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]
- Swelling
Physical examination disclosed painful swelling over left distal arm, elbow, and forearm with three needle punctures. [ncbi.nlm.nih.gov]
Normally, it is recommended that you alternate sites with each injection so that you can avoid any swelling or soreness. [verywellhealth.com]
Has swelling of the mouth, lips, or face. Call the provider if: You have questions about how to give the injection. After getting the injection, the person gets a fever or gets sick. [medlineplus.gov]
Check the site at least once more a short time after the injection to ensure that no bleeding, swelling or any other signs of reaction to the medication are present. [encyclopedia.com]
- 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]
- Severe Pain
Clinical evidence of very severe pain at the site of injection with septicemia and collapse within 24 to 48 hours should arouse the suspicion of clostridial myositis rather than pyogenic infection. [ncbi.nlm.nih.gov]
The first is that the delivery of the vaccination could be compromised and the second is that the needle could hit the bone and this causes severe pain. [enotes.com]
- 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]
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]
Cardiovascular
- Hypertension
The first patient was known to have generalized arteriosclerosis due to longstanding arterial hypertension, which has also been listed as a risk factor [ 13 ]. [academic.oup.com]
Case report 2 A 73 year old Caucasian female patient with history of hypertension, congenital hip dislocation, and degenerative arthritis, was admitted to the Internal Medicine Ward due to anemia (Hb:5.7 gm/dL), persistent low-grade fever (37.3°C) and [casesjournal.biomedcentral.com]
Pulmonary edema developed in 1 of those being reported and hypertension and arrhythmias in the other 2. Severe deterioration in left ventricle function was confirmed by echocardiographic measurement of diminished ejection fraction. [ima.org.il]
> 65 years; residents of nursing homes and other chronic-care facilities that house persons of any age who have chronic medical conditions; adults and children who have chronic disorders of the pulmonary or cardiovascular systems, including asthma (hypertension [cdc.gov]
- Tachycardia
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]
[…] fascia and the surrounding deep layer of the subcutaneous tissue (involvement of the muscle or the skin was optional or secondary); pneumococci isolated from culture of blood and/or local aspirates; and incipient or evident septic shock (e.g., hypotonia, tachycardia [academic.oup.com]
Skin
- Flushing
In a study of 100 samples, the BD blunt fill needle was shown to have no visible coring during medication draw. 2 Pre-filled flush syringes BD pre-filled flush syringes provide dependable, cost-effective alternatives to vial-based flushing systems. [bd.com]
Nausea, vomiting, dry mouth, constipation, flushing, increased sweating, lightheadedness, swelling/pain/ itching at injection site, dizziness, or drowsiness may occur. [webmd.com]
However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. [medlineplus.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]
- Angioedema
Immediate --- presumably allergic --- reactions (e.g., hives, angioedema, allergic asthma, and systemic anaphylaxis) rarely occur after influenza vaccination ( 195 ). [cdc.gov]
- Eruptions
Pruritic urticarial papules and plaques of pregnancy (PUPPP), also known as polymorphic eruption of pregnancy, is a common and benign but exceedingly uncomfortable dermatosis of pregnancy. [ncbi.nlm.nih.gov]
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]
- Muscle Spasm
If these effects persist or worsen, notify your doctor or pharmacist promptly.Tell your doctor promptly if any of these side effects occur: muscle spasm/stiffness, shaking (tremor), restlessness, mask-like facial expression, drooling. [medicinenet.com]
Urogenital
- Renal Insufficiency
Further studies are needed to determine multiple-dose pharmacokinetics and the most appropriate dosages for patients with renal insufficiency. [cdc.gov]
Neurologic
- Tingling
Assess injection site for pain, bruising, burning, or tingling. Data source: CDC, 2013, 2015; Perry et al., 2014 Checklist 59 outlines the steps to perform a Z-track IM injection. [opentextbc.ca]
Call your doctor or healthcare provider right away if you experience: severe pain at the injection site tingling or numbness redness, swelling, or warmth at the injection site drainage at the injection site prolonged bleeding signs of an allergic reaction [healthline.com]
- Dizziness
Nausea, vomiting, dry mouth, constipation, flushing, increased sweating, lightheadedness, swelling/pain/ itching at injection site, dizziness, or drowsiness may occur. [webmd.com]
SIDE EFFECTS: Dizziness, drowsiness, difficulty urinating, trouble sleeping, headache, anxiety, and pain at the injection site may occur. [medicinenet.com]
[…] after you inject epinephrine, tell your doctor if you are experiencing any of these side effects: skin redness, swelling, warmth, or tenderness at the site of injection difficulty breathing pounding, fast, or irregular heartbeat nausea vomiting sweating dizziness [medlineplus.gov]
Clinicians should: (1) make sure the person who is being vaccinated is always seated or lying down; (2) be aware of symptoms that precede fainting (e.g. weakness, dizziness, pallor); and (3) provide supportive care and take appropriate measures to prevent [cdc.gov]
- Stroke
The authors report a stroke that occurred within minutes following an intramuscular injection of diclofenac. [ncbi.nlm.nih.gov]
3 Month) 11.25 Mg IM Syringe And 5 (90) Tablets,Kit Conditions: breast cancer Diabetes excessive fat in the blood Porphyria overweight depression Migraine Headache Optic Disk Edema high blood pressure heart attack lung embolism chronic heart failure stroke [webmd.com]
Tactile Stimulation Rubbing or stroking the skin near the injection site prior to and during the injection process with moderate intensity may decrease pain in older children (4 years and older) and adults. [cdc.gov]
- Insomnia
However, incidence of CNS side effects (e.g., nervousness, anxiety, insomnia, difficulty concentrating, and lightheadedness) is higher among persons taking amantadine than among those taking rimantadine ( 320 ). [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]
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]