In some populations, a change in injection site, needle length, or technique is necessary. For example, in very young people or frail elderly people, a normal length needle may be too long to safely inject in the desired muscle. For this reason, in these people, a shorter needle is recommended to decrease the risk of injecting too deep. It is also recommended to consider using the anterolateral thigh as an injection site in infants under one year old. To help infants and children cooperate with injection administration, the Advisory Committee on Immunization Practices in the United States recommends using distractions, giving something sweet, and slow lateral swaying.
Special populations
Intramuscular injection
Intramuscular injection | Special populations
In some populations, a change in injection site, needle length, or technique is necessary; for  example, in very young people or frail elderly people, a normal length needle may be too long to safely inject in the desired muscle For example, in very young people or frail elderly people, a normal length needle may be too long to safely inject in the desired muscle. For this reason, in these people, a shorter needle is recommended to decrease the risk of injecting too deep. Yes, In very young people or frail elderly people change in injection site, needle length, or technique is necessary. These people a shorter needle is recommended to decrease the risk of injecting too deep. Yes -  In some populations, a change in injection site, needle length, or technique is necessary.
the three most commonly used sites for intramuscular injections are
user
The deltoid muscle of the upper arm, the gluteal muscle of the buttock, in infants, the vastus lateralis muscle of the thigh
assistant
does this have any complications?
user
Yes, the most frequent complications of a deltoid injection include pain, redness, and inflammation around the injection site, which are almost always mild and last only a few days at most.
assistant
why is it taken?
user
In medicine, it is one of several methods for parenteral administration of medications.
assistant
is it meant for any specific populations?
user
In some populations, a change in injection site, needle length, or technique is necessary. For example, in very young people or frail elderly people, a normal length needle may be too long to safely inject in the desired muscle. For this reason, in these people, a shorter needle is recommended to decrease the risk of injecting too deep. It is also recommended to consider using the anterolateral thigh as an injection site in infants under one year old. To help infants and children cooperate with injection administration, the Advisory Committee on Immunization Practices in the United States recommends using distractions, giving something sweet, and slow lateral swaying.
Intramuscular injection | Special populations
In people who are overweight, a 1.5-inch needle may be used to ensure the injection is given below the subcutaneous layer of skin, while a -inch needle may be used for people who weigh under . In any case, the skin does not need to be pinched up prior to injecting when the appropriate length needle is used.
Intramuscular injection | Special populations
Intramuscular injection, often abbreviated IM, is the injection of a substance into a muscle. In medicine, it is one of several methods for parenteral administration of medications. Intramuscular injection may be preferred because muscles have larger and more numerous blood vessels than subcutaneous tissue, leading to faster absorption than subcutaneous or intradermal injections. Medication administered via intramuscular injection also is not subject to the first-pass metabolism effect which affects oral medications. Common sites for intramuscular injections include the deltoid muscle of the upper arm and the gluteal muscle of the buttock. In infants, the vastus lateralis muscle of the thigh is commonly used.
Intramuscular injection | Introduction
Certain substances, including ketamine, may be injected intramuscularly for recreational purposes. Disadvantages of intramuscular administration include skill and technique required, pain from injection, anxiety or fear (especially in children), and difficult proper self-administration of medications. Vaccines, especially inactivated vaccines, are commonly administered via intramuscular injection. However, it has been estimated that for every vaccine injected intramuscularly, over 20 injections are given to administer drugs or other therapy. This can include medications such as antibiotics, immunoglobulin, and hormones such as testosterone and medroxyprogesterone. In a case of severe allergic reaction, or anaphylaxis, a person may use an epinephrine autoinjector to self-administer epinephrine in the muscle.
Intramuscular injection | Uses
The site is located by dividing the front thigh into thirds vertically and horizontally to form nine squares; the injection is administered in the outer middle square. This site is also the usual site of administration for epinephrine autoinjectors, which are used in the outer thigh, corresponding to the location of the vastus lateralis muscle.
Intramuscular injection | Injection sites
Intramuscular injection is commonly used for medication administration. Medication administered in the muscle is generally quickly absorbed in the bloodstream, and avoids the first pass metabolism which occurs with oral administration. The medication may not be considered 100% bioavailable as it must still be absorbed from the muscle, which occurs over time. An intramuscular injection can be administered faster and is less invasive than an intravenous infusion, as the site of injection (a muscle versus a vein) is much larger. Medications administered in the muscle may also be administered as depot injections, which provide slow continuing release of medicine over a long period of time.
Intramuscular injection | Uses
Intramuscular injections, abbreviated as IM, deliver a substance deep into a muscle, where they are quickly absorbed by the blood vessels into systemic circulation. Common injection sites include the deltoid, vastus lateralis, and ventrogluteal muscles. Medical professionals are trained to give IM injections, but people who are not medical professionals can also be trained to administer medications like epinephrine using an autoinjector in an emergency. Some depot injections are also administered intramuscularly, including medroxyprogesterone acetate among others. In addition to medications, most inactivated vaccines, including the influenza vaccine, are given as an IM injection.
