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.
Technique
Intramuscular injection
Intramuscular injection | Technique
The injection site is first cleaned using an antimicrobial and allowed to dry, it is performed in a quick, darting motion perpendicular to the skin, at an angle between 72 and 90 degrees. 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. Vaccines, especially inactivated vaccines, are commonly administered via intramuscular 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. The needle is withdrawn at the same angle inserted.
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
assistant
which country was it used first?
user
Sorry. I cannot find the answer based on the context.
assistant
can you list some of it's uses?
user
Intramuscular injection is commonly used for medication administration, such as, vaccination
assistant
what technique is used for it?
user
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
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
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
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 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
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 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
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
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
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 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
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
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
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
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
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
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
The exact procedures and techniques of the intravitreal injection varies among different guidelines, and may depend on the practices of the person performing the injection. Below is an example of the steps for the injection: The patient usually leans back on the chair (in supine position), in which the headrest is stable and the patient is comfortable. Sterile drape is sometimes used to cover the face of the patient and only show the eye for the injection. The specialist first applies anesthetics to the eye and eyelid to numb the area, so that the patient will not feel the pain during the procedure.
Intravitreal injection | Steps
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
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
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
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
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
Aseptic technique should always be practiced when administering injections. This includes the use of barriers including gloves, gowns, and masks for health care providers. It also requires the use of a new, sterile needle, syringe and other equipment for each injection, as well as proper training to avoid touching non-sterile surfaces with sterile items. To help prevent accidental needlestick injury to the person administering the injection, and prevent reuse of the syringe for another injection, a safety syringe and needle may be used. The most basic reuse prevention device is an "auto-disable" plunger, which once pressed past a certain point will no longer retract.
Injection (medicine) | Technique
Common injection sites include the inner surface of the forearm and the upper back, under the shoulder blade..
Intradermal injection | Injection sites
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
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
Intravenous injection is a common clinical route of administration. (to be completed)
Physiologically based pharmacokinetic modelling | Intra-venous injection
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
for CHNO: 370.1681. Found: 370.1692.
Intramolecular Heck reaction | Example Procedure
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
Autotransplantation
Facial Autologous Muscular Injection | See also
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
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
The CV-4 technique is done with the patient lying supine with the physician's thenar eminences cradling the occiput with the fingers left free. The physician encourages extension (towards the physician) while discouraging flexion. These movements are continued until a "still point" is reached, where softening and warmth of the surrounding occur.
CV4 technique | Procedure
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
Additionally, the body's reaction to substances is more easily visible since it is closer to the surface.
Intradermal injection | Introduction
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
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
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
Traditionally hypodermic needles are used for intradermal injections, instead of intradermic needles. Various microneedle technology researchers worldwide develop new devices and therapies to overcome typical usability issues associated with traditional Mantoux Procedure. Most intradermic needles require a change in injection technique or instruction to use, for example a perpendicular intradermal injection.
Intradermal injection | Intradermic needles
Injection of radiocontrast may be used to visualize organs. Interventional procedures, such as thermoablation, angioplasty, embolisation or biopsy, may be performed. Upon completion of the desired procedure, the sheath is withdrawn. In certain settings, a sealing device may be used to close the hole made by the procedure.
Seldinger technique | Description
Methods to help prevent peripheral nerve injury include injection pressure monitoring. The presence of a high opening injection pressure (> 20 PSI) is a sensitive sign of intrafascicular/intraneural needle tip placement. Extrafascicular needle tip placement is associated with low pressures (< 20 PSI). Also, high pressure injection was associated with neurologic deficits and severe axonal damage after the block. Other methods of preventing peripheral nerve injury include electrical nerve stimulation and ultrasonography. Electrical stimulation with a motor response at < 0.2 mA only can occur with an intraneural/intrafasciular needle tip location.
