A gluteal injection (IM) delivers medication directly into the gluteal muscles. This method is chosen for medications requiring deep muscle absorption, allowing faster entry into the bloodstream than subcutaneous injections. The muscle’s rich blood supply facilitates quick absorption and accommodates larger volumes. This guide provides safe administration information; always consult a healthcare provider before attempting any injection.
Getting Ready for the Injection
Gathering necessary supplies ensures a smooth, sterile process. These include:
Prescribed medication
Appropriate needle and syringe
Alcohol wipes
Cotton balls or gauze
Adhesive bandage
Clean gloves
Puncture-resistant sharps disposal container
Proper patient and environmental preparation are important. Ensure the individual is comfortable, lying on their side or stomach, to relax the gluteal muscle. The injection area should be clean, well-lit, and private to minimize discomfort and contamination.
Identifying the correct injection site avoids complications. The ventrogluteal site is preferred for its distance from major nerves and blood vessels, making it safer for adults and children over seven months. To locate, place the heel of your hand on the patient’s greater trochanter (hip bone), pointing fingers towards their head. Extend your index finger to the anterior superior iliac spine and spread your middle finger towards the iliac crest, forming a V-shape; the injection goes into the V center.
The dorsogluteal site, in the upper outer quadrant of the buttock, has been traditionally used but carries a higher risk due to its proximity to the sciatic nerve. To locate, divide the buttock into four imaginary quadrants and use the upper outer section, approximately 5-8 cm below the iliac crest. Some recommend drawing an imaginary line between the posterior superior iliac spine and the greater trochanter, with the area above this line considered a safe zone.
Performing the Gluteal Injection
Wash hands thoroughly with soap and warm water, then don clean gloves. After selecting the site, clean the area with an alcohol wipe using a firm, circular motion, moving outwards. Allow alcohol to air dry completely to prevent stinging.
Prepare medication by removing the cap from the vial and cleaning the rubber stopper with an alcohol swab. Attach the appropriate needle (typically 22-25 gauge and 1 to 1.5 inches for adults) to the syringe and draw air equal to the dose. Insert the needle into the vial, inject air, then invert the vial and draw the prescribed amount, ensuring no air bubbles remain.
Prepare the skin by stretching it taut at the chosen site or pinching a muscle mass, depending on body type. Hold the syringe like a dart and insert the needle quickly and firmly at a 90-degree angle directly into the muscle. A swift motion minimizes patient discomfort.
Aspiration, pulling back on the plunger to check for blood, was once standard. However, current guidelines from the WHO and CDC state it is often unnecessary for most IM injections, especially vaccines, due to low risk of hitting a major vessel. If aspiration is performed and blood appears, withdraw the needle, discard the syringe, and prepare a new injection at a different site.
If no blood is aspirated, or if aspiration is not indicated, slowly depress the plunger to inject the medication. A slow injection rate, approximately 10 seconds per milliliter, can reduce pain, tissue trauma, and minimize medication leakage. After the medication is fully injected, quickly and smoothly withdraw the needle at the same 90-degree angle of insertion.
After the Injection and Important Safety Information
Once the needle is withdrawn, immediately apply gentle pressure to the injection site with a clean cotton ball or gauze. Secure a small adhesive bandage if needed, but avoid rubbing; this can cause irritation or force medication into the subcutaneous tissue.
Prompt disposal of the used needle and syringe prevents accidental needle sticks and infection spread. Immediately place the entire needle and syringe unit into a designated sharps disposal container. These containers are puncture-resistant and should be kept out of reach of children and pets. Never place used sharps in regular trash or recycling bins.
Monitor the individual for immediate adverse reactions like dizziness, excessive pain, swelling, redness, or bleeding. While minor reactions are common, certain symptoms warrant immediate medical attention.
Seek medical consultation for severe pain, excessive bleeding, or signs of infection (e.g., pus, increased warmth, red streaks). Numbness, tingling, or weakness in the limb could indicate nerve irritation or damage, requiring prompt medical evaluation.
Gluteal injections carry risks and should be performed by, or under the direct supervision of, a trained healthcare professional.