Giving an intramuscular injection

Adult Deltoid can take between 1-2 mL
Adult Ventogluteal or Dorsogluteal can handle between 2-5 mL

1. Wash your hands.
2. Gently agitate the medication by rolling the vial between your palms.
   (purpose: to mix any medication that may have settled)
3. Clean the rubber stopper of the vial with alcohol using a circular surface.
4. Draw up an equal amount of air into the syringe to what your about to inject.
   • not enough replaced air will make it difficult to withdraw the medication; too much replaced air will force the medication into the syringe without pulling on the plunger to withdraw it.
5. Inject the aspirated air in the syringe into the vial.
   -pick the vial and syringe unit up and invert it. Slowly pull back on the plunger until the proper amount is withdrawn.
   -withdrawing medication rapidly will cause air bubbles to form in the syringe.
6. While the needle is still in the vial, check that there are no air bubbles in the syringe.
   -air bubbles displace medication and you wont receive the proper amount.
   -If there are bubbles tap the syringe until the air bubbles dislodge and float to the tip of the syringe. Expel the air bubbles through the needle, then continue withdrawing the medication
7. The proper deltoid injection site is located approximately two to three fingers widths below the acromial process (the bone in the shoulder).
   -Ventrogluteal (is the safest free of major nerves and blood vessels). You would need two people to get the correct spot for the first time you locate it. You lay on your side - place the palm of your hand (who ever is helping) on the greater trochanter (below your hip its actual the top, outside part of your femur) pointing your index finger toward the anterior iliac spine (front of your hip bone) and spread your middle finger back as far as possible from your index finger forming a triangular injection area. (basically its like a hip injection)
   -Dorsogluteal easiest way is divide the butt check in fours then take the top outer corner and divide into fours again (like a plus sign...) use the top outer most spot BELOW the start of your butt crack.
8. Clean the skin with alcohol using a circular motion, moving outward from the center.
9. With your thumb and index finger spread the skin tightly.
10. Grasp the syringe like a dart, insert the entire needle at a 90 degree angle into the site
11. Aspirate: withdraw the plunger slightly to be sure that no blood enters the syringe (you can watch the hub of the needle.. )If you see blood start over. If no blood inject the medication
12. Take the syringe out - fast - and massage the site - it helps to decrease pain and increase absorption.

Now as far as pip goes here is a few things to help..
1. Inject slowly
2. Run the vial under hot water to warm up gear.
3. Massage site to disperse the oil in the site.
4. Take a hot bath.
5. Use heat pad as needed.