Nerve injury | Prevention of intraneural injections
Intracerebroventricular injection (also called ICV injection, i.c.v. injection, or sometimes ICVI) is an invasive injection technique of substances directly into the cerebrospinal fluid in cerebral ventricles in order to bypass the blood brain barrier. Although this barrier effectively protects the brain, it can prevent important medications from entering the CNS. The technique is widely used in biomedical research to introduce drugs, therapeutic RNAs, plasmid DNAs, and viral vectors into the CNS of diseased mice models. It can also be used in human in cases of neurodegenerative disorders like spinal muscular atrophy (SMA), or administering chemotherapy in gliomas as well as delivering neurotrophic factors to CNS.
Intracerebroventricular injection | Introduction
Methods for estimating the degree of neuromuscular block include valuation of muscular response to stimuli from surface electrodes, such as in the "train-of-four" test, wherein four such stimuli are given in rapid succession. With no neuromuscular blockade, the resultant muscle contractions are of equal strength, but gradually decrease in case of neuromuscular blockade. It is recommended during use of continuous-infusion neuromuscular blocking agents in intensive care.
Neuromuscular-blocking drug | Estimating effect
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
Testosterone undecanoate and testosterone buciclate can be injected intramuscularly as infrequently as four times per year.
Pharmacokinetics of testosterone | Intramuscular injection
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
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
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
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
Designs exist for both intramuscular and subcutaneous injection. Disposable autoinjectors commonly use a pre-loaded spring as a power source. This spring and the associated mechanical components form a one-shot linear actuator. When triggered the actuator drives a three step sequence: Some injectors are triggered by simply pushing the nose ring against the injection site. In these designs the protective cap is the primary safety. Other designs use a safety mechanism similar to nail guns: The injection is triggered by pushing the nose ring against the injection site and simultaneously, while applying pressure, pushing a trigger button at the rear end of the device.
Autoinjector | Design
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
Intracardiac injections are injections that are given directly into the heart muscles or ventricles. They are used in emergencies.
Intracardiac injection | Introduction
Others are used in some countries.
Rotavirus vaccine | Introduction
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
This can be done in reverse, depending on which eye is operated on.
Trabectome | Method
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
By coupling assayable enzymes such as horseradish peroxidase (HRP) or fluorescent proteins such as green fluorescent protein (GFP) to the α-bungarotoxin, AChRs can be visualized and quantified.
Neuromuscular junction | Research methods
Precisely targeted eye muscle injections are useful for both diagnosis and treatment, but the bodies of the 6 muscles that rotate the eye lie close together, adjacent to the eyeball, and are not normally visible. Scott and colleagues therefore developed EMG-guided injection, a system that uses a hypodermic needle that records the electrical activity of the muscle (the electromyogram or EMG) at its tip. The needle is introduced under local anesthesia, and as the awake patient looks in different directions, the pattern of muscle activity, played through a speaker, indicates when the belly of the target muscle has been entered, and the drug is then injected.
Alan B. Scott | Electrically guided injection
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
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
Intramuscular electrical stimulation (IMES) of muscle tissue has been used in various experimental and clinical settings. The advantage to using an IMES system over a standard such as hypertonic saline is that IMES can be turned on and off. This allows the researcher to exert a much higher degree of control and precision in terms of the stimulus and the measurement of the response. The method is easier to carry out than the injection method as it does not require special training in how it should be used. The frequency of the electrical pulse can also be controlled. For most studies a frequency of about 10 Hz is needed to stimulate both local and referred pain.
Referred pain | Using electrical stimulation
IC methods can improve fast power given the fact that parts of movement take below 200ms.
Intramuscular coordination | Methods of exercise
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
However, recent analysis shows no evidence of techniques involving injection. Analysis of the "blood vessels" indicate they are constructed of beeswax, iron wire, and silk.
Cappella Sansevero | Anatomical exhibits
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
Most vaccines are given by subcutaneous (under the skin) or intramuscular (into the muscle) injection. Respiratory tract disease vaccination may be given intra-nasally (in the nose) in some cases.