Injection (medicine) | Intramuscular injection
Intramuscular administration of medication is contraindicated in people with an active infection at the injection site, and those with thrombocytopenia or clotting problems. It is also not recommended in people who are suffering from hypovolemic shock, myopathies, or muscle atrophy, as these may affect the absorption of the medication. Other forms of administration are preferred in people with a myocardial infarction, as the damage to the muscle from an injection may affect tests used in the evaluation thereof.
Intramuscular injection | Contraindications
However, this is no longer recommended as evidence shows no safety benefit and it lengthens the injection, which causes more pain.
Intramuscular injection | History
Intramuscular injections began to be used for administration of vaccines for diphtheria in 1923, whooping cough in 1926, and tetanus in 1927. By the 1970s, researchers and instructors began forming guidance on injection site and technique to reduce the risk of injection complications and side effects such as pain. Also in the early 1970s, botulinum toxin began to be injected into muscles to intentionally paralyze them for therapeutic reasons, and later for cosmetic reasons. Until the 2000s, aspiration after inserting the needle was recommended as a safety measure, to ensure the injection was being administered in a muscle and not inadvertently in a vein.
Intramuscular injection | History
An intramuscular injection can be administered in multiple different muscles of the body. Common sites for IM injection include: deltoid, dorsogluteal, rectus femoris, vastus lateralis and ventrogluteal muscles. Sites that are bruised, tender, red, swollen, inflamed or scarred are generally avoided. The specific medication and amount being administered will influence the decision of the specific muscle chosen for injection. The injection site is first cleaned using an antimicrobial and allowed to dry. The injection is performed in a quick, darting motion perpendicular to the skin, at an angle between 72 and 90 degrees. The practitioner will stabilize the needle with one hand while using their other hand to depress the plunger to slowly inject the medication - a rapid injection causes more discomfort.
Intramuscular injection | Technique
The needle is withdrawn at the same angle inserted. Gentle pressure may be applied with gauze if bleeding occurs. Pressure or gentle massage of the muscle following injection may reduce the risk of pain. The CDC does not recommend the practice of aspirating for blood to rule out injecting into a blood vessel, as aspiration may increase the risk of pain. There is no evidence that aspiration is useful to increase safety of intramuscular injections when injecting in a site other than the dorsogluteal site.
Intramuscular injection | Technique
Injections into muscular tissue may have taken place as early as the year 500. Beginning in the late 1800s, the procedure began to be described in more detail and techniques began to be developed by physicians practicing at the time. In the early days of intramuscular injections, the procedure was performed almost exclusively by physicians. In the mid 1900s, nurses began preparing equipment and patients for intramuscular injections as part of their delegated duties from physicians, and by 1961 they had "essentially taken over the procedure". To this time, there was not uniform procedures or education for nurses in proper administration of intramuscular injections, and complications from improper injection were common.
Intramuscular injection | History
Rarely, nerves or blood vessels around the injection site can be damaged, resulting in severe pain or paralysis. If proper technique is not followed, intramuscular injections can result in localized infections such as abscesses and gangrene. While historically aspiration was recommended to prevent inadvertent administration into a vein, it is no longer recommended for most injection sites.
Intramuscular injection | Introduction
The area must be cleaned prior to administering the injection, and the injection should be administered in a fast, darting motion to decrease the discomfort to the individual. The volume to be injected in the muscle is usually limited to 2-5 milliliters, depending on injection site. A site should not be chosen which has signs of infection or muscle atrophy. Intramuscular injections should not be used in people with myopathies or clotting problems. Intramuscular injections commonly result in pain, redness, and swelling or inflammation around the injection site. These side effects are generally mild and last no more than a few days at most.
Intramuscular injection | Introduction
As with any injection which pierces the skin, there is a risk of infection from bacteria or other organisms present in the environment or on the skin prior to the injection. This risk is lessened with proper aseptic technique and cleansing of the area prior to administration. Intramuscular injections may also cause an abscess or gangrene at the injection site, depending on the specific medication and amount administered. There is also a risk of nerve or vascular injury if a nerve or blood vessel is inadvertently hit during injection. If single-use or sterilized equipment is not used, there is the risk of transmission of infectious disease between users.
Intramuscular injection | Risks and complications
Injection in saline is normally conducted intramuscularly (IM) in skeletal muscle, or intradermally (ID), delivering DNA to extracellular spaces. This can be assisted either 1) by electroporation; 2) by temporarily damaging muscle fibres with myotoxins such as bupivacaine; or 3) by using hypertonic solutions of saline or sucrose. Immune responses to this method can be affected by factors including needle type, needle alignment, speed of injection, volume of injection, muscle type, and age, sex and physiological condition of the recipient.
DNA vaccination | Saline injection
This is termed parenteral nutrition and may provide all or only part of a person's nutritional requirements. Parenteral nutrition may be pre-mixed or customized for a person's specific needs. Intravenous injections may also be used for recreational drugs when a rapid onset of effects is desired.
