Learn about the Best Injection Sites for an Intramuscular Injection (2022)

Intramuscular (IM) injections are shots delivered to a large muscle. The shot can be given by a healthcare provider or self-administered to any one of four injection sites on the body. IM injections are used for people of all ages, including infants.

Some IM injection sites may be preferred over others, depending on the age of the recipient, the type of medication used, the dose, the intramuscular needle size, and whether the shot is being given to yourself or by someone else. Choosing the right site is important as it helps reduce the risk of injury and ensures that the medicine is properly absorbed.

Self-administered IM injections may be used for different reasons, including assisted fertility treatments, gender-affirming hormone therapy, vitamin B12 supplementation, and some disease-modifying treatments for autoimmune diseases like rheumatoid arthritis.

The article lists the four sites commonly used for intramuscular injections and provides instructions on how to give the shots safely. It also discusses the right injection technique as well as possible side effects.

Learn about the Best Injection Sites for an Intramuscular Injection (1)

How to Give an Intramuscular Injection

Where Are the Four Intramuscular Injection Sites?

There are four sites you can use to give yourselfan IM shot. These sites have large, easy-to-locate muscles with little fatty tissue.

Upper Arm

Your deltoid muscle is the large muscle in yourupper arm, just below your shoulder.

To find the injection site, feel for the bone at the top of your arm where your arm meets your shoulder. The injection site is about two inches below that spot (or roughly two or three finger widths). Be sure to give the injection in the center of the muscles where it is thickest.

(Video) How to Give Yourself an Intramuscular Injection

It can be difficult to give yourself a shot in the deltoid muscle. You may need help from a partner.

Thigh

Your vastus lateralis and rectus femoris muscles are located in your thigh. They make up what is known as the quadriceps (quad) muscle.

To find these muscles, imagine lines dividing the front of your thigh into thirds from the top to the bottom.

  • To inject into the vastus lateralis, the needle should go into the middle third on the outer portion of your thigh.
  • To inject into the rectus femoris muscle, the needle should go in the middle third at the front of your thigh.

The vastus lateralis muscle is considered the preferred site for IM injections in infants and babies, particularly those not yet walking.

Buttock

The dorsogluteal muscle is the large muscle located in your buttocks. It is one of the largest muscles on the body but one that can be awkward to access on your own. For this site, you will need a partner.

To find this site, divide one butt cheek into fourths from top to bottom and side to side. Your partner will want to give the injection in the outer, upper quadrant toward the hip. This is the part of the buttocks with the least fatty tissue.

The dorsogluteal muscle may seem the preferred choice because it is so large, but IM injections pose risks as there are major blood vessels and nerves located there, including the sciatic nerve.

Hip

Your ventrogluteal muscle is located near yourhip. While it is possible to give yourself a shot there, it may be easier to do with a partner.

To find the site, lie on your back and have your partner stand facing your hips. Have your partner place the heel of their hand so that their wrist is lined up with your thigh.

(Video) Intramuscular (IM) Injection: Sites

Your partner's thumb should be pointed toward your groin and their fingers should be pointed toward your head. They should be able to feel the border of a bony area with their ring finger and pinkie.

Next, your partner should spread their pointer finger and middle finger into a "V" and give the injection between those fingers.

The ventrogluteal muscle is the most common site for IM injections in adults and children of walking age. It is a large muscle situated well away from vulnerable nerves like the sciatic nerve.

Overcoming Fears of Self-Injection

Proper Technique for IM Injections

Your healthcare provider will give you a prescription for your IM medication as well as for the appropriately sized syringes and needles. The gauge of the needle is especially important as small needles can fail if the injectable medication is thick.

A nurse or other healthcare provider will teach you or your partner how to deliver the injections. It is important that you are comfortable with the technique before doing it yourself.

If you are concerned about pain, you can numb the injection site for five to 10 minutes with ice. There are also numbing creams, typically containing lidocaine, available at most drugstores.