Vaccination of dogs | Method
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
With standard intravenous induction of general anesthesia, the patient typically receives an opioid, and then a hypnotic medication. Generally the patient will be manually ventilated for a short period of time before a neuromuscular blocking agent is administered and the patient is intubated. During rapid sequence induction, the person still receives an IV opioid. However, the difference lies in the fact that the induction drug and neuromuscular blocking agent are administered in rapid succession with no time allowed for manual ventilation. Commonly used hypnotics include thiopental, propofol and etomidate. The neuromuscular blocking agents paralyze all of the skeletal muscles, most notably and importantly in the oropharynx, larynx, and diaphragm.
Rapid sequence induction | Paralysis with induction
Intramuscular injection does give a faster and higher pharmacokinetic profile when compared to subcutaneous injection.
Epinephrine (medication) | Anaphylaxis
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
Lars-Göran Öst expanded upon this research, having BII-phobic individuals engage in applied muscle tension while shown blood stimuli. Those who were trained in the technique showed notable symptom improvement over the course of five one-hour treatment sessions. An AT treatment program most often involves an individual being instructed to clench their arm, leg, and chest muscles in 10 to 15 second intervals as they are systematically exposed to triggers of increasing likeness to real blood or needles. This program is designed to increase heart rate and blood pressure, counteracting vasovagal response.
Blood-injection-injury type phobia | Treatments
The traditional procedure of ID injection (Mantoux Procedure) involves injecting at angle of administration of 5 to 15 degrees angle, almost against the skin. With bevel (opening) side up, the needle is inserted about with the entire bevel inside and injected while watching for a small wheal or blister to appear. When the needle is removed, it is immediately placed in the sharps container. The patient is instructed to avoid touching the injection site, to not apply a bandaid, and to return within 48 hours to have their TB test read. All soiled supplies are disposed of in a biohazard container, and the procedure is documented, making note of patient identifiers, injection site, NDC or LOT number, and expiration date on the vial.
Intradermal injection | Mantoux Procedure
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
Another common safety feature is an auto-retractable needle, where the needle is spring-loaded and either retracts into the syringe after injection, or into a plastic sheath on the side of the syringe. Other safety syringes have an attached sheath which may be moved to cover the end of the needle after the injection is given. The World Health Organization recommends the use of single-use syringes with both reuse prevention devices and a needlestick injury prevention mechanism for all injections to prevent accidental injury and disease transmission.
Injection (medicine) | Technique
Although studies have suggested that the technique provides good intra-tester reliability, the reliability has also been reported to be poor.
Passive physiological intervertebral movements | Clinical evidence
They are asked to lie flat during the procedure.
Intravenous pyelogram | Procedure
Particularly for intravenous administration, self-injection in the arm can be awkward, and some people modify a syringe for single-handed operation by removing the plunger and affixing a bulb such as from a large dropper or baby pacifier to the end of the barrel to in effect make it a large dropper with a needle affixed. This is therefore a variant of the common method of injection with a dropper with the hypodermic needle affixed, using a "collar" made of paper or other material to create a seal between the needle and dropper. Removing part of the plunger assembly by cutting off most of the shaft and thumb rest and affixing the bulb to the end of the barrel, thereby allowing the bulb to operate the plunger by suction, also does work in many cases.
Drug injection | Modifications
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
Precautions should be taken before, during, and after the injection to lower the chances of complications:
Intravitreal injection | Precautions
The isoinertial's muscle activity follows the muscular action of the sporting gesture or rather what the body or parts of it are in duty to perform in sports, according to which, in strength and speed variable, an inertial load (such as a ball), a limb or the body itself (such as when accelerating or changing direction) the athlete is forced to respond at the level coordinative motor and neuromuscular very quickly to situations and motor gestures sudden and not predetermined.
Isoinertial | The Isoinertial Method
If the patient is not awake, movement-related EMG cannot be recorded. Scott and colleagues therefore developed another system in which the injection needle stimulates, rather than records, producing characteristic eye movements that identify the muscle in which the needle is placed.
