Injections I.M. (Intramuscular)

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Some medicine must be given by shot (injection). One type of injection goes into the muscle. This is called an intramuscular (I.M) injection. Giving an injection to your child can be scary. You can practice giving the injection to an orange before giving the first injection to your child.

To Give the Injection You Will Need:

  • Bottle of medicine
  • Disposable 1 mL or 3 mL syringe
  • Needle, size _________Parts of a syringe
  • Alcohol swabs
  • Band-Aid®
  • Sharps container

For the sharps container, you can use a hard plastic container with a screw-on cap for used needles and syringes. An empty bleach bottle or liquid laundry soap bottle works well. Do not use glass or thin plastic containers, like milk jugs, water bottles or soda bottles. Keep syringes and all supplies out of the reach of children.


Practice Giving an Injection

  • Use a 10 mL vial of sterile water to practice. Do not reuse the practice syringe.
  • Follow the directions on the next pages to practice getting the syringe ready and giving the injection.
  • Repeat this until you feel good about handling the syringe.

Preparing the Medicine and Syringe for Injection

1. Wash your hands or use hand sanitizer. 2. Check the medicine bottle for the correct name and dosage to give. 3. Let medicine warm to room temperature if needed. Some medicines need to be gently shaken to mix. Follow the directions on the medicine label. 4. Clean the top of the bottle well with an alcohol swab. 5. Remove the needle cap. Do not touch the needle or set the syringe down while the cap is off. 6. Pull air into the syringe equal to the amount of medicine to be given.

7. Push the needle through the top of the bottle at a 90 degree angle. Push the plunger to put the air into the bottle. 8. Turn the bottle upside down. Gently pull the plunger to fill the syringe with the amount of medicine to be given. 9. If there is a bubble in the syringe, fill the syringe with a little more medicine. Tap the side of the syringe to make the air bubbles go to the top. Push the plunger to get all the air out of the syringe. 10. Check the syringe to make sure the dosage is right. 11. Once the medicine is in the syringe, place the needle cap on a flat surface. Remove the needle from the bottle. Using one hand, slowly guide the needle into the cap. Do not hold the cap when inserting the needle. Do not let the needle touch the table. 12. Lift syringe and snap on needle cap.

Aim for the dark spots for injection.

Where to Give the Injection

  • Give the injection halfway between the hipbone and knee on the outer part of the thigh (Picture 1). This area is good because it does not have large blood vessels and nerves.
  • This site can be used for a child of any age.
  • Do not give the injection in the same spot every time.
  • Write down the site you used and give the injection in a different spot the next time.

Preparing Your Child For the Injection

Infants and Toddlers

  • Give your child something to hold, like a toy or a book, or let them squeeze someone's hand.
  • Hold your child firmly between your elbow and body. You may need someone to help hold your child.

Older Children

  • Explain what you are going to do and why.
  • Be honest with your child, the shot will hurt for a short time.
  • Give your child something to hold, such as a toy or a book, have them focus on watching TV, or let them squeeze someone's hand.Your child needs to stay still.
  • Tell them it is okay to cry, and they must keep still (Picture 2).
  • Have your child lie on their back and turn their foot inward to relax the thigh muscle.

How to Give the Injection

1. Clean the skin at the injection site with an alcohol swab and allow to dry. Hold the syringe barrel like a pencil and remove the cap. With your three middle fingers, pull the skin back away from the spot where you are going to inject the medicine. Hold the skin off to the side about 1 inch. This is called Z-Tracking. This helps keep the medicine from seeping out onto the skin. Insert the needle quickly at a 90 angle. 2. Then, push the plunger all the way in. 3. While still keeping the skin pulled back, remove the needle. Let go of the skin only after the needle has been removed. 4. Do not put the cap back on the used needle. Place the used needle and syringe into the sharps box or hard plastic container. Hold a gauze pad or dry tissue over the injection site for a few seconds if needed.

5. Put a Band-Aid® on the injection site and give your child a hug. Wash your hands or use hand sanitizer.

Caution: If you accidentally poke your skin with the needle after the medicine has been given, wash your wound and call your doctor.

Used Needles and Syringes

  • Do not re-use needles or syringes.
  • Keep the sharps container upright and out of the reach of children.
  • Do not put needles in a container that will be recycled or returned to a store.
  • When the container is almost full, use a new container.
  • If you are using a hard-plastic container, write "used needles and syringes" on the side.
  • Ask your local trash or public health department if there are any special handling rules about throwing away the used needles and syringes container.

If you have any questions, be sure to ask your health care provider or nurse.

Injections - IM (PDF)

HH-V-60 ©1981, Revised 2020, Nationwide Children’s Hospital