To give yourself or your partner an IM injection:

  1. Gather your supplies.
  2. Wash your hands.
  3. Clean the injection site with an alcohol swab.
  4. Remove the cap from the needle.
  5. Push the needle through the rubber seal on top of the vial.
  6. Draw back the plunger to fill the syringe.
  7. Withdraw the needle from the vial.
  8. Remove any air bubbles by gently tapping the syringe and compressing the plunger.
  9. Holding the syringe like a dart, position the needle at a 90-degree angle to the injection site.
  10. Insert the needle with a brisk, controlled motion.
  11. Compress the plunger to inject the drug.
  12. Remove the needle.
  13. Apply pressure to the injection site with some gauze.
  14. Discard the needle and syringe safely.

Alternating Injection Sites

If you need to give yourself IM injections regularly, be sure to alternate injection sites. This prevents the build-up of scar tissues that can make injections difficult. Your healthcare provider can show you which injection sites are appropriate.

(Video) Intramuscular Injection in Deltoid Muscle with Z-Track Technique

Possible Side Effects

There may be temporary pain and discomfort during the IM injection itself, but these tend to ease quite quickly. There also be minor bleeding, pain, swelling, or redness following the shot.

If you give yourself an injection in the dorsogluteal site, there is a risk of sciatic nerve injury. This can lead to a painful condition called sciatica that tends to resolve on its own but can make you uncomfortable for several days or weeks. Significant bleeding is also possible.

Although unlikely, it is possible to get an infection from an IM injection. This can occur if you do not adhere to hygienic practices (like washing your hands), reuse needles or syringes, or use medications that are expired or look tainted.

When to Seek Medical Attention

Seek immediate medical care if you have signs of severe infection at an injection site, including.

  • High fever with chill
  • Increasing redness, warmth, swelling, or pain at the injection site
  • A pus-like discharge
  • Red streaks spreading outward from the injection site

Summary

There are four sites on your body that can be used to give yourself an intramuscular injection. These include the upper arm, thigh, hip, and buttocks.

Make sure you are comfortable with the injection technique before you start giving yourself shots. A nurse or other healthcare provider can show you how to do it. Look out for side effects and report any concerns to your healthcare provider.

A Word From Verywell

The idea of giving yourself an intramuscular injection can make you squeamish, but, with practice, most people become quite comfortable doing so. As with anything, practice makes perfect. While you're getting the hang of it, you can practice by giving shots to an orange.

The main thing to remember is not to "stab" the needle but to give the shot with a brisk, controlled movement. To do so, you need to hold the syringe firmly. If you don't, you'll have less control when administering the shot and may end up bouncing the needle off of the skin.

(Video) HOW TO GIVE IM INJECTIONS | sites, considerations, nursing care for nurses

Frequently Asked Questions

  • Can you hit the bone with an intramuscular injection?

    With the right size needle and proper injection site, the risk of hitting bone is unlikely. With that said, some muscles (like the deltoid muscle of the upper arm) are smaller in some people, and it is possible to hit bone if the shot is not given in the thickest part. Even so, it doesn't usually cause pain or complications.

  • When is an intramuscular injection avoided?

    If you're taking blood thinners or have a bleeding disorder or low platelet count, your doctor may avoid intramuscular injections due to the risk of bleeding. They may also be inappropriate for people with hypovolemic shock or muscle wasting as these conditions will affect drug absorption.

  • Do you massage intramuscular injections?

    Your first instinct may be to massage an intramuscular injection site to ease the pain or help "get the medicine in," but doing so is not recommended. Massaging the injection site may force the medication from the muscle into the skin layers, reducing the absorption of the drug.

    (Video) How to Give an IM Intramuscular Injection Ventrogluteal Buttock Muscle

FAQs

Learn about the Best Injection Sites for an Intramuscular Injection? ›

A ventrogluteal site is the most commonly used and recommended site for IM injections in adults and children of walking age because of the large muscle mass. This site is located away from the superior and inferior gluteal arteries as well as the sciatic and superior gluteal nerves,9 and is also the least painful.

What is the correct way to perform an intramuscular injection? ›

Hold the skin around where you will give the injection: With your free hand, gently press on and pull the skin so that it is slightly tight. Insert the needle into the muscle: Hold the syringe barrel tightly and use your wrist to inject the needle through the skin and into the muscle at a 90 degree angle.

Which site is preferable for giving an intramuscular injection to adults? ›

Where to inject The easiest site when self-administering an IM injection is the middle third of the vastus lateralis muscle of the thigh. Other options include the deltoid muscle of the upper arm and the dorsogluteal site on the bottom.

