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2.1
Intramuscular Injection
Injection Intramuscular

Images

WIKIDATA, Public Domain
WIKIDATA, CC BY 2.0
WIKIDATA, CC BY 4.0
WIKIDATA, CC BY 4.0

Presentation

MATERIALS AND METHODS: This was an observational study in which records of febrile pediatric patients presenting to the emergency department were analyzed. [ncbi.nlm.nih.gov]

The present study was conducted during anatomy practice for medical students in 2018. [tandfonline.com]

Entire Body System

  • Pain

    Intramuscular injection of hypertonic saline produces pain in the belly of the injected muscle (primary pain) and, often, pain that projects distally (referred pain). [ncbi.nlm.nih.gov]

  • Fever

    Sepsis symptoms include general malaise, fever, chills, nausea, vomiting, diarrhea, tachypnea, and confusion. Sometimes the body will get small haematomas. [dopinglinkki.fi]

    Fever alleviation was defined as the temperature decline to 1°C below the temperature at presentation. Patients who received diclofenac sodium twice or more on different days were observed for side effects such as allergic reaction. [ncbi.nlm.nih.gov]

    Sometimes a baby or child will be fussy or have a fever after an immunization. Tylenol® (acetaminophen) may make him feel better. Call your doctor if the child does not get better. [hog.org]

    Needle that breaks off in the injection site Medicine injected into the wrong area Problems that keep you from giving yourself the injection Bleeding or pain at the injection site that won't stop Rash or swelling at the injection site Shortness of breath Fever [saintlukeskc.org]

  • Intravenous Administration

    The onset of action is typically longer than with intravenous administration, but shorter than with subcutaneous administration. Patients generally experience more pain via intramuscular administration compared to intravenous administration. [pharmlabs.unc.edu]

    […] a patient cannot tolerate oral medication or when adherence is a concern.2 IM injections also may be beneficial for absorption compared with other routes of administration (ie, faster than subcutaneous injection and slower than intravenous administration [oncologynurseadvisor.com]

    Practice points Issue to note regarding administration of IM injections: Avoid subcutaneous and intramuscular injections when intravenous administration is a suitable alternative option. [bettersafercare.vic.gov.au]

    In order to avoid unnecessary aspiration during IM medication administration, and minimize the risk of inappropriate systemic (intravenous or intra-arterial) administration: Select the site and needle size which are most appropriate for the patient. [amsn.org]

  • Inflammation

    […] and Ageing, Centre of Translational Inflammation Research, University of Birmingham Research Laboratories, Queen Elizabeth Hospital, Edgbaston, Birmingham, B15 2WB, UK. 4 Birmingham Clinical Trials Unit (BCTU), Public Health Building, Institute of Applied [ncbi.nlm.nih.gov]

    Sepsis always requires hospitalization. [3, 5] In addition to sepsis, the spread of bacteria, if left untreated, may result in a rare but life-threatening soft tissue inflammation which is necrotizing i.e. leads to necrosis. [dopinglinkki.fi]

    Intramuscular injection when applied poorly can cause: - Intense pain and hardening of the place where the injection was applied; - Redness of the skin; - Decreased sensitivity at the site of application; - Inflammation of the region where the injection [cilveducult.blogspot.com]

    Observe the site for local inflammation. Dispose of the needles and syringe into a labelled puncture proof container to prevent needle stick injury or reuse. [bettersafercare.vic.gov.au]

  • Sepsis

    These data can be divided into 3 groups; nerve palsies, musculoskeletal injuries and cutaneous reactions and reflect inappropriate site of injection, needle over or under penetration, local sepsis and vascular complications. [ncbi.nlm.nih.gov]

    […] infections, and can rarely progress to generalized sepsis and multi-organ failure [ 4 ]. [casesjournal.biomedcentral.com]

    Sepsis always requires hospitalization. [3, 5] In addition to sepsis, the spread of bacteria, if left untreated, may result in a rare but life-threatening soft tissue inflammation which is necrotizing i.e. leads to necrosis. [dopinglinkki.fi]

Respiratoric

  • Pneumonia

    Less severe skin infections due to S. pneumoniae that have involved im injections have also been described. [academic.oup.com]

    Abstract Two cases of pneumococcal necrotizing fasciitis (NF) occurred after intramuscular injections of nonsteroidal anti-inflammatory drugs; another 5 cases reported in the literature fulfilled the criteria for NF involving Streptococcus pneumoniae. [ncbi.nlm.nih.gov]

    This includes comatose states; toxemias; local gastric disease and other conditions accompanied by nausea and vomiting; infections, such as pneumonia and typhoid, in which dextrose by mouth is avoided because of its tendency to favor tympanites; local [jamanetwork.com]

