Procedure for Pediatric Intramuscular Injections

A pediatric intramuscular injection is a type of shot you give a child when they cannot get the medicine orally. These injections are typically injected into a large muscle such as the outer thigh, outer hip or upper arm, according to Children's Healthcare of Atlanta (CHOA). Knowing the procedure for how to properly give these injections is important in preventing complications.

Supplies

• A few basic necessities must be in place when giving an injection. You need alcohol swabs (or rubbing alcohol and cotton balls), a 1cc or 3cc syringe, the proper gauge needle (a one-inch needle is recommended for children two years and younger), an adhesive bandage, the medicine and a dry gauze or tissue.

Preparing the Injection

• The CHOA says to allow the medicine to come to room temperature, which will typically take 15 to 30 minutes. Wash your hands thoroughly and check the label on the medicine for proper name and dosing instructions.
  Use alcohol to clean the top of the medicine bottle and allow the alcohol to dry. Place the needle on the syringe and remove the cap from the needle. Be careful to not touch the needle or let it come in contact with any surface with the cap off.

  Pull air into the syringe equal to the amount of medicine indicated on the dosing instructions. Stick the needle through the top of the bottle and push the air into the medicine bottle. Turn the bottle upside down and pull back slowly on the plunger to fill the syringe with the exact amount of medicine to be given. If there is an air bubble, pull back a little more medicine. If air bubbles still appear, tap the side of the syringe to make the air go to the top of the syringe and push out the air. Check again to be sure the dose is correct. Take the needle out of the bottle and put the cap back on.

The Shot

• Wash your hands again before the injection takes place and locate the spot you wish to inject the medicine into. For young children you will want to use the upper or outer part of the thigh, and for school age children the upper arm is usually used. It is not recommended that you inject into the buttocks, according to the National Institutes of Health.

  Clean the injection site with alcohol swab; using some force to make sure it is a thorough cleaning. And allow the alcohol to dry. This will only take a short time.

  Hold the muscle firmly between your thumb and index finger and hold the syringe like a pencil. Quickly insert the needle through the skin at a 90-degree angle.

  Pull back the plunger slightly to see if blood is visible in the syringe. If you see blood, pull the needle out and discard the needle, syringe and medicine and start over.

  If the syringe is clear of blood, slowly push the plunger in to inject the medicine into the tissue. Count to five, and then remove the needle. After removing the needle, gently press on the site with dry gauze or tissue until bleeding stops. Apply an adhesive bandage to the site and be sure to tell the child what a great job she did.