Alan B. Scott | Electrically guided injection
The current injection technique is a technique developed to reduce the turn-OFF switching transient of power bipolar semiconductor devices. It was developed and published by Dr S. Eio of Staffordshire University (United Kingdom) in 2007.
Current injection technique | Introduction
The needle is injected through the bone's hard cortex and into the soft marrow interior which allows immediate access to the vascular system. The IO needle is positioned at a 90 degree angle to the injection site, and the needle is advanced through manual traction, impact driven force, or power driven. Each IO device has different designated insertion locations. The most common site of insertion is the antero-medial aspect of the upper, proximal tibia as it lies just under the skin and is easily located. This is on the upper and inner portion of the tibia. Other insertion sites include the anterior aspect of the femur, the superior iliac crest, proximal humerus, proximal tibia, distal tibia, sternum (manubrium).
Intraosseous infusion | Procedure
Immunophysical techniques include nuclear magnetic resonance spectroscopy, magnetic resonance imaging (MRI), dual-energy computed tomography, fluorescence-lifetime imaging microscopy, multispectral optoacoustic tomography (MSOT), high-throughput microfluidic cytometry, interferometric scattering microscopy (iSCAT) and cryogenic optical localization in 3D (COLD).
Immunophysics | Methods
Thus, the approach has also transferred well for the treatment of hepatitis B and HIV.
Intrastructural help | 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
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
Although the injury is typically associated with vaccination, it can also occur as the result of any other kind of injection into the shoulder area. However, examination of injury reports suggests that this type of injury is of increased severity when administration of a vaccine is involved, which "may be due either to the antigenic or nonantigenic components of the vaccine". In order to avoid this type of injury, injection administrators are advised to avoid injecting the patient too high, too low, or too far to the side, and to avoid using needles that fail to penetrate deeply into the muscle, or that penetrate too deeply and contact the bone.
Shoulder injury related to vaccine administration | Introduction
Treatment is usually surgical, performed at the "insertional" ends of extraocular muscles (where they attach to the globe). "Resection" surgery removes tissue in order to stretch a muscle, increasing its elastic force; "recession" moves an insertion so as to reduce stretch, and so reduce elastic force; "transposition" moves an insertion “sideways”, sacrificing one direction of muscle action for another; "posterior" "fixation" relocates a muscle’s effective insertion to a mechanically disadvantageous position. All are kinds of compensatory impairment. Pharmacologic injection treatments, in contrast, offer the possibility of directly increasing or decreasing contractile muscle strength and elastic stiffness, as well as changing muscle length, without removing tissue or otherwise compromising orbital mechanics.
Management of strabismus | Surgery
Injection is the most common method used by individuals administering AAS for non-medical purposes.
Anabolic steroid | Routes of administration
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
A 25 to 31 gauge thick, 3/8" to 1" long needle can be used. The size is determined by the amount of subcutaneous tissue present, which is based on patient build. The 3/8" and 5/8" needles are most commonly used. Usually, no more than 1 mL of solution is given, compared to intradermal injections, where no more than 0.5 mL is usually given. Subcutaneous injections may also be given using an injector pen.
Subcutaneous injection | Equipment
Sit- Supraspinatus In - Infraspinatus The - Teres minor Seat - Subscapularis muscle
List of anatomy mnemonics | Rotator cuff Muscles
The precise mechanism of how the polyadenylation site is chosen remains unclear.
Immunoglobulin D | Method of coexpression
In joint disarticulation amputations tenodesis may be used where the muscle tendon is attached to the bone. Muscles should be attached under similar tension to normal physiological conditions. An experimental technique known as the "Ewing amputation" aims to improve post-amputation proprioception.
Amputation | Method
The dura is sewn closed. The skull is reconstructed and the overlying tissues are closed in multiple layers. The patient is allowed to wake up and is taken to an intensive care unit or other close observation unit.
Microvascular decompression | Surgical technique
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
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