Injection (medicine) | Intravenous injections
The ventrogluteal (hip) site is used for injections which require a larger volume to be administered, greater than 1 ml, and for medications which are known to be irritating, viscous, or oily. It is also used to administer narcotic medications, antibiotics, sedatives and anti-emetics. The ventrogluteal site is located in a triangle formed by the anterior superior iliac spine and the iliac crest, and may be located using a hand as a guide. The ventrogluteal site is less painful for injection than other sites such as the deltoid site. The vastus lateralis site is used for infants less than 7 months old and people who are unable to walk or who have loss of muscular tone.
Intramuscular injection | Injection sites
The term injection encompasses intravenous (IV), intramuscular (IM), subcutaneous (SC) and intradermal (ID) administration. Parenteral administration generally acts more rapidly than topical or enteral administration, with onset of action often occurring in 15–30 seconds for IV, 10–20 minutes for IM and 15–30 minutes for SC. They also have essentially 100% bioavailability and can be used for drugs that are poorly absorbed or ineffective when they are given orally. Some medications, such as certain antipsychotics, can be administered as long-acting intramuscular injections. Ongoing IV infusions can be used to deliver continuous medication or fluids. Disadvantages of injections include potential pain or discomfort for the patient and the requirement of trained staff using aseptic techniques for administration.
Route of administration | Parenteral
The deltoid muscle (upper arm) is used for injections of small volume, usually equal or less than 2 ml. This includes most intramuscular vaccinations. It is not recommended to use the deltoid for repeated injections due to its small area, which makes it difficult to space out injections from each other. The deltoid site is located by locating the lower edge of the acromion process, and injecting in the area which forms an upside down triangle with its base at the acromion process and its midpoint in line with the armpit. An injection into the deltoid muscle commonly uses a 1-inch long needle, but may use a -inch long needle for younger people or very frail elderly people.
Intramuscular injection | Injection sites
Subcutaneous injections, abbreviated as SQ or sub-Q, consist of injecting a substance into the fat tissue between the skin and the muscle. Absorption of the medicine from this tissue is slower than in an intramuscular injection. Since the needle does not need to penetrate to the level of the muscle, a bigger gauge (thinner) and shorter needle can be used. Subcutaneous injections may be administered in the fatty tissue behind the upper arm, in the abdomen, or in the thigh. Certain medications, including epinephrine, may be used either intramuscularly or subcutaneously. Others, such as insulin, are almost exclusively injected subcutaneously.
Injection (medicine) | Subcutaneous injection
Additionally, the body's reaction to substances is more easily visible since it is closer to the surface.
Intradermal injection | Introduction
A vaccine administration may be oral, by injection (intramuscular, intradermal, subcutaneous), by puncture, transdermal or intranasal. Several recent clinical trials have aimed to deliver the vaccines via mucosal surfaces to be up-taken by the common mucosal immunity system, thus avoiding the need for injections.
Vaccination | Routes of administration
Although there are risks of infections or other complications, with suitable precautions throughout the injection process, chances for these complications could be lowered.
Intravitreal injection | Introduction
Common injection sites include the inner surface of the forearm and the upper back, under the shoulder blade..
Intradermal injection | Injection sites
Intravenous injection is a common clinical route of administration. (to be completed)
Physiologically based pharmacokinetic modelling | Intra-venous injection
Intradermal injections, abbreviated as ID, consist of a substance delivered into the dermis, the layer of skin above the subcutaneous fat layer, but below the epidermis or top layer. An intradermal injection is often given at a 5 to 15 degree angle with the needle placed almost flat against the skin. Absorption from an intradermal injection takes longer than when the injection is given intravenously, intramuscularly, or subcutaneously. For this reason, few medications are administered intradermally. Intradermal injections are most commonly used for sensitivity tests, including tuberculin skin tests and allergy tests, as well as sensitivity tests to medications a person has never had before.
Injection (medicine) | Intradermal injection
This includes common injections such as subcutaneous, intramuscular, and intravenous injections, as well as less common injections such as intraperitoneal, intraosseous, intracardiac, intraarticular, and intracavernous injections. Injections are among the most common health care procedures, with at least 16 billion administered in developing and transitional countries each year. Of these, 95% are used in curative care or as treatment for a condition, 3% are to provide immunizations, and the rest are used for other purposes, including blood transfusions. The term "injection" is sometimes used synonymously with inoculation, but injection does not only refer to the act of inoculation. Injections generally administer a medication as a bolus (or one-time) dose, but can also be used for continuous drug administration.
Injection (medicine) | Introduction
Intracardiac injections of drugs were generally used only to provide emergency drugs to a patient if other approaches would be ineffective; for example if drugs could not be administered intravenously due to individual circumstances. The procedure is performed by inserting a long spinal needle into the ventricular chamber. The needle is inserted in the fourth intercostal space between the ribs. Today it is considered obsolete, and other routes to give drugs are preferred (i.e. via an endotracheal tube or intraosseous (direct in the bone))
Intracardiac injection | Procedure
Routes of administration of injections in laboratory mice are mainly subcutaneous, intraperitoneal and intravenous. Intramuscular administration is not recommended due to small muscle mass. Intracerebral administration is also possible. Each route has a recommended injection site, approximate needle gauge and recommended maximum injected volume at a single time at one site, as given in the table below: To facilitate intravenous injection into the tail, laboratory mice can be carefully warmed under heat lamps to vasodilate the vessels.