Do you pinch the skin for IM injection? ›

Needle insertion

Insert needle at an 45o angle to the skin. Pinch up on SQ tissue to prevent injecting into muscle. Aspiration before injection is not required. Multiple injections given in the same extremity should be separated as far as possible (preferably at least 1” apart).

Should you draw back when giving IM injection? ›

Aspiration. It is common practice to draw back on a syringe after the needle is inserted to check whether it is in a blood vessel. While it is important to aspirate if the DG muscle site is used – because of proximity to the gluteal artery – it is not required for other IM injection sites (PHE, 2013; Malkin, 2008).

How do I find IM injection sites? ›

Intramuscular (IM) Injection: Sites - YouTube

What are the 4 injection sites? ›

There are four sites on your body that can be used to give yourself an intramuscular injection. These include the upper arm, thigh, hip, and buttocks. Make sure you are comfortable with the injection technique before you start giving yourself shots.

Do you massage after intramuscular injection? ›

Don't massage the site after injection. Massaging can irritate the tissue and increase discomfort. Don't administer subsequent injections into the same injection site.

What happens if intramuscular injection hits a blood vessel? ›

If you see blood in the syringe, you have hit a blood vessel. If you hit a vessel, pull the needle out of the skin. Get rid of the needle and syringe, and prepare a new syringe with medicine. Insert the new needle in a different spot, and check again to see if there is blood.

How do you know if you hit a blood vessel while injecting? ›

(See illustration on following page.) Once you think you're in a vein, pull the plunger back to see if blood comes into the syringe. If so, and the blood is dark red and slow moving, you know that you've hit a vein. You can now untie your tourniquet and proceed to inject your drugs.

How deep do you go for an IM injection? ›

Identify the injection site.

The injection site will be approximately 2 inches below the bone and above the axillary fold/armpit.

What happens if you don't remove air from injection? ›

The air bubble would float along the vein back to the heart; it would go through the right side of your heart and into your lungs and it would lodge in a blood vessel, which is a bit smaller than it is. The result is that blood would then be stuck behind this bubble of air.

What do you do if you aspirate blood during IM injection? ›

What if I see blood in the syringe?
  1. Remove the needle without giving the medicine.
  2. Dispose of the needle in a safe way. Use a hard plastic, metal, or "sharps" container with a lid.
  3. Use a new needle to give the shot. You can put a new needle on the syringe and then give the injection in a new spot.

What size needle do you use for IM injections? ›

Intramuscular injections are administered at a 90-degree angle to the skin, preferably into the anterolateral aspect of the thigh or the deltoid muscle of the upper arm, depending on the age of the patient (Table 6-2). The needle gauge for intramuscular injection is 22-25 gauge.

Why injection is given in buttocks? ›

That's because the gluteal muscle is a large muscle with a large amount of muscle mass, and it is also a safe place because there are few nerves and large blood vessels passing through. Therefore, doctors and nurses often choose butt injection for drugs that are indicated for intramuscular injection.

Why is Ventrogluteal preferred? ›

The ventrogluteal injection site is an area on the most prominent part of the hip that's considered the preferred site for intramuscular injections. Experts say it's one of the safest areas for such injections because of the thick thigh muscles in the area. There are also fewer blood vessels and nerves in that area.

How do you give an intramuscular injection painlessly? ›

To reduce the pain and fear associated with regular injections, try numbing the injection site with ice and/or a numbing cream. Talk with your healthcare provider about the best sites for intramuscular or subcutaneous injections, and rotate the injection site if there is any pain or bruising.

Do you apply pressure after IM injection? ›

Based on these results before the injection, applying manual pressure to the adult's intramuscular injection site is recommended. Relevance to clinical practice: Applying pressure to the injection area is a simple and cost-effective method to reduce the pain associated with injection.

What type of injections should not be massaged? ›

Doing a massage of the site after an injection can cause the drug to back up through the subcutaneous tissue, so any type of massage is to be avoided with intramuscular injections.

