In this video I will identify intramuscular injection sites. This route is abbreviated IM.
Before administering any vaccine always start with proper hand hygiene. CDC has hand hygiene
guidelines and resources for health care personnel available online.
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An intramuscular injection deposits vaccine deep into the muscle tissue to allow for rapid
absorption. The deltoid and the vastus lateralis muscles are the recommended sites for
administering vaccines by IM injection. For children birth through 2 years of age the
recommended injection site is the vastus lateralis muscle because of the relatively large muscle mass
and the lack of major nerves and blood vessels. This muscle is located on the anterior or
outer aspect of the thigh. Sometimes children need more than one vaccine during the same
medical visit. The vastus lateralis muscle is preferred for administering multiple IM
injections to this age group. To correctly identify the muscle, expose the child's leg. The
entire thigh should be clearly visible. To find the injection site place one hand across the
top of the thigh and the other hand just above the knee. Give the IM injection in the area in
between. Here's another way to find the vastus lateralis muscle. When a toddler or young
child stands and their arm is relaxed and hanging down to their side their middle finger
dangles just over the vastus lateralis muscle. For persons 3 years of age and older the
deltoid muscle is the recommended site for IM injections.
This muscle is located in the upper arm and is shaped like an upside down triangle.
If more than 1 vaccine is needed the deltoid muscle can be used. To identify the site have the
patient seated with the upper arm completely exposed. Ask the patient to relax their arm.
Shirts with tight-fitting sleeves that cannot be rolled up above the shoulder should be removed.
Locate the acromion process or bony point in the shoulder. This marks the base of the upside
down triangle. The tip of the triangle is directly below the middle of the base at about the
level of the armpit. The correct area to give an IM injection is in the center of the triangle.
1 to 2 inches or about 3 fingers width below the acromion
process. Before administering any IM injection check for lumps, swelling, redness,
warmth, bruising, or wounds near the injection site. Sometimes a patient may have a tattoo
located on the injection site. Intramuscular injections may be given through a tattoo.
When more than 1 vaccine is administered, separate injection sites by at least 1 inch if
possible. Local reactions such as redness, swelling, or a sore injection site are associated with some
vaccines more than others. Administer these vaccines in separate limbs if possible.
CDC has injection safety resources for health care personnel available online at
www.cdc.gov/injectionsafety
This video is part of a series designed to demonstrate vaccine administration skills and best
practices. This series is available on the Vaccine Administration web page on the
CDC Vaccines and Immunizations website at www.cdc.gov/vaccines