Laboratory mouse | Injection procedures
Intradermal injection, often abbreviated ID, is a shallow or superficial injection of a substance into the dermis, which is located between the epidermis and the hypodermis. This route is relatively rare compared to injections into the subcutaneous tissue or muscle. Due to the more complex use, ID injections are not the preferred route of administration for injection and therefore used for certain therapies only, such as tuberculose tests and allergy tests. Specific benefits are a higher immune responses for vaccinations, immunology and novel cancer treatments and faster drug uptake, since for certain small and well soluble proteins or molecules, ID route of administration is associated with fast uptake systemically compared to subcutaneous injections, applied in novel closed loop insuline infusion systems.
Intradermal injection | Introduction
Intraperitoneal injection or IP injection is the injection of a substance into the peritoneum (body cavity). It is more often applied to animals than to humans. In general, it is preferred when large amounts of blood replacement fluids are needed or when low blood pressure or other problems prevent the use of a suitable blood vessel for intravenous injection. In animals, it is used predominantly in veterinary medicine and animal testing for the administration of systemic drugs and fluids because of the ease of administration compared with other parenteral methods. In humans, the method is widely used to administer chemotherapy drugs to treat some cancers, particularly ovarian cancer.
Intraperitoneal injection | Introduction
The injection is usually done at the inferotemporal quadrant (i.e. the lower quadrant away from the nose) of the eye undergoing the procedure, as it is usually more accessible. However, depending on the eye's condition, patient's and the ophthalmologist's preference, other regions could also be used. Patient with aphakic (without lens due to cataract surgery), or pseudophakic eye (with implanted lens after removal of natural lens) would have the injection 3.0-3.5 mm posterior to the limbus, while injection to the phakic eye (with natural lens) is done 3.5-4.0 mm posterior to the limbus.
Intravitreal injection | Injection Site
After immunoglobulin therapy's discovery and description in "Pediatrics" in 1952, weekly intramuscular injections of immunoglobulin (IMIg) were the norm until intravenous formulations (IVIg) began to be introduced in the 1980s. During the mid and late 1950s, one-time IMIG injections were a common public health response to outbreaks of polio before the widespread availability of vaccines. Intramuscular injections were extremely poorly tolerated due to their extreme pain and poor efficacy – rarely could intramuscular injections alone raise plasma immunoglobulin levels enough to make a clinically meaningful difference.
Immunoglobulin therapy | 1950s – intramuscular
Injection fibrosis is a complication of intramuscular injection, occurring especially often in infants and children. Injections are often delivered to the quadriceps, triceps, and gluteal muscles, and thus the complication often manifests itself in those muscles. Patients are unable to fully flex the affected muscle. The condition is painless but progressively worsens over time. Orthopedic surgery is the typical treatment.
Injection fibrosis | Introduction
Injections are usually classified by the tissue into which the substance is administered, and may be sub-classified based on the site of the body at which they are administered. All injections are considered a type of parenteral administration, which avoid the first pass effect of oral administration. Furthermore, all injections should be considered sterile procedures for which proper aseptic technique should be followed, as they necessarily involve breaking the skin or other outer layer of protection from pathogens and the environment.
Injection (medicine) | Types
Equipment include syringes calibrated in tenths and hundredths of a milliliter. The dosage given is usually less than 0.5 mL, less than given subcutaneously or intramuscularly. A and 26 or 27 gauge thick needle is used.
Intradermal injection | Equipment
The placement of the bolus dose depends on the systemic levels of the contents desired throughout the body. An intramuscular injection of vaccines allows for a slow release of the antigen to stimulate the body's immune system and to allow time for developing antibodies. Subcutaneous injections are used by heroin addicts (called 'skin popping', referring to the bump formed by the bolus of heroin), to sustain a slow release that staves off withdrawal symptoms without producing euphoria. A bolus delivered directly to the veins through an intravenous drip allows a much faster delivery which quickly raises the concentration of the substance in the blood to an effective level.
Bolus (medicine) | Placement
However, in some cases, patients are taught to self-inject, such as SC injection of insulin in patients with insulin-dependent diabetes mellitus. As the drug is delivered to the site of action extremely rapidly with IV injection, there is a risk of overdose if the dose has been calculated incorrectly, and there is an increased risk of side effects if the drug is administered too rapidly.
Route of administration | Parenteral
Injections into the skin and soft tissue generally do not cause any permanent damage, and the puncture heals within a few days. However, in some cases, injections can cause long-term adverse effects. Intravenous and intramuscular injections may cause damage to a nerve, leading to palsy or paralysis. Intramuscular injections may cause fibrosis or contracture. Injections also cause localized bleeding, which may lead to a hematoma. Intravenous injections may also cause phlebitis, especially when multiple injections are given in a vein over a short period of time. Infiltration and extravasation may also occur when a medication intended to be injected into a vein is inadvertently injected into surrounding tissues.
