Intramuscular injections

1. Wash hands
2. Assemble all of your supplies
3. Attach an 18-gauge 1½ inch needle to a 3-cc syringe
4. Open both the water and medication ampules/vials
   • To open an ampule
     1. Put your thumb on the blue dot located on the neck of the ampule
     2. Cover the ampule with a paper towel or tissue to protect your hands from injury
     3. Snap the ampule by pushing thumbs away from you
   • To open a vial
     1. Just flip off the cap exposing the rubber stopper
5. Pull water out of ampule or vial. If using vial, inject 1 cc of air into the vial before pulling out the water.
6. Inject water into the first powder
7. Pull everything out
8. Continue injecting water into additional ampules or vials until all are mixed
9. Switch to the 25-gauge 1½ inch needle
10. Tap on syringe to make sure there are no extra air bubbles. Push air out of the syringe.
11. Injection medication
12. The patient can lie down or stand. If the patient is standing, do not bear weight on the side of the injection
13. See attached diagram for injection sites
14. Stretch the skin
15. Inject at a 90 degree angle
16. Pullback on bevel of syringe to check for blood
17. If no blood, inject and remove needle
18. If blood, discard medicine and start again