    Medication Uses | How To Use | Side Effects | Precautions | Drug Interactions | Overdose | Notes | Missed Dose | Storage WARNING: There may be a slightly increased risk of serious, possibly fatal side effects (such as heart failure, fast/irregular heartbeat, pneumonia [medicinenet.com]

  • Rhinitis

    However, minor illnesses with or without fever do not contraindicate use of influenza vaccine, particularly among children with mild upper-respiratory-tract infection or allergic rhinitis. [cdc.gov]

Cardiovascular

  • Hypotension

    The recognition and treatment of hypotension is particularly important to avoid complications such as cerebral ischaemic... Read more... [health.vic.gov.au]

    While there is some evidence that the more immediate, higher concentration of bolus delivery could lead to stronger effect on uterine contractions [23], this route is less frequently used due to fear of hypotension, although this problem has only been [bmcpregnancychildbirth.biomedcentral.com]

    Postoperatively, the patient was admitted to the ICU due to developing multi-organ failure, (tachycardia, hypotension, oliguria and deterioration of pulmonary function). [casesjournal.biomedcentral.com]

    He collapsed and was admitted to our hospital the same day with refractory hypotension. Physical examination revealed that the patient was severely ill, hoarse, and had a temperature of 35.7°C and cold skin with signs of impaired perfusion. [academic.oup.com]

  • Heart Disease

    Your doctor may need to monitor you carefully for side effects. tell your doctor if you have or have ever had chest pain, irregular heartbeat, high blood pressure, or heart disease; asthma; diabetes; hyperthyroidism (an overactive thyroid); pheochromocytoma [medlineplus.gov]

    The risk for hospitalization was higher for HIV-infected women than for women with other well-recognized high-risk conditions, including chronic heart and lung diseases ( 158 ). [cdc.gov]

  • Heart Failure

    […] embolism chronic heart failure stroke Obstruction of a Blood Vessel by a Blood Clot Blood Clot in Vein blood clot in a deep vein of the extremities At Risk for Formation of Blood Clots liver problems kidney disease with reduction in kidney function Systemic [webmd.com]

    Before using haloperidol decanoate, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG ), family history of certain [medicinenet.com]

Skin

  • Ulcer

    This condition is initially hemorrhagic, then it ulcerates, and eventually heals with an atrophic scar. Many different drugs have been reported to cause Nicolau syndrome. [ncbi.nlm.nih.gov]

    SHOWING 1-10 OF 10 REFERENCES Diagnostic dilemma : intramuscular injections site injuries masquerading as pressure ulcers The origins of hypodermic medication Intramuscular injection injuries and complications Possible complication of intramuscular injections [semanticscholar.org]

    Diagnostic Dilemma: Intramuscular Injection Site Injuries Masquerading As Pressure Ulcers. WOUNDS. 2003;15(9):302-312. Harvinder S. Gill and Mark R. Prausnitz. Does Needle Size Matter? J Diabetes Sci Technol. 2007 Sep; 1(5): 725–729. [transguys.com]

  • Urticaria

    Side effects such as urticaria, asthmatic attack, vasospastic angina, ischemic stroke, and Kounis syndrome may be seen after the use of diclofenac sodium. However, anaphylactic shock is rare. [ncbi.nlm.nih.gov]

    These signs and symptoms can include, but are not limited to: flushing, facial edema, urticaria, itching, swelling of the mouth or throat, wheezing, and difficulty breathing. [cdc.gov]

  • Skin Lesion

    lesions at the injection site; the nurse displaces the tissue before inserting the needle, then once the needle is withdrawn, the tissue is restored to its normal position.[16] Risks and Complications Most of the adverse events caused by IM injections [legalnursepdx.com]

    Check the site for signs of oedema, infection or skin lesions. If any of these are present, select a different site. Wash and dry hands. If gloves are considered necessary, following the risk assessment, these should be applied. [nursingtimes.net]

  • Eczema

    We treated a 26-year-old woman who had received a presumed intramuscular injection of triamcinolone in the left buttock for chronic eczema four weeks earlier. [nejm.org]

Musculoskeletal

  • Myopathy

    We report a patient in whom chronic intramuscular piritramide led to a focal fibrotic myopathy. Since piritramide myotoxicity has never been reported, we have studied its effect on rat skeletal muscle. [ncbi.nlm.nih.gov]

Neurologic

  • Encephalopathy

    Influenza infection has also been associated with encephalopathy, transverse myelitis, Reye syndrome, myositis, myocarditis, and pericarditis ( 32,40,44,45 ). [cdc.gov]

Workup

A careful diagnostic workup identified misguided subcutaneous injections due to a wrong injection angle as the most plausible cause. [ncbi.nlm.nih.gov]

Diagnostic workup included a CT-scan of the abdomen, which revealed fluid collection along the soft tissues on both thighs, extending into the abdominal cavity. [casesjournal.biomedcentral.com]

