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z track method is not a must do...but interesting.
The Z-track method of IM injection is used to administer a drug in a large muscle that prevents the leakage of the medication into the layers of subcutaneous tissues. It is named Z-track method because after this technique, a zigzag path is responsible for sealing the drug in the muscles.
Tissue irritation is minimized by the displacement of the skin during injection that seals the drug into the muscle tissue. A large and deep muscle is best used for this procedure. (Glutes, VG, etc.)
- Aspirate the prescribed medication into the syringe. Draw 0.2 cc of air to create an air lock. Air-lock Technique is used frequently in intramuscular sites. Injection of the needle is done at 90 degrees so that all of the air you aspirated should be the LAST to exit the syringe, creating an air lock inside the skin (*minimizes amount of "wasted" gear*).
- Place fingers on the skin surface and pull the overlying skin and subcutaneous tissue approximately 1 to 1 ½ inches laterally to the side.
- Holding the skin tight with the nondominant hand, insert the needle at a 90 degree angle at the spot where the finger was initially placed before displacing the skin laterally.
- Aspirate for blood return with the dominant hand only (DO NOT let go of holding skin tight once needle is in). If there is no blood return on aspiration, inject the drug slowly, followed by the air. Air clears the needle of the medication (*Again, minimize "waste" of gear*).
- Wait for 10 seconds before withdrawing the needle to allow the medication to disperse evenly.
- Slowly remove the needle.
- Release the skin. A zigzag needle track is created (by sliding of the tissue planes across each other) preventing the escape of medication from the muscle tissue.
- Do not massage the site (I never do. I feel it causes unnecessary damage and/or pip) because it can force out the injected medication to the subcutaneous layers.
****There are differing opinions on the air-lock technique, mostly because of myths and urban legends. This technique is standard procedure for IM injects in many hospitals worldwide. It would take more than 1cc of air directly into a vein to cause any serious harm. *****
(FOR EDUCATIONAL PURPOSES ONLY)
Info found on- nursingcrib, wiki, and my own thoughts