Intramuscular injection is a commonly used drug injection treatment method, which refers to passing liquid medicine throughSyringeinjectionMuscle tissueTo achieve the goal of curing diseases.
Intramuscular injection is mainly applicable to: inappropriate or impossibleintravenous injection, requirement ratiosubcutaneous injectionWhen the curative effect occurs more quickly, and when the drug with strong irritation or large dosage is injected.
The most commonly used part of intramuscular injection is gluteus maximus, followed by gluteus medius, gluteus minimus, lateral thigh muscle andthe deltoid。For intramuscular injection, it is very important to accurately locate the injection part.
Positioning of gluteus maximus injection: cross method: draw a horizontal line from the top of the hip fissure to the left or right, draw a vertical bisector from the highest point of the iliac crest downward, divide the hip into four quadrants, of which the upper outer quadrant avoids the inner corner as the injection area.Connection method: fromAnterior superior iliac spineThe outer third of the line to the tailbone is the injection site.
Location of gluteus medius muscle and gluteus minimus muscle injection: there are few blood vessels and nerves, and the adipose tissue is thin. At present, it is widely used. There are two positioning methods:
A Place the index finger tip and the middle finger tip at the anterior superior iliac spine and the lower edge of the iliac crest respectively, and form a triangle area between the iliac crest, index finger and middle finger.The injection site is in the angle formed by the index finger and the middle finger.
B At the three lateral fingers of the anterior superior iliac spine.Sick children should be based on the width of their fingers.
Location of lateral thigh muscle injection: it is located at the outside of the middle part of the thigh: generally, adults can take a section from 10cm below the hip joint to 10cm above the knee, where large blood vessels and nerve trunks rarely pass through, and the site is wide, which can be used for multiple injections.
Upper arm deltoid muscle injection location: outside the upper arm, 2~3 transverse fingers below the shoulder peak.The muscles here are thinner than those in the buttocks, so only a small dose of injection can be done.
Seating or lying position is acceptable.
(1) Lying position: when intramuscular injection of buttock, in order to relax local muscles and relieve pain and discomfort, the following positions can be adopted:
Prone position: the toes are opposite, the heels are drooping, and the head is inclined to one side.
Supine position: commonly used for critical patients and patients who cannot turn over, it is convenient to use gluteus medius and gluteus minimus injection.
(2) Seating position:Outpatient DepartmentThe patient usually takes the position when receiving the injection.It can be used for the deltoid head of the upper arm. If the injection drug is oil or suspension, a thicker needle should be prepared;Prepare the liquid medicine according to the doctor's instructions.
Operating procedures
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(1) Prepare all supplies and take them to the bedside, check them and explain to the patients for cooperation.
(2) Help the patient to take proper position, disinfect the skin with 2% iodine and 70% ethanol or 3% complexed iodine alone, and leave it dry.
(3) Exhaust the air in the syringe for extracting drugs.
(4) Use the left thumb and index finger to separate the skin, and hold the needle in the right hand as if holding a penmiddle fingerSecure the pin.The needle and the injection site were mp, and the needle was quickly inserted into the muscle, generally about 2.5~3cm (2/3 of the needle, depending on the emaciated and sick children).
(5) Loosen the left hand, twitch the piston, if there is no blood return, fix the needle and inject medicine.After injection, press the needle into the needle with a dry cotton swab, and pull out the needle quickly at the same time.
(6) Help the patient lie in a comfortable position.Cleaning materials.
The following issues should be noted during intramuscular injection:
(1) Two kinds of liquid medicine need to be injected at the same time, and the incompatibility should be noted.
(2) The drug can be injected only when there is no blood return.
(3) The injection site is suitable for individuals.Infants under 2 years old should not use gluteus maximus injection, but should use gluteus medius and gluteus minimus injection.Because the gluteus maximus muscle injection of young children is dangerous to damage the sciatic nerve because their buttocks muscles generally do not develop well before they can walk alone.
(4) Accurate positioning, especially gluteus maximus injection should avoid damaging the sciatic nerve.
(5) Do not pierce all the needles to prevent the needles from breaking off from the joint.Once the needle is broken, keep the part and limb still, and quickly clamp the broken end with vascular clamp and pull it out.If all the broken ends enter into the muscles, they should be removed surgically.
(6) For patients requiring long-term intramuscular injection, the injection site should be changed frequently to prevent local induration. If induration occurshot-water bagOr hot wet compress, physiotherapy, etc.
Child care
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Intramuscular injection is a commonly used method of administration in children with diseases.It is generally used when the medicine is not suitable for oral use, the sick child cannot take the medicine orally, or the condition requires rapid drug effect.Generally, although intramuscular injection is performed by nurses, parents should also assist in nursing work.
(1) For sensible children, it is necessary to explain the necessity of injection, so that children can accept it bravely, especially give children sympathy and comfort, eliminate nervousness and fear, and reduce adverse reactions.
(2) Assist the nurse in three checks and three pairs before injection, and ensure that they are accurate.
(3) If allergy test is required before use, parents should closely observe whether the child is abnormal or uncomfortable.If there is chest tightnessShortness of breath. Poor breathing, paleness, cyanosis or restlessness, so as to report to the medical staff in time and take corresponding measures immediately.
(4) In the process of intramuscular injection, the infants should be well fixed and not allowed to struggle and move, so as not to break the needle.
(5) Do not leave immediately after injection, but stay in the hospital for observation for about 15 minutes.
(6) After intramuscular injection, let the child rest for a period of time and do not run violently.After intramuscular injection, if the child complains that the injection site is painful and inconvenient to walk, close observation is required.If necessary, go to the hospital for a doctor's inspection.
(7) Local hard lump caused by drugs after intramuscular injection, availableHot compressOr moxa sticks to promote its absorption.
Route of transmission
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After the drug is dissolved in the tissue fluid, it enters the capillary network and then flows into the vein, or directly into the small vein or lymph and then flows into the large vein. With the venous blood, it flows into the right atrium, then into the right ventricle. After passing through the pulmonary circulation, it returns to the left atrium, then into the left ventricle, enters the systemic circulation, reaches the liver, metabolizes the active ingredients, and then reaches the whole body or the focus with the blood flow.If there is activity without metabolism, it can directly reach the whole body without entering the liver.
