Administration of Vaccine via Intramuscular Route

Hand hygiene is the first step in medication administration is hand hygiene. Use either an alcohol-based hand rub or a soap and water hand wash

Verify the medication. Note the expiration date and lot number. Check for particulate matter or turbidity that is abnormal for the vaccine

Remove the plastic cap from the top of the vial. Swab the top of the vial with a sterile alcohol swab.

Inspect your equipment. Ensure the size of the syringe and needle are appropriate for the vaccine administration. Make sure you know how to active any safety devices. When opening the package, watch to ensure that hands do not touch the sterile ends of the needle and syringe

Carefully connect the sterile end of the needle to the syringe

If a leur end is present, twist the needle so it is securely attached to the syringe. If no leur end is present, be sure the push the end of the needle firmly onto the end of the syringe

If you are not ready to use the syringe immediately, place it aside in a manner that will ensure the cleanliness of the items. Keeping them inside the package is an ideal choice.

Remove the cap to the needle and insert the needle into the rubber septum of the vial. Try to insert the needle directly into the center of the septum. Lay the cap aside for future use. Never use teeth to pull the cap off the needle

If you are using a single-dose vial, it is often unnecessary to inject air into that vial. If, however, you are using a multidose vial, a small amount of air similar to the volume you will be removing from the vial may make it easier to withdraw that vaccine as it counters the negative pressure that is present inside the vial

Invert the vial and withdraw the dose of vaccine.

Pulling back slowly on the syringe plunger minimizes air pulled into the syringe

Make sure the tip of the needle stays below the level of the fluid in the vaccine. Otherwise, air instead of vaccine is pulled into the syringe

Maintain control over your syringe so the needle is not inadvertently pulled out of the vial and the tip contaminated or the syringe dropped

Verify the volume/dose of vaccine you want to administer before pulling the needle out of the vial. This is a chance to double check your medication

Tap or gently shake the syringe if air needs to be encouraged to the top of the syringes so it can be expelled into the vial

Take care to avoid touching the area where the needle enters the vial.

Avoid withdrawing the needle then squirting excess vaccine into the air

It is acceptable to recap a clean needle. This protects the needle from contamination and thereby protects the patient

If you accidentally stick yourself, wash the area and dispose of the entire needle and syringe. Do not simply change the needle and continue to use the syringe

When preparing to administer, make sure you can easily visualize the injection site. Remove any constricting clothing such as tight sleeves and try to help make sure the recipient is comfortable. Find your landmarks

Use a sterile alcohol swab and a clean 2x2 to prepare the injection site. The 2x2 will be important in controlling any small bleeding that may occur at the injection site

Make sure your needle is capped until ready to perform the injection

Once the site is prepared, move the alcohol swab and 2x2 out of the way, but close enough so it can be moved to cover the injection site once the vaccine has been administered and needle pulled out of the skin.

Hold the swab and 2x2 under a finger so it still leaves you able to use that had to assist with the injection

Visualize the injection site to ensure that you have selected the correct size needle. If not, change needles taking care to prevent contamination of the syringe tip as well as inadvertent stick.

Use the ‘press and spread’ method to ensure that the needle can reach the belly of the muscle. Enter the arm at a 90 degree angle.

Using this technique, your thumb and forefinger are free to drop down and help stabilize the needle while the vaccine is injected. Take care to keep fingers away from the point where the needle and syringe join.

If you were taught to aspirate, do so at this point. Gently pull back on the plunger to ensure that you are not in a blood vessel. If you draw back blood, discard the entire needle and syringe and start over

When finished injected, quickly pull the needle out of the arm and slide the alcohol swab and 2x2 down over the injection site.

Gently massage the area.

Activate your safety device before moving away from the patient.