Checklist
| Preparation | Wash – Name – Explain | |
| Check for allergies | ||
| Check prescription | ||
| Clean preparation surface | ||
| Gather equipment | Clean equipment tray | |
| Wash hands | ||
| Drug to be injected | ||
| Drawing up needle | ||
| 21-23G injection needle | ||
| Syringe | ||
| Skin cleaning wipe | ||
| Cotton wool ball | ||
| Plaster | ||
| Safe sharps disposal | ||
| Draw up drug | Put on gloves | |
| Open ampoule | ||
| Draw up drug | ||
| Remove and dispose of drawing up needle | ||
| Attach injection needle and expel air | ||
| Remove gloves and dispose of waste | ||
| Intramuscular injection | Wash hands and put on 2nd pair of gloves | |
| Select appropriate injection site | ||
| Clean skin and allow to air-dry | ||
| Traction skin | ||
| Insert needle | ||
| Aspirate to ensure no blood | ||
| Inject drug | ||
| Withdraw needle | ||
| Dispose of sharp safely | ||
| Remove traction | ||
| Apply cotton wool ball and pressure to injection site | ||
| Ensure haemostasis and apply plaster | ||
| Finishing | Dispose of all waste appropriately | |
| Wash hands | ||
| Sign prescription | ||
| Document injection in patient’s notes | ||
| Discuss aftercare |
Explanation
Preparation
Wash, name, explain:
- Wash your hands
- Introduce yourself by name and role
- Check the patient’s name and date of birth
- Explain the task and get consent
- Check whether the patient has any known allergies, e.g., to plasters, medication components
“Hello, I’m one of the doctors. I’ve been asked to give you an injection of medication which will be administered into a muscle in your upper arm. You will feel a sharp scratch, but it will be over very quickly. You can ask me to stop at any time. Would that be okay?”
Check the prescription, ensuring that the patient’s details match those of the patient on whom you intend to perform the procedure, and verify the presence of the prescriber’s signature. Take the prescription with you as a reference when gathering your equipment
Clean your preparation area, typically a clinical trolley, using an appropriate surface cleaning agent.
Gather Equipment
Clean an equipment tray and place it on your preparation surface. Wash your hands again after cleaning surfaces.
Gather the following equipment, placing it in your clean tray while ensuring that key parts remain protected:
- Drug to be injected – check this against the prescription and check the expiry date
- Drawing-up needle
- Injection needle – usually 21-23G needle
- Syringe – use the smallest syringe appropriate for the volume of liquid to be injected
- Skin cleaning wipe – usually alcohol based
- Cotton wool ball
- Plaster
- Safe sharps disposal e.g., sharps bin
Note that some intramuscular injections e.g., vaccines, vitamin B12 may come already drawn–up.
Draw Up Drug
Put on your first pair of gloves.
Open the ampoule containing the drug to be injected. Attach the drawing–up needle to the syringe, then draw up the drug. Retain the empty ampoule to record the batch number and expiry date in the patient’s notes later.
Dispose of the drawing–up needle safely and attach the injection needle to the syringe. All key parts are now protected. Expel any air bubbles in the syringe.
Remove the first pair of gloves and dispose of all waste appropriately.
Intramuscular Injection
Return to the patient, wash your hands, and confirm that they are still willing to proceed. Put on your second pair of gloves.
Identify the injection site. Common sites include the deltoid muscle in the upper arm or the gluteal muscle (the upper, outer quadrant is the safe area of the gluteal muscle). Ensure the site is visibly clean and is not inflamed or bruised.
Clean the skin for 30 seconds and then allow the site to air–dry for a further 30 seconds. Tether the surrounding skin and apply gentle traction with your non-dominant hand.
With your dominant hand, insert the needle into the injection site at a 90° angle to the skin. Draw back slightly on the syringe plunger to ensure no blood is aspirated. Blood in the syringe would indicate accidental vascular puncture and the injection would need to be abandoned and re–sited. Gently advance the plunger on the syringe to slowly inject the drug.
Withdraw the needle and release the traction on the surrounding skin. Cover the wound with a cotton wool swab and apply gentle pressure. You can ask the patient to apply pressure if they are able. Dispose of sharps immediately and safely.
Ensure pressure is applied until the site has stopped bleeding. This may take longer if the patient is taking anticoagulants. Once haemostasis has been established, cover the site with a plaster.
Finishing
Confirm that the patient is feeling well. Ensure that you sign the prescription to indicate that the injection has been given and document the injection site, batch number, and expiry date of the drug.
Inform the patient that there may be a small amount of redness and swelling at the injection site and it may be tender for 24-48 hours.
Dispose of all waste appropriately, clean your tray and trolley, and wash your hands.
Last updated April 2025
Head to members.zerotofinals.com for practice OSCE stations, including an interactive checklist, specific cases and clinical findings.