What are 3 ways to give injections? ›

The four most frequently used types of injection are:
  1. Intravenous (IV) injections. An IV injection is the fastest way to inject a medication and involves using a syringe to inject a medication directly into a vein. ...
  2. Intramuscular (IM) injections. ...
  3. Subcutaneous (SC) injections. ...
  4. Intradermal (ID) injections.
Nov 2, 2021

How do you know if you hit a nerve when injecting? ›

Unlike some veins, nerves are not visible from outside the body, although you will definitely know if you've hit one while injecting because you'll experience extreme pain and no blood will enter the syringe when you pull back to register. You may feel an electric “burn” along your limb.

How do you give an IM injection in nursing? ›

Administer the injection using the Z-track method.
  1. Position the ulnar side of the nondominant hand just below the site and pull the skin laterally. ...
  2. With the dominant hand, inject the needle quickly into the muscle at a 90-degree angle using a steady and smooth motion.

What is the site for intramuscular injection? ›

A ventrogluteal site is the most commonly used and recommended site for IM injections in adults and children of walking age because of the large muscle mass. This site is located away from the superior and inferior gluteal arteries as well as the sciatic and superior gluteal nerves,9 and is also the least painful.

Do you massage after im injection? ›

Don't massage the site after injection. Massaging can irritate the tissue and increase discomfort. Don't administer subsequent injections into the same injection site.

How do you make intramuscular injections less painful? ›

To reduce the pain and fear associated with regular injections, try numbing the injection site with ice and/or a numbing cream. Talk with your healthcare provider about the best sites for intramuscular or subcutaneous injections, and rotate the injection site if there is any pain or bruising.

How far do you inject a needle? ›

This muscle forms an upside down triangle that starts at the bone going across the upper arm. The point of the triangle is at the level of the armpit. Put the injection in the center of the triangle of the muscle. This should be 1 to 2 inches (2.5 to 5 centimeters) below that bone.

What happens if intramuscular injection hits a blood vessel? ›

If you see blood in the syringe, you have hit a blood vessel. If you hit a vessel, pull the needle out of the skin. Get rid of the needle and syringe, and prepare a new syringe with medicine. Insert the new needle in a different spot, and check again to see if there is blood.

Which nerve is crucial during intramuscular injection? ›

The sciatic nerve is the nerve most frequently affected by IM injection because of its large size and the fact that the buttock area is a common injection site.

What happens if you give an IM injection too high? ›

One of the most common errors in IM injection is introducing the needle either too high on the shoulder or too low on the arm. Injections given too high (into the shoulder joint) or too low (into tendons and soft tissue) have the possibility of leading to serious shoulder or arm pain that can last several months.

Is it better to give IM injection fast or slow? ›

In IM injection, the needle should be inserted into the body fast, like a dart, and perpendicular, because fast injection is less painful, and the syringe movement damages the tissue[23] and if we want to inject without pressure on the skin by the conventional method, our hand may shake or the needle may not enter the ...

Which of these sites is not used for intramuscular injections? ›

Dorsogluteal muscles of the buttocks

You should not use an injection site that has evidence of infection or injury.

What are the 4 injection sites? ›

There are four sites on your body that can be used to give yourself an intramuscular injection. These include the upper arm, thigh, hip, and buttocks. Make sure you are comfortable with the injection technique before you start giving yourself shots.

Why are injections given in the bum? ›

Intramuscular injection can be given in the arm, thigh or buttocks. So why do we often see butt injections more often? That's because the gluteal muscle is a large muscle with a large amount of muscle mass, and it is also a safe place because there are few nerves and large blood vessels passing through.

Why is Ventrogluteal preferred? ›

The ventrogluteal injection site is an area on the most prominent part of the hip that's considered the preferred site for intramuscular injections. Experts say it's one of the safest areas for such injections because of the thick thigh muscles in the area. There are also fewer blood vessels and nerves in that area.

Videos

1. Vastus Lateralis Intramuscular Injection - Everything You Need To Know - Dr. Nabil Ebraheim
(nabil ebraheim)
2. Intramuscular and Subcutaneous Injections - Clinical Skills
(Oxford Medical Education)
3. Locating the site for a Ventrogluteal Injection - Clinical Skills | @Level Up RN
(Level Up RN)
4. Deltoid Intramuscular injection - Everything You Need To Know - Dr. Nabil Ebraheim
(nabil ebraheim)
5. Glute injection - Everything You Need To Know - Dr. Nabil Ebraheim
(nabil ebraheim)
6. Intramuscular Injection Techniques (Nursing Skills)
(NURSINGcom)

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