General Warnings

Mistakenly Giving Intramuscular Injection In A Blood Vessel

An intramuscular injection is a technique used to deliver a medication deep into the muscles. This allows the medication to be absorbed into the bloodstream quickly. You may have received an intramuscular injection at a doctor’s office the last time you got a vaccine, like the flu shot.

In some cases, a person may also self-administer an intramuscular injection. For example, certain drugs that treat multiple sclerosis or rheumatoid arthritis may require self-injection.

Intramuscular injections are a common practice in modern medicine. They’re used to deliver drugs and vaccines. Several drugs and almost all injectable vaccines are delivered this way.

Intramuscular injections are used when other types of delivery methods aren’t recommended. These include:

  • oral (swallowed into the stomach)
  • intravenous (injected into the vein)
  • subcutaneous (injected into the fatty tissue just under the layer of skin)

Intramuscular injections may be used instead of intravenous injections because some drugs are irritating to veins, or because a suitable vein can’t be located. It may be used instead of oral delivery because some drugs are destroyed by the digestive system when a drug is swallowed.

Intramuscular injections are absorbed faster than subcutaneous injections. This is because muscle tissue has a greater blood supply than the tissue just under the skin. Muscle tissue can also hold a larger volume of medication than subcutaneous tissue.

What Will Happen If You Mistakenly Give IM Injection In A Blood Vessel?

if you mistakenly give an intramuscular injection through vein (Intravenously),   the content will damage the blood cells due to variation of pH of the solution, haemolysis and/or coagulation will occur due to the presence of fatty substances present in the diluent. It will be an unexplained reaction( varies drug to drug) which may be serious to fatal depends on the nature of the medicine.

If you give someone Ativan IV instead of the intended IM (which would not be diluted as you would for IV administration) it would be very painful for the patient and could possibly damage the vein. On the other hand if you give someone Phenergan IV instead of IM you could rot their hand off.

How to administer an intramuscular injection

Any person who administers intramuscular injections should receive training and education on proper injection techniques. The needle size and injection site will depend on many factors. These include the age and size of the person receiving the medication, the volume and type of medication. Your doctor or pharmacist will give you specific guidelines about which needle and syringe are appropriate to administer your medication.

The needle should be long enough to reach the muscle without penetrating the nerves and blood vessels underneath. Generally, needles should be 1 inch to 1.5 inches for an adult, and will be smaller for a child. They’ll be 22-gauge to 25-gauge thick, noted as 22g on the packaging.

Follow these steps for a safe intramuscular injection:

1) Wash your hands

Wash your hands with soap and warm water to prevent potential infection. Be sure to thoroughly scrub between fingers, on the backs of hands, and under fingernails.

The Centers for Disease Control and Prevention (CDC)  recommends lathering for 20 seconds — the time it takes to sing the “Happy Birthday” song twice.

2) Gather all needed supplies

Assemble the following supplies:

•          needle and syringe with medication

•          alcohol pads

•          gauze

•          puncture-resistant container to discard the used needles and syringe — typically a red, plastic sharps container

•          bandages

3) Locate injection site

To isolate the muscle and target where you’ll place the injection, spread the skin at the injection site between two fingers. The person receiving the injection should get into a position that’s comfortable, provides easy access to the location, and keeps the muscles relaxed.

4) Clean injection site

Clean the site selected for injection with an alcohol swab and allow the skin to air dry.

5) Prepare syringe with medication

Remove the cap. If the vial or pen is multi-dose, take a note about when the vial was first opened. The rubber stopper should be cleaned with an alcohol swab.

Draw air into the syringe. Draw back the plunger to fill the syringe with air up to the dose that you’ll be injecting. This is done because the vial is a vacuum and you need to add an equal amount of air to regulate the pressure. This also makes it easier to draw the medication into the syringe. Don’t worry — if you forget this step, you can still get the medication out of the vial.

Insert air into the vial. Remove the cap from the needle and push the needle through the rubber stopper at the top of the vial. Inject all of the air into the vial. Be careful not to touch the needle to keep it clean.

You can also find useful information on: What Will Happens If You Mistakenly Give Subcutaneous Injection Intramuscularly?

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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