Injection (medicine) | Others
Autotransplantation
Facial Autologous Muscular Injection | See also
Other infections may occur when pathogens enter the body through the injection site, most commonly due to improper cleaning of the site before injection. Infections occurring in this way are mainly localized infections, including skin infections, skin structure infections, abscesses, or gangrene. An intravenous injection may also result in a bloodstream infection (termed sepsis) if the injection site is not cleaned properly prior to insertion. Sepsis is a life-threatening condition which requires immediate treatment.
Injection (medicine) | Infection
The volume of distribution at steady-state following intravenous administration is approximately 5.4 liters. Intersubject variability is about 40%.
Preotact | Distribution
The procedure also only allows for one attempt per bone meaning another route of infusion must be secured, or a different bone chosen. Although intravascular access is still the preferred method for medication delivery in the prehospital area, IO access for adults has become more common. As of 2010, American Heart Association no longer recommends using the endotracheal tube for resuscitation drugs, except as a last resort when IV or IO access cannot be gained. ET absorption of medications is poor and optimal drug dosings are unknown. The IO is becoming more common in civilian and military based pre-hospital emergency medical services (EMS) systems globally.
Intraosseous infusion | Procedure
Injections into the deltoid site in the arm can result in unintentional damage to the radial and axillary nerves. In rare cases when not performed properly, the injection may result in shoulder dysfunction. The most frequent complications of a deltoid injection include pain, redness, and inflammation around the injection site, which are almost always mild and last only a few days at most. The dorsogluteal site of injection is associated with a higher risk of skin and tissue trauma, muscle fibrosis or contracture, haematoma, nerve palsy, paralysis, and infections such as abscesses and gangrene. Furthermore, injection in the gluteal muscle poses a risk for damage to the sciatic nerve, which may cause shooting pain or a sensation of burning.
Intramuscular injection | Risks and complications
Intramuscular injection does give a faster and higher pharmacokinetic profile when compared to subcutaneous injection.
Epinephrine (medication) | Anaphylaxis
Imipramine is available in the form of oral tablets and as a formulation for depot intramuscular injection.
Imipramine | Available forms
Sciatic nerve damage can also affect a person's ability to move their foot on the affected side, and other parts of the body controlled by the nerve. Damage to the sciatic nerve can be prevented by using the ventrogluteal site instead, and by selecting an appropriate size and length of needle for the injection.
Intramuscular injection | Risks and complications
The reactions caused by tests which use intradermal injection are more easily seen due to the location of the injection, and when positive will present as a red or swollen area. Common sites of intradermal injections include the forearm and lower back.
Injection (medicine) | Intradermal injection
An injection (often referred to as a "shot" in US English, or a "jab" in UK English) is the act of administering a liquid, especially a drug, into a person's body using a needle (usually a hypodermic needle) and a syringe. An injection is considered a form of administering drugs via the parenteral route, which refers to routes of administration which do not involve absorption in the digestive tract. This allows the medication to be absorbed more rapidly and avoid the first pass effect. There are many types of injection, which are generally named after the body tissue the injection is administered into.
Injection (medicine) | Introduction
Injection site reactions are allergic reactions that result in cutaneous necrosis that may occur at sites of medication injection, typically presenting in one of two forms, (1) those associated with intravenous infusion or (2) those related to intramuscular injection. Intra muscular injections may produce a syndrome called livedo dermatitis.
Injection site reaction | Introduction
Emergent intramuscular dosing can be given if child is not tolerating oral medications or unable to get IV within 15 minutes. IM hydrocortisone sodium succinate doses are:
Stress dose | Pediatric doses
Heparin is given parenterally because it is not absorbed from the gut, due to its high negative charge and large size. It can be injected intravenously or subcutaneously (under the skin); intramuscular injections (into muscle) are avoided because of the potential for forming hematomas. Because of its short biologic half-life of about one hour, heparin must be given frequently or as a continuous infusion. Unfractionated heparin has a half-life of about one to two hours after infusion, whereas LMWH has a half-life of four to five hours. The use of LMWH has allowed once-daily dosing, thus not requiring a continuous infusion of the drug.
Heparin | Administration
Within intramuscular exercise athletes focus on achieving highest recruiting and frequenting of muscular fibres. Cyclic periodised athletes work, referring to literature, in between 6 and 8 weeks in IC. Stress intensity shall be in between 85 and 100% of highest mass, movable by the athlete within one repetition. 1 to 3 repetitions per series are recommended. The number of series shall be in between 3 and 6. High, up to full, recovery in between series shall be guaranteed. Current authors advise the athlete to intend explosive development of power, within slow movement. We shall mention theses advises concern classical strengthening exercise working with isolated drills.
