SACRED HEART COLLEGE
College of Nursing
Lucena City
ADMINISTERING Z-TRACK INTRAMUSCULAR INJECTION
Z-TRACK METHOD
- is a type of IM injection technique used to prevent tracking (leakage) of the
medication into the subcutaneous tissue (underneath the skin).
- is a type of IM injection technique used to prevent tracking (leakage) of the
medication into the subcutaneous tissue (underneath the skin.
PURPOSE OF Z-TRACK INJECTION:
- Useful with medication that must be absorbed by muscle to work.
- It also helps to prevent medication from seeping into the subcutaneous tissue
and ensures a full dosage
Z-TRACK INJECTION SITES
1. Thigh (vastus lateralis muscle): Divide the upper thigh in thirds. Use the middle third, on
the outside or middle of the muscle for the injection.
2. Hip (ventrogluteal): Place the heel of your hand on the head of the greater trochanter (hip
bone) with your thumb pointing toward the abdomen. Extend your index finger up to the
anterior superior iliac spine then spread your other fingers back along the iliac crest.
Insert the needle in the “V” formed between your index and third fingers.
Special Considerations:
1. Ensure the patient’s position for injection is not contraindicated by a medical condition
like surgery or injury.
2. Always wear gloves to administer injections.
3. Aspirate for blood prior to administering an IM medication.
4. Upon injection, if a patient complains of radiating pain, burning, or a tingling sensation,
remove the needle and discard.
5. Take all necessary steps to avoid interruptions and distractions when preparing and
administering medications.
6. NEVER recap needles after giving an injection. Apply the safety shield and dispose in
the closest sharps container.
Complications of Poorly Administered IM Injections:
Pain
Bleeding
Abcess formation
Cellulitis
Muscle fibrosis
Injuries to nerves and blood vessels
Sites for Intramascular Injection
Procedure
1. Explain the procedure and gain consent.
2. Screen the patient to ensure privacy during the procedure.
3. Before drug administration, check whether the patient has any allergies.
4. Check the prescription is correct, following the ‘five rights’ of drug administration
and local medicines administration policy to reduce the risk of error.
5. Wash and dry hands to reduce the risk of infection.
6. Assemble the syringe and needle, and withdraw the required amount of drug from the
ampoule. Some medicines are available in pre-filled syringes and manufacturer’s
instructions should be followed.
7. Disperse air bubbles from the syringe.
8. Change the needle. Doing so will ensure that the needle used for the injection is
sharp, thereby reducing pain. A safety-engineered needle should be used as this
reduces the risk of sharps injury.
9. Dispose of the used needle in a sharps container according to local policy.
10. Place the filled syringe in a tray and take it to the patient, along with a sharps bin so
the used sharps can be disposed of immediately after the procedure.
11. Check the patient’s identity, according to local medicines management policy.
12. Position the patient comfortably with the injection site exposed. The site is influenced
by the assessment of the patient, the drug and the volume to be injected.
13. Check the site for signs of oedema, infection or skin lesions. If any of these are
present, select a different site.
14. Wash and dry hands.
15. If gloves are considered necessary, following the risk assessment, these should be
applied.
16. Ensure the skin is clean and follow local policy on skin cleansing.
17. If skin cleansing is considered necessary, swab for 30 seconds with isopropyl alcohol
and allow to dry for 30 seconds.
18. Inform the patient you are going to carry out the procedure. Use distraction and
relaxation techniques to reduce pain if needed.
19. Hold the syringe and needle in your dominant hand and gently stretch the skin around
the injection site using the non-dominant hand. This displaces the subcutaneous tissue
and aids needle entry.
20. A Z-track technique can be used to prevent backtracking and leakage from the
injection site.
21. Insert the needle at a 90-degree angle using a dart-like action. This
prevents accidental depression of the plunger during insertion of the needle.
22. Aspiration to check whether the needle is in a blood vessel.
23. Depress the plunger slowly at a rate of 1ml/10 seconds; this aids absorption of the
drug and reduces pain.
24. Wait for 10 seconds to allow the drug to diffuse into the tissue and then quickly
withdraw the needle.
25. Dispose of the sharps directly into the sharps bin and the syringe according to local
policy.
26. Ensure the patient is comfortable and wash your hands.
27. Record administration on the prescription chart, as well as the administration site as
repeated injections into the same site can lead to induration and abscesses.
28. Monitor the patient for any effects of the prescribed medicine and any problems with
the injection site.
Five Rights of Medicine Administration
1. Right Patient
2. Right drug
3. Right time
4. Right dose
5. Right route
