Emergency Medicine Book


Intramuscular Injection

Aka: Intramuscular Injection
  1. See Also
    1. Injectable Drug Delivery Route
    2. Emergency Medication Delivery
    3. Subcutaneous Injection
    4. Intravascular Injection
  2. Technique: Location
    1. Deltoid muscle
    2. Outer thigh (Vastus lateralis muscle)
    3. Upper, outer aspect of buttock
      1. Avoid sciatic nerve at inferior medial aspect
  3. Precautions
    1. Avoid frequent site reuse due to injection site fibrosis risk
  4. Efficacy
    1. Many standard IM medication uses are no more effective than their oral counterparts
      1. Vitamin B12 Replacement
      2. Ketorlac (Toradol)
      3. Corticosteroids
      4. Ceftriaxone in cases of refractory Otitis Media or Urinary Tract Infections in children
      5. Shatsky (2009) Am Fam Physician 79(4):297-300 [PubMed]
  5. Contraindications
    1. Bleeding Diathesis (e.g. Coagulopathy or Thrombocytopenia)
  6. Indications
    1. Analgesics
      1. Morphine
    2. Sedative-Hypnotics
      1. Diazepam
      2. Ketamine
    3. Vaccinations
      1. GardasilVaccine
      2. Hepatitis A Vaccine
      3. Hepatitis B Vaccine
      4. Rabies Vaccine
    4. Sex Hormones
      1. Testosterone
      2. Estradiol
      3. Depo Provera
      4. Lupron
    5. Antibiotics
      1. Penicillin
      2. Ceftriaxone
    6. Miscellaneous
      1. Interferon Beta (Multiple Sclerosis)

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