Best practice technique in intramuscular injection

In this month's Clinical Skills article, best practice for the administration of intramuscular (IM) injections will be discussed. It is important to re-visit clinical skills as many are taught during initial training and then not re-visited. This can lead to poor practice and incorrect technique, which in turn can lead to patient discomfort and potential complications (Hunter, 2008; Malkin, 2008). An overview of injection sites, indications and complications will be provided with an evidence-based approach to best practice technique. Full critique of the injection sites will not be explored here owing to the overview nature of this article.

It is important for patient care to ensure optimal effects of the medications administered, and to minimise the experience of any discomfort or pain. Within paramedic practice, examples of medications administered via the IM route include:

There are five known sites identified for intramuscular injections with differences in the literature in terms of which are recommended (Thomas and Monaghan, 2014) (Figure 1):