Intramuscular coordination | Methods of exercise
Intravenous injections, abbreviated as IV, involve inserting a needle into a vein, allowing a substance to be delivered directly into the bloodstream. An intravenous injection provides the quickest onset of the desired effects because the substance immediately enters the blood, and is quickly circulated to the rest of the body. Because the substance is administered directly into the bloodstream, there is no delay in the onset of effects due to the absorption of the substance into the bloodstream. This type of injection is the most common and is used frequently for administration of medications in an inpatient setting. Another use for intravenous injections includes for the administration of nutrition to people who cannot get nutrition through the digestive tract.
Injection (medicine) | Intravenous injections
Shoulder injury related to vaccine administration (SIRVA) is "shoulder pain and limited range of motion occurring after the administration of a vaccine intended for intramuscular administration in the upper arm . . . thought to occur as a result of unintended injection of vaccine antigen or trauma from the needle into and around the underlying bursa of the shoulder". SIRVA has been described as under-reported and preventable, and "caused by incorrect technique or landmarking for intramuscular deltoid injections". Because the injury is a result of the injection technique rather than the substance injected, SIRVA can occur irrespective of the vaccine being administered.
Shoulder injury related to vaccine administration | Introduction
Pharmacologic injection treatments can be given to cooperative adults under local anesthesia in an outpatient setting, and for some agents, under light general anesthesia. In the former case, it is possible to bring the injection needle to an optimal location in the desired muscle using EMG guidance as the alert patient looks in diagnostic directions, the needle is advanced until the "electromyogram" (the electrical signal from an activated skeletal muscle) indicates it is optimally positioned, whereupon the injection is completed. Some agents (e.g., botulinum toxin) can be injected at the insertional end of a muscle under visual guidance, using special forceps and allowed to diffuse posteriorly, whereas others (e.g., bupivacaine) must be distributed throughout the body of the muscle, which requires non-visual guidance.
Management of strabismus | Medication
Blood seepage and collection of blood may occur if heparin is given via an intramuscular route; to avoid this, heparin must be given intravenously or subcutaneously.
Hematoma | Introduction
Streptomycin is traditionally given intramuscularly, and in many nations is only licensed to be administered intramuscularly, though in some regions the drug may also be administered intravenously.
Streptomycin | Medication
Precautions should be taken before, during, and after the injection to lower the chances of complications:
Intravitreal injection | Precautions
A droplet of ACAM2000 is administered by the percutaneous route (scarification) using 15 jabs of a bifurcated needle. ACAM2000 should not be injected by the intradermal, subcutaneous, intramuscular, or intravenous route.
Smallpox vaccine | ACAM2000
Intracardiac injections are injections that are given directly into the heart muscles or ventricles. They are used in emergencies.
Intracardiac injection | Introduction
In contrast to oral administration, the bioavailability of estradiol valerate is complete (i.e., 100%) via intramuscular injection. Due to the far greater bioavailability of intramuscular estradiol valerate relative to oral, the former is substantially stronger (in terms of potency) than the latter. As an example, a single 4 mg intramuscular injection is said to be approximately equivalent to 2 mg/day of the medication administered orally over the course of 3 weeks. Estradiol valerate, when given intramuscularly in oil, has a relatively long duration due to the formation of an intramuscular depot from which the medication is slowly released and absorbed.
Estradiol valerate | Intramuscular injection
For comparison, the bioavailability of oral estradiol is around 5%. The estradiol levels that result with typical clinical doses of estradiol and estradiol esters by intramuscular injection tend to be high compared to the typical estradiol levels that occur with other clinically used routes and forms of estradiol.
Pharmacokinetics of estradiol | Intramuscular injection
A dart injection is used to give a single intramuscular or subcutaneous injection to livestock without restraining the animal. It can be contrasted with hand injection. These injections are usually administered by a tranquilliser gun, if in the wild, or sometimes a blowgun if in captivity.
Dart injection | Introduction
Testosterone undecanoate and testosterone buciclate can be injected intramuscularly as infrequently as four times per year.
Pharmacokinetics of testosterone | Intramuscular injection
In the movie "Pulp Fiction", an intracardiac injection of epinephrine is used to treat a heroin overdose (far from the normal medical treatment for this condition, an intravenous or intramuscular injection of naloxone).
Intracardiac injection | Society and culture
for CHNO: 370.1681. Found: 370.1692.
Intramolecular Heck reaction | Example Procedure
This vaccine cannot induce VAPP nor do cVDPV strains arise from it, but it likewise cannot induce contact immunity and thus must be administered to every individual. Added to this are greater logistical challenges. Though a single dose is sufficient for protection, administration requires medically trained vaccinators armed with single-use needles and syringes. Taken together, these factors result in substantially higher delivery costs. Original protocols involved intramuscular injection in the arm or leg, but recently subcutaneous injection using a lower dose (so-called fractional-dose IPV, fIPV) has been found to be effective, lowering costs and also allowing for more convenient and cost-effective delivery systems.
Polio eradication | Vaccination
Increased plasma free-fatty acid levels and increased accumulation of IMTG correlate well with insulin resistance in muscles. However, athletes often do not exhibit this correlation since they are typically insulin sensitive, while expressing high levels of IMTG. Researchers believe that the improved efficiency of trained skeletal muscles prevents the development of insulin resistance.
