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Intramuscular Injection in Deltoid Muscle with Z-Track Technique

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IM injection technique for the deltoid muscle site using the Z-track technique.

The deltoid muscle is one of the IM injection sites you can use to administer vaccines or other medications. In this video, I give you some tips on doing this.

First, you'll want to check to make sure you have the right patient, medication, dose, time, and the right route. Protocols for injections or medication administration do change based on research, so always verify the proper protocol for administering a particular medication or vaccine.

You'll want to gather your supplies and perform hand hygiene. I prefer to wear gloves when giving an injection, although the CDC does state that gloves are optional unless there is an open lesion on the hand or if contact with body fluids is likely.

You'll want to locate the deltoid muscle using the acromion process landmark. Move about two finger widths below this landmark. You'll also want to choose a needle length based on the patient's adipose tissue, and a proper needle gauge based on the medication you plan to administer.

Rather than pinching the skin, the Z-track technique is now the recommended method. Using one hand, pull the skin to the side. Insert the needle into the deltoid muscle at a 90 degree angle. Slowly depress the plunger at a rate of about 10 seconds per mL.

Carefully remove the needle, engage the safety, and dispose of it in the proper sharps container. You can use gauze to cover the injection site.

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