FFinalistSouthampton · 2027
All procedures
GMC #17/Prescribing taught Y3

Prepare & administer injectable drugs (IM/SC/IV)

Prepare and administer injectable drugs and prefilled syringes.

Target · Perform under supervision0% ready

Do it on a patient with a supervisor observing you (GMC “direct supervision”).

Overview

Right drug, right route, right technique. The pre-administration checks and correct site/angle are the marked elements. IM injections use the Z-track technique to lock the drug in the muscle and stop it tracking back into subcutaneous tissue.

Key numbers

  • IM injection: insert at 75–90°, inject ~1 mL per 10 seconds; Z-track technique prevents drug tracking back into subcutaneous tissueRCN / clinical practice
  • Sites: deltoid ≤1 mL (vaccines) · ventrogluteal up to ~2.5–3 mL (larger volumes) · vastus lateralis (infants, EpiPen)RCN injection technique

Indications

  • Vaccines & many drugs (IM/SC)
  • IV medications (via cannula)

Equipment

Drug + diluent, syringe & needles (drawing-up + administration)ANTT items, sharps bin, drug chart

Step by step

Check & prepare
  1. 1Confirm the “five rights”: right patient, drug, dose, route, time (+ documentation & allergies)
  2. 2Check drug name, dose, expiry; draw up; expel air; label if not immediate
Administer — IM
  1. 1Choose the site: deltoid (small volumes/vaccines), vastus lateralis (infants; self-administered adrenaline), ventrogluteal (larger volumes, avoids nerves/vessels)
  2. 2Apply Z-track traction: pull the skin ~2–3 cm to one side with the non-dominant hand and hold it
  3. 3Insert like a dart at 75–90°, leaving ~⅓ of the shaft exposed; aspirate briefly to check not intravascular
  4. 4Inject slowly — ~1 mL per 10 seconds; wait ~10 s, withdraw, then release the traction (locks the drug in the muscle)
Administer — SC / IV
  1. 1SC: abdomen/outer thigh/upper arm; pinch the skin; insert at 45–90°
  2. 2IV: via a patent cannula using ANTT; flush before and after
  3. 3Dispose of the sharp immediately; document; monitor for reactions

Complications

  • Pain, bleeding, infection/abscess, nerve injury, inadvertent intravascular injection, anaphylaxis

OSCE tips

  • State the pre-administration checks (five rights + allergies) — heavily marked.
  • Correct site & angle per route; Z-track for IM.
  • Never re-sheath; sharps straight to the bin.

Watch

Read

Intramuscular injection — OSCE GuideGeeky Medics

Sources & credits

Authored to UK finals standard and verified against UK guidance (RCN · RCN injection technique) and Geeky Medics OSCE guides . Southampton teaching materials © University of Southampton. Always follow current local policy.