How to Administer IM (Intramuscular) Injections - PKIDs

1 IM site for infants and toddlers(birth to 36 months of age)IM site for older toddlers, children, and adultsInsert needle at 80-90 angle into vastus lateralis muscle in anterolateralaspect of middle or upper needle at 80-90 angle into densest portion of deltoid muscle -above armpit and below insertionNeedle size*Site (see illustrations below)Patient s ageInfants (birth to 12months of age)Toddlers (12 to 36months of age)Toddlers (>36months of age),children, andadultsVastus lateralis muscle inanterolateral aspect of middleor upper thighVastus lateralis muscle pre-ferred until deltoid muscle hasdeveloped adequate mass(approximately age 36 months)Densest portion of deltoidmuscle - above armpit andbelow acromion7/8 to 1 needle,23-25 gauge7/8 to 1 needle,23-25 gauge1 to 2 needle,23-25 gaugeAdminister these vaccines via IM ( intramuscular ) route: DTaP, DT, Td, Hib, hepati-tis A, hepatitis B, influenza, PCV7.

2 Administer IPV & PPV23 either IM or you Administer these vaccines, follow the age recommendationsindicated in the current Minnesota immunization to Administer IM ( intramuscular ) InjectionsUse a needle long enough to reach deep into the needle at an 80 to 90 angle to the skin with a pressure on skin around injection site with thumband index finger while needle is are no data to document the necessity of aspiration,however, if performed and blood appears after negativepressure, the needle should be withdrawn and a new siteselected.*( )Multiple Injections given in the same extremity should beseparated as far as possible (preferably 1 to 1 withminimum of 1 apart).skinsubcutaneous tissuemuscle80 -90 anglevastus lateralis (shaded area)IM injection site areadeltoid muscle (shaded area)acromionelbowIM injection site*Red Book 2000, American Academy of PediatricsMinnesota Department of Health 6/01SQ site for infants and toddlers(birth to 36 months of age)SQ site for toddlers,children, and adultsInsert needle at 45 angle into fatty area of anterolateral thigh.

3 Make sure youpinch up on SQ tissue to prevent injection into needle at 45 angle into outer aspect of upper arm. Make sure you pinch upon SQ tissue to prevent injection into insertionNeedle size*Site (see illustrations below)Patient s ageInfants (birth to 12months of age)Toddlers (12 to 36months of age)Children andadultsFatty area of the thighFatty area of the thigh or outeraspect of upper armOuter aspect of upper arm5/8 to 3/4 needle,23-25 gauge5/8 to 3/4 needle,23-25 gauge5/8 to 3/4 needle,23-25 gaugeAdminister these vaccines via SQ (subcutaneous) route: MMR, varicella,meningococcal. Administer IPV & PPV23 either SQ or you Administer these vaccines, follow the age recommendations indicatedin the current Minnesota immunization to Administer SQ (Subcutaneous) InjectionsInsert needle at 45 angle to the up on SQ tissue to prevent injection are no data to document the necessity ofaspiration, however, if performed and bloodappears after negative pressure, the needleshould be withdrawn and a new siteselected.

4 *( )Multiple Injections given in the same extremityshould be separated as far as possible(preferably 1 to 1 with minimum of 1 apart).skinsubcutaneous tissuemuscle45 angleSQ injection site areaacromionSQ injection site areaelbow*Red Book 2000, American Academy of PediatricsMinnesota Department of Health - 6/01