The Treatment

The Treatment

Dosage 

One injection every 2-3 days for a loading dose period over two weeks. Maintenance treatment every four weeks. For specific hair or skincare rejuvenation, please see earlier treatment advise.

 

Equipment Needed 

  • 2.5ml Syringe
  • 23g, 30mm blue needle
  • 21g, green drawing needle
  • 2ml Biotin 0.5%
  • Antiseptic skin wipes
  • Gauze or cotton wool
  • Gloves
  • Kidney dish
  • Glass ampoule opener

 

 

Intramuscular Injections

Intramuscular (IM) injections deposit medications into the muscle fascia, which has a rich blood supply, allowing medications to be absorbed faster through muscle fibres than they are through the subcutaneous route. The IM site is used for medications that require a quick absorption rate but also a reasonably prolonged action. Due to their rich blood supply, IM injection sites can absorb larger volumes of solution. In addition, muscle tissue is less sensitive than subcutaneous tissue to irritating solutions and concentrated and viscous medications.

 

Intramuscular injections must be done carefully to avoid complications. Complications with IM include muscle atrophy, injury to the bone, cellulitis, sterile abscesses, pain, and nerve. With IMs, there is an increased risk of injecting the medication directly into the patient’s bloodstream. In addition, any factors that impair blood flow to the local tissue will affect the rate and extent of drug absorption.

 

Sites for intramuscular injections include the ventrogluteal, vastus lateralis, and deltoid site. There is sufficient evidence that the ventrogluteal IM site is the preferred site whenever possible. The ventrogluteal site is free from blood vessels and nerves and has the greatest thickness of muscle when compared to other sites. A longer needle with a larger gauge is required to penetrate deep muscle tissue. The needle is inserted at a 90-degree angle perpendicular to the client’s body or at as close to a 90-degree angle as possible. Use a quick, darting motion when inserting the needle.

 

Aspiration refers to the action of pulling back on the plunger for 5 seconds prior to injecting medication. The current practice is to aspirate IM injections to checking for blood return in the syringe. Lack of blood in the syringe confirms that the needle is in the muscle and not in a blood vessel. If blood is aspirated, remove the needle, discard it appropriately, and re-prepare and administer the medications.

 

The dorsogluteal site

 

The dorsogluteal (buttock) site is not routinely used due to its location near major blood vessels and nerves, as well as having an inconsistent depth of adipose tissue. Many injections in this site do not penetrate deep enough under the skin to be correctly administered in the muscle.

 

Since the dorsogluteal site is in close proximity to the sciatic nerve, significant injury, pain, and temporary or permanent paralysis can occur if medication damages the sciatic nerve. Damage can occur if the injection site is not mapped correctly.

 

IM injection into the Gluteus medius site (buttock)

 

  • Find the trochanter. It is the knobbly top portion of the long bone in the upper leg (femur). It is the size of a golf ball.
  • Find the posterior iliac crest. Many people have ‘dimples’ over this bone.
  • Draw an imaginary line between the two bones
  • After locating the centre of the imaginary line, find a point one inch toward the head. This is where (X) to insert the needle.
  • Stretch the skin-tight
  • Hold the syringe like a pencil or dart. Insert the needle at a right angle to the skin
  • Up to 3ml of fluid can be given in this site.

 

 

The ventrogluteal site 

 

Giving an IM injection into the ventrogluteal site

 

The Ventrogluteal site provides the greatest thickness of gluteal muscle (consisting of both the gluteus medius and gluteus minimus), is free of penetrating nerves and blood vessels, and has a narrower layer of fat of consistent thinness than is present in the dorsogluteal.

 

 

Giving an IM injection into the ventrogluteal site

 

  • Find the trochanter. It is the knobbly top portion of the long bone in the upper leg (femur). It is about the size of a golf ball.
  • Find the anterior iliac crest
  • Place the palm of your hand over the trochanter. Point the first or index finger toward the anterior iliac crest. Spread the second or middle finger toward the back, making a ‘V’. The thumb should always be pointed toward the front of the leg. Always use the index finger and middle finger to make the ‘V.’
  • Give the injection between the knuckles on your index and middle fingers.
  • Stretch the skin-tight
  • Hold the syringe like a pencil or dart. Insert the needle at a right angle to the skin (90°)
  • Up to 3ml of fluid may be given in this site.

 

The deltoid site

 

The ease of access, especially in an outpatient setting, possibly adds to the frequency with which the deltoid site is used for IM injections. This site is used for immunisations/non-irritating medications; hence vaccines that are usually small in volume tend to be administered into the deltoid site. This is a relatively small area and muscle mass, especially in atrophied clients compounded by the close proximity of the radial nerve, brachial artery and bony processes to this site, means that more substantial injuries can occur.

 

  • Find the knobbly top of the arm (acromion process)
  • The top border of an inverted triangle is two finger widths down from the acromion process
  • Stretch the skin and then bunch up the muscle
  • Insert the needle at a right angle to the skin in the centre of the inverted triangle

 

Caution: This is a small site – give only 1-2ml or less of fluid in this site

  • Prepare everything, ensure you have your syringe, drawing needle, injection needles and vitamin vile ready, along with your sharps bin.
  • Open your syringe and drawing needle, keeping the packaging on where possible in order to not contaminate the needle.
  • We recommend using a 21g Gauge drawing.
  • Attach the drawing needle onto the syringe, leaving the protection cap on the needle.
  • Open your vitamin ampoule. Break the top off the ampoule from the dot and dispose of the top.
  • Take the top protection cap off the drawing needle and draw up from the ampoule the correct dose as recommended or suggested by your prescriber.
  • Dispose of the single-use ampule, do not use any further product from it.
  • Open the packing for your injection needle; we recommend the 23 Gauge needle.
  • Take your syringe and untwist the drawing needle with the cap off, and put it in your sharps bin.
  • Put your injection needle with packaging left on onto the syringe; once secured, remove the packaging and push up all the air out of the syringe until you hit your dosage marker on the syringe.
  • Clean the injection area using an alcohol wipe once you have located it.
  • Dart the needle into the muscle and push in relatively quickly.
  • Press and wipe the area with an alcohol wipe and dispose of your injection needle into the sharps bin.

  • Prepare everything, ensure you have your syringe, drawing needle, injection needles and vitamin vile ready, along with your sharps bin.
  • Open your syringe and drawing needle, keeping the packaging on where possible in order to not contaminate the needle.
  • We recommend using a 21g Gauge drawing.
  • Attach the drawing needle onto the syringe, leaving the protection cap on the needle.
  • Open your vitamin ampoule. Break the top off the ampoule from the dot and dispose of the top.
  • Take the top protection cap off the drawing needle and draw up from the ampoule the correct dose as recommended or suggested by your prescriber.
  • Dispose of the single-use ampule, do not use any further product from it.
  • Open the packing for your injection needle; we recommend the 23 Gauge needle.
  • Take your syringe and untwist the drawing needle with the cap off, and put it in your sharps bin.
  • Put your injection needle with packaging left on onto the syringe; once secured, remove the packaging and push up all the air out of the syringe until you hit your dosage marker on the syringe.
  • Clean the injection area using an alcohol wipe once you have located it.
  • Dart the needle into the muscle and push in relatively quickly.
  • Press and wipe the area with an alcohol wipe and dispose of your injection needle into the sharps bin.