Intramuscular fat | Insulin Resistance
Intravitreal injection is the method of administration of drugs into the eye by injection with a fine needle. The medication will be directly applied into the vitreous humor. It is used to treat various eye diseases, such as age-related macular degeneration (AMD), diabetic retinopathy, and infections inside the eye such as endophthalmitis. As compared to topical administration, this method is beneficial for a more localized delivery of medications to the targeted site, as the needle can directly pass through the anatomical eye barrier (e.g. cornea, conjunctiva and lens) and dynamic barrier (e.g. tears and aqueous humor). It could also minimize adverse drug effect to other body tissues via the systemic circulation, which could be a possible risk for intravenous injection of medications.
Intravitreal injection | Introduction
Intramuscular coordination or neuromuscular coordination describes the interaction in between the nervous system and muscle. The intramuscular coordination defines the number of muscular fibres that can be controlled synchronously by the nervous system within a certain muscle. Thereby IC determines maximum strength, independent from muscular hypertrophia.
Intramuscular coordination | Introduction
SIRVA is not caused by any specific medicine that is in an injection. Instead, it is caused by improper insertion of the needle used in injections. It is "a preventable occurrence caused by the injection of a vaccine into the shoulder capsule rather than the deltoid muscle. As a result, inflammation of the shoulder structures causes patients to experience pain, a decreased range of motion, and a decreased quality of life."
Shoulder injury related to vaccine administration | Cause
Most drugs are eliminated from the blood plasma with first-order kinetics. For this reason, when a drug is introduced into the body at a constant rate by intravenous therapy, it approaches a new steady concentration in the blood at a rate defined by its half-life. Similarly, when the intravenous infusion is ended, the drug concentration decreases exponentially and reaches an undetectable level after 5–6 half-lives have passed. If the same drug is administered as a bolus (medicine) with a single injection, peak concentration is achieved almost immediately and then the concentration declines exponentially. Most drugs are taken by mouth. In this case, the assumption of constant infusion is only approximated as doses are repeated over the course of several days.
Plateau principle | The plateau principle in pharmacokinetics
Drug injection via intravenous administration, intramuscular administration, or subcutaneous administration carries relatively greater risks than other methods of administration. The doses used by recreational intravenous users vary widely, with a range of 1–200 times the doses used therapeutically (i.e., up to several grams). Intravenous users risk developing pulmonary embolism (PE), a blockage of the main artery of the lung or one of its branches, and commonly develop skin rashes or infections at the site of injection. As with the injection of any drug, if a group of users share a common needle without sterilization procedures, blood-borne diseases, such as HIV or hepatitis, can be transmitted.
History and culture of substituted amphetamines | Injection
Following peripheral nerve injury to the ulnar nerve, the AIN is often used as a donor branch to reinnervate the paralysed muscles innervated by the ulnar nerve.
Anterior interosseous nerve | Clinical significance
This, too, is standard medical procedure: it must be ascertained that the IV lines are not blocked, ensuring the chemicals have not precipitated in the IV lines and blocked the needle, preventing the drugs from reaching the subject. A heart monitor is attached to the inmate.
Lethal injection | Procedure in U.S. executions
Drug injection is a method of introducing a drug into the bloodstream via a hollow hypodermic needle and a syringe, which is pierced through the skin into the body (usually intravenously, but also at an intramuscular or subcutaneous location). , there were 13.2 million people worldwide who used injection drugs, of which 22% are from developed countries. A wide variety of drugs are injected, often opioids: these may include legally prescribed medicines and medication such as morphine, as well as stronger compounds often favored in recreational drug use, which are often illegal. Although there are various methods of taking drugs, injection is favoured by some people as the full effects of the drug are experienced very quickly, typically in five to ten seconds.
Drug injection | Introduction
Court rulings in Pennsylvania have determined that safe injection sites are not illegal under federal law.
Injection (medicine) | Society and culture
Completions/attemptsCarriesLong gainReceptionsTimes targeted
Super Bowl LIII | Individual statistics
Intravenous infusion or intravitreous injection.
Foscarnet | Administration
Like many injections, intravitreal injection is commonly performed in the office setting. An operation room may be a better option to provide a more sterile environment for the procedure to lower the chance of infections, yet it will also increase the costs. Since the occurrence of serious post-injection infection (e.g. endophthalmitis) is low, in-office intravitreal injection is preferred.
Intravitreal injection | Location
IC aims at synchronous activation of a large number of fibres within a certain muscle. Training of IC is recommended for athletes heading towards increasing maximum available power without growth of muscular mass. The use of available muscular mass will be used more effective. That aspect is relevant for endurance athletes such as triathlon, long distance runners, as well as martial arts. Both groups profit of increased strength without increased body mass, which results from hypertrophic exercise. Furthermore, IC methods are used within high jump, shot put and Olympic weight lifting.
Intramuscular coordination | Role
Injection is the most common method used by individuals administering AAS for non-medical purposes.
