http://www.ccmckids.org/Patient_Education/IMinject.htm How to Give an Intramuscular (IM) Injection Wash your hands. Read the label on the medicine bottle and check the dose. Remove the plastic cap from the vial and clean the rubber stopper with an alcohol wipe. Assemble the needle and syringe without touching any part of the needle or syringe that connect together. It is important to never touch the uncapped needle. (Syringes may come from the pharmacy already assembled.) Pull the plunger out to the "cc" mark for the amount of medicine to be given (to draw air into the syringe). Put the needle of the syringe into the rubber stopper of the vial. Turn the vial and syringe upside down and inject the air into the vial. Make sure the tip of the needle is in the medicine. Pull the plunger of the syringe out until the medicine is drawn up to the correct "cc" mark (this is the amount of medicine to be given). If you notice any large air spaces, tap the side of the syringe while the needle is pointing upright so that the air bubbles will rise. Then adjust the plunger to expel the air and so you have the correct amount of medicine in the syringe. Remove the needle and syringe from the vial. You are now ready to give the medicine. If you must lay the syringe down, carefully place the needle cover over the needle to keep it sterile. Do not touch the needle. Finding an Injection Site Select an injection site on the thigh. The medicine is given in the large muscle of the leg. Here are two helpful hints for finding the right site on the thigh: - Imagine a line drawn down the center of the thigh –The injection should be given on the outer portion. - Place two fingers just above the knee and two fingers at the top of the leg. The injection can be given in the middle area between the fingers on the outer half of the thigh. You may need people to help hold a child who cannot be very still for the "shot". This will help you maintain the correct injection site. Rotate the sites of the injections from left to right. Try to avoid using daily injection sites that are too close together. How to Inject the Medicine Clean the site with alcohol. Let the skin dry and avoid touching the area after you clean it. Hold the syringe like a dart at a 90 degree angle to the site (straight up and down with the needle pointed toward the site. With the other hand, hold the muscle firmly at the site. Insert the needle straight into the skin with a quick, firm motion. Holding the barrel of the syringe, pull the plunger back slightly to check for blood. This is rarely seen, but if it is, withdraw the needle, replace with a new needle, and try a new site. Slowly push down on the plunger until the syringe is empty. Remove the needle quickly (at the same angle it was inserted). Apply gentle pressure to the site with cotton ball or gauze. The site may bleed a bit. Cover with a band – aid or small gauze if needed. After the Injection is Given Throw out the needle and syringe in a puncture-proof container (like a coffee can or a plastic laundry bottle). You should never reach into the container. Comfort your child and praise him/her for their cooperation. Write down the date and time of the dose and which injection site was used. Check the time that the next dose needs to be given.