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Your guide on where to do Intramuscular (IM) injections
Buttock (Gluteus Medius) Site For IM Injection
Find the trochanter. It is the knobby top portion of the long bone in your upper leg (femur). It is the size of a golf ball.
Find the posterior iliac crest. Many people have "dimples "over this bone. The nurse will help you find the bone landmarks.
Draw an imaginary line between the two bones.
After locating the center of the imaginary line, find a point one inch toward your head. This is where (X) you will put the needle in.
Stretch the skin tight.
Hold the syringe like a pencil or dart. Insert the needle at a right angle to your skin (90 degrees).
You may give up to 3 ml. (cc) of fluid in this site
Leg (Vastus Lateralis) Site For IM Injection
To find the thigh injection site, you will be making an imaginary box on your upper leg. Find the groin. One hand's width below the groin becomes the upper border of the box.
Find the top of knee. One hand's width above the top of the knee becomes the lower border of the box.
The center of the top to your leg becomes the left border of the box.
The center of the side of your leg becomes the right border of the box. The nurse will help you find the landmarks.
The best areas to use for injection is in the middle of this imaginary box. The sites are marked with X's.
Stretch the skin to make it tight.
Insert the needle at a right angle to the skin (90 degrees) straight in.
You may give up to 2 ml. (cc) of fluid into the site.
Shoulder (Deltoid) Site For IM Injection
To find this site you will form an imaginary box on the upper arm.
Find the knobby top of the arm (acromion process).
The top border of the box is two finger widths down from the acromion process.
The bottom border is an imaginary line running from the crease of the armpit, from front to back.
To make the two side borders, divide the arm into three equal sections, from front to back. The site is in the center of the middle third.
Stretch the skin and then bunch up the muscle.
Insert the needle at a right angle to your skin (90 degrees). The nurse will show you how.
Caution: This is a small site. Give only 1 ml. (cc) or less of fluid in this site. Use only if other sites are not available.
What Type Of Needle To Use
To understand what type of needle syringe combo you need you first have to understand a few basic attributes such as needle gauge, needle length. Here is a straight forward guide to what you need to know when deciding what needle / syringe you need.
What is needle guage?
The gauge of the needle refers to the width or barrel size of the needle. It is important to always remember that the bigger the number the smaller the needle size, it’s the opposite of what you might initially think. For instance, the smaller the number is, the larger the needle size is. So a 16 gauge needle is larger than 23 gauge.
What gauge needles should I use?
If you are injecting intramuscularly (IM) either water or oil based liquids then the standard needle size is a 22 or 23 gauge, for glutes and quads whereas you may want to use a 25 gauge needle for delts which is a smaller muscle. Generally just use common sense because oil is thicker therefore you want a slightly bigger needle hole (smaller needle gauge) so you aren’t there all day trying to inject.
Common Needle Gauge
Location Guage
Glutes 22 or 23
Quads 22 or 23
Delts 25
Needle length
The needle length is usually 1.5 inch but you can use 1 inch for smaller site injections like deltoid injections. I would recommend you use 1.5 inch needle all the time to ensure you reach the deep muscle tissue.
Common Needle Length
Location Size
Glutes 1.5 inch
Quads 1.5 inch
Delts 1.0 inch
Syringe size
The standard syringe is the 3 cc (3ml – same size) will be what 95% of users will use when injecting. The 3cc syringe is so popular because if you are injecting 1cc, 2cc or 3cc the 3cc has you covered.
Brand of needle
Terumo, B-D, and Monoject are the most common brands.
Look for the ones with the “ultra thin wall design” because that means you can inject more fluid without buying a larger gauge needle. The ones that have this design is Terumo and B-D, with the sharpest being Terumo.
Pre-loading syringes
If you have to just make sure they are stored safely because if the plungers are accidentally pushed then you lost some of your steroid plus you’ve wasted big money as well. If possible don’t preload your syringes and just leave your gear in the vial or amp until you’re ready.
Aspiration - What You Need To Know
By definition, to aspirate is to withdraw fluid with a syringe. So in our case after you insert the needle, you should pull back slowly on the plunger of the syringe for a few seconds to see if the needle is in a blood vessel. If blood begins to enter the syringe, you know you
When aspirating, you shouldn’t see anything come back into the syringe. This is how you know you are in the right spot. You create a vacuum in your syringe when you pull back on the plunger so if there’s blood then you know you’ve broken a blood vessel.
Why do I need to aspirate?
Those who inject without aspirating are taking unnecessary chances. You may have warning signs such as sweating, coughing, breathing problems, nausea, dizziness, or even more serious signs such as anaphylactic shock, coma or even death. Some or all of these things could be the consequences from forgetting to aspirate.
Usually steroid users only experience dizziness and severe coughing when they accidentally inject a blood vessel but why even chance it when it takes virtually no time to do this simple procedure
Being sterile is the name of the game when it comes to injections. If you think the injection is painful, then an abcess is going to ruin your world. Make sure you clean the top of the vial with alcohol before drawing out the substance. Many steriods are manufactured in underground labs that don't have the strict regulations and policies that other labs have.
Personally, I buy needles with an 18 gauge tip on it, to make it easy to draw, then replace the tip with a BRAND NEW screw on pin. You can find pictures on the web of needles and how scarred up they are after ONLY going through the rubber top of a vial. Replacing the tip is a very easy way to save yourself some pain.
After you have the injection ready, clean the area to be injected thoroughly with alcohol. I'm talking clean anywhere that might be even sort of AROUND the area to be injected here. No place to mess around here.
Inject slowly but steadily, so you can feel if you hit a nerve. Once the needle is all the way is, pull back on the plunger to make sure you haven't hit a blood vessel. A little air or fluid is ok, but if you pull back blood, you are in a vessel, and want to inject somewhere else. (new needle).
If you dont find any blood, inject slowly but steadily, which will stretch the fascia of the muscle, instead of possibly tearing it with a fast injection. This cuts down on pain later. Have an alcohol swap ready to sterilize the site after you, quickly, pull out the syringe.
Take a few minutes to massage the area to disperse the substance into the muscle. This will also cut down the pain later.
later
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