flat against the injection puncture site.
- • Massaging the site vigorously, which forces medication into subcutaneous layers.
- • Using both hands to manually snap the safety shield over the needle.
Credit: inspired by an original tutorial by DOCTOR KIRAN DOGAR — watch the original on YouTube.
Don’t have everything?
- No IM injection practice pad? Fresh thick-skinned orange or dense synthetic foam block
- No Practice vial? Small clean bottle filled with sterile saline