Anabolic steroid | Routes of administration
Pectoralis major muscle in rare occasions may develop intramuscular lipomas. Such rare tumors may mimic malignant breast tumors as they look like enlargements of the breasts. They are well-encapsulated radiolucent tumours of fat density. Their location can be accurately identified through computed tomography and magnetic resonance imaging (MRI). The treatment in these cases involves complete surgical excision because of the risk of liposarcoma they post especially large intramuscular liposomas. Partial excision is risky because recurrence may occur.
Pectoralis major | Other diseases
Others are used in some countries.
Rotavirus vaccine | Introduction
Similarly to the case of testosterone, epitiostanol shows poor bioavailability and weak therapeutic efficacy when taken orally due to extensive first-pass metabolism. As such, it must instead be administered via intramuscular injection.
Epitiostanol | Pharmacokinetics
For more details on this topic, see Inflammation. Inflammation is an immune response in the body tissue due to stimulation of immune cells by pathogens, DAMPs, or stress. The vasculature provides a means of transportation for alerting and recruiting immune cells.
Intravascular immunity | Inflammation
The volume of distribution (V) after intravenous injection is approximately 20 liters. 98% of the circulating entacapone is bound to serum albumin, which limits its distribution into tissues.
Entacapone | Distribution
Intravitreal is a route of administration of a drug, or other substance, in which the substance is delivered into the vitreous humor of the eye. "Intravitreal" literally means "inside an eye". Intravitreal injections were first introduced in 1911 when Ohm gave an injection of air into the vitreous humor to repair a detached retina. In the mid-1940s, intravitreal injections became a standard way to administer drugs to treat endophthalmitis and cytomegalovirus retinitis.
Intravitreal administration | Introduction
In contrast to oral administration, which is associated with very low bioavailability (<10%), the bioavailability of both estradiol and estradiol esters like estradiol valerate is complete (i.e., 100%) via intramuscular injection. In addition, estradiol esters like estradiol cypionate and estradiol valerate when given as an injection of oil solution or microcrystalline aqueous suspension have a relatively long duration due to the formation of an intramuscular depot from which they are slowly released and absorbed. Upon intramuscular injection of estradiol cypionate in an oil solution, the solvent (i.e., oil) is absorbed, and a primary microcrystalline depot is formed within the muscle at the site of injection.
Estradiol cypionate | Intramuscular injection
This is why the USAN for "OPV" is "poliovirus vaccine live oral" rather than "oral poliovirus vaccine".
Vaccine | Nomenclature
The vaccine is supplied in separate vials, one containing the adjuvant, and the other the inactivated virus, which require mixing before intramuscular injection. Originally it was thought that two doses given 21 days apart would be required for full efficacy. Subsequent testing has allowed the UK programme to consist of just a single dose for most people, with a two-dose schedule for children under the age of 10 years and immunocompromised adults.
Pandemrix | Dosage
The agent would be administered intrathecally, intranasally, or directly to the hippocampus or cortex via an injection.
Anne Schaefer (scientist) | Pharmaceutical industry involvement
Reported adverse events are minor and temporary.
Surgery for temporomandibular joint dysfunction | Intra-articular injections
The muscle relaxant should be given intravenously to ensure optimal bioavailability but pancuronium bromide may be administered intramuscularly at an increased dosage level of 40 mg.
Sodium thiopental | Euthanasia
Intrathecal administration is a route of administration for drugs via an injection into the spinal canal, or into the subarachnoid space so that it reaches the cerebrospinal fluid (CSF) and is useful in spinal anesthesia, chemotherapy, or pain management applications. This route is also used to introduce drugs that fight certain infections, particularly post-neurosurgical. The drug needs to be given this way to avoid being stopped by the blood brain barrier. The same drug given orally must enter the blood stream and may not be able to pass out and into the brain. Drugs given by the intrathecal route often have to be compounded specially by a pharmacist or technician because they cannot contain any preservative or other potentially harmful inactive ingredients that are sometimes found in standard injectable drug preparations.
Intrathecal administration | Introduction
Complications from facial autologous muscular injections are very rare. The procedure is minimally invasive and does not require the use of general anesthesia, however, local anesthesia is used to block the patient from feeling pain or discomfort. FAMI procedures are not surgical, it is an outpatient procedure done outside of a hospital. From the 2011 Advanced Techniques in Liposuction and Fat Transfer report, it was noted that in 726 cases over 14 years there were no reports of complications such as cytosteatonecrosis, pseudocyst formation, infections or other issues.
Facial Autologous Muscular Injection | Complications
Intramuscular fat (also known as intramuscular triglycerides, intramuscular triacylglycerol, or intramyocellular triacylglycerol [IMTG]) is located inside skeletal muscle fibers. It is stored in lipid droplets that exist in close proximity to the mitochondria, where it serves as an energy store that can be used during exercise. In humans, excess accumulation of intramuscular fat has been associated with conditions such as insulin resistance and type 2 diabetes. The human immunodeficiency virus (HIV)-lipodystrophy syndrome is associated with over-accumulation of intramuscular fat, which may contribute to AIDS wasting syndrome.
Intramuscular fat | Introduction