Microbiology

  • Streptococcus Pneumoniae

    pneumoniae, Clin Infect Dis, 1993, vol. 17 pg. 939 26 Deep soft tissue infections caused by Streptococcus pneumoniae, Eur J Clin Microbiol Infect Dis, 1995, vol. 14 (pg. 1002 - 4 ) 27 Pneumococcal pyomyositis secondary to pneumonia, Scand J Infect Dis [academic.oup.com]

    Abstract Two cases of pneumococcal necrotizing fasciitis (NF) occurred after intramuscular injections of nonsteroidal anti-inflammatory drugs; another 5 cases reported in the literature fulfilled the criteria for NF involving Streptococcus pneumoniae. [ncbi.nlm.nih.gov]

    View Article PubMed Google Scholar Frick S, Cerny A: Necrotizing fasciitis due to Streptococcus pneumoniae after intramuscular injection of nonsteroidal anti-inflammatory drugs: report of 2 cases and review. [casesjournal.biomedcentral.com]

  • Staphylococcus Aureus

    Blood culture and anterior chamber paracentesis was positive for methicillin-sensitive Staphylococcus aureus. The authors believe this to be the first case of an iris abscess due to gluteal abscess after intramuscular injection. [ncbi.nlm.nih.gov]

    Multi-resistant Staphylococcus aureus was isolated from blood cultures. [casesjournal.biomedcentral.com]

  • Candida

    The culture test resulted positive to Proteus mirabilis, Acinetobacter baumannii, Candida albicans, and Escherichia coli; the histological examination of the tissue removed from the left hip described a colliquative necrosis, associated with widespread [hindawi.com]

Treatment

Investigation of new treatment options has been limited by patient concerns about the negative fetal effects of medication. To assess the efficacy of intramuscular injection of autologous whole blood (AWB) for treatment of PUPPP. [ncbi.nlm.nih.gov]

If you're using assisted fertility treatments as you are trying to conceive, you may have to regularly inject yourself with hormone treatments. [verywellhealth.com]

Prognosis

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. [healdove.com]

From this review, it is evident that a prompt treatment represents an essential condition to improve the overall prognosis and mortality. [hindawi.com]

Etiology

In this paper, we discuss etiologies, risk factors, and treatment options for gluteal Nicolau syndrome referring to patients treated in our hospital. [ncbi.nlm.nih.gov]

The common etiologies of NSTIs are insect bites, chronic wounds, trauma, or idiopathic origin. Otherwise, possible and infrequent sources are iatrogenic, for example, injections or surgical wounds. [hindawi.com]

[…] through MEDLINE (1966–1999), Serline (unlimited), and Science Citation Index of the Web of Science (1983–1999) for the following terms: “pneumococcal soft tissue infection”; “pneumococcal necrotizing fasciitis”; “soft tissue infection/microbiology” and “etiology [academic.oup.com]

Epidemiology

Funding and Disclosures * From the Laboratory on Housing and Illness, Armed Forces Epidemiological Board, and the Department of Medicine, State University of New York Upstate Medical Center. [nejm.org]

The epidemiologic investigation of any IM injection site infection can be quite complex. [ncbi.nlm.nih.gov]

Cases of GBS after influenza infection have been reported, but no epidemiologic studies have documented such an association ( 209,210 ). [cdc.gov]

Pathophysiology

Considering the aforementioned pathophysiological impact of NSAIDs, treatment with NSAIDs may well have been an accelerating factor in the evolution of NF. [academic.oup.com]

More definitive data probably will require using other methodologies (e.g., laboratory studies of the pathophysiology of GBS). [cdc.gov]

Prevention

Royal College of Nursing (2018) Tools of the Trade: Guidance for Health Care Staff on Glove Use and the Prevention of Contact Dermatitis. Small SP (2004) Preventing sciatic nerve injury from intramuscular injections: literature review. [nursingtimes.net]

& control* Pain Measurement Palivizumab Parents/psychology Pilot Projects Respiratory Syncytial Virus Infections/prevention & control Statistics, Nonparametric Tetracaine/therapeutic use* Treatment Outcome Videotape Recording Substances Anesthetics, [ncbi.nlm.nih.gov]

This prevents needle from touching side of the cap and prevents contamination. Pull cap off needle 18. With non-dominant hand, hold the skin around the injection site. This secures the area for injection. 19. [opentextbc.ca]

Prostaglandins for preventing postpartum haemorrhage. Cochrane Database Syst Rev. 2007;3(CD000494):i–280. 32. FIGO. Prevention of Post-partum Haemorrhage with Misoprostol: FIGO Guideline, Annotated Version. [bmcpregnancychildbirth.biomedcentral.com]

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