What Is Z Track Method for Injection? (2023)

The Z track method is a technique for intramuscular injections (IM) that helps to keep the medication in the muscle. Learn more about the purpose of the test as well as what to expect before, during, and after the procedure.

What Is Z Track Method for Injection? (1)

Giving an Intramuscular Injection

Purpose of Test

The idea behind the Z track method of IM injections is to put medications into the muscle tissue and not allow them to leak (track) back into the subcutaneous tissue layer over the muscle.

Medication absorption in the muscle is different than in the subcutaneous tissue, so it is important that medications designed to be absorbed through the muscle stay in the muscle.

The the Z Track method is only used is for intramuscular injections, and not other types of injections.The type and amount of medication given will help determine the length and gauge of the needle as well as the proper location of the injection.

Patients who are learning to give injections for home-based treatment should ask their healthcare provider to explain the best method for their specific medication and situation.

How the Z Track Method Works

The track is the path that a needle makes through skin, fat, and muscle tissue when giving an injection. Any kind of injection creates a track from the needle site. When the needle is removed, a small amount of medication or blood—can sometimes wick up through the track and leak out of the body. That leaking is also called tracking.

The Z track method helps to prevent leaking after an IM injection by altering the track created by the needle. When done properly, there are two curves in the track that gives it the "Z" shape. You can't see the track because it's under the skin, but you may know that it was effective if no medication leaks out after the injection.

In addition to helping to prevent leaking, there is some question over whether using the Z track method reduces pain when giving an intramuscular injection.

Risks and Contraindications

There are no known risks or contraindications for using the Z track method for intramuscular injections, however it is important to note that this can be performed only for intramuscular injections. The Z track method will not be appropriate for any types of medications that are given via subcutaneous injection or intravascularly. Your healthcare provider will advise you on which medications can be used with this method.

Before the Injection

For patients, caregivers, or family members who are administering medications at home, be sure to ask a healthcare provider to instruct on the proper technique for administering an intramuscular injection. You should feel confident administering the injection prior to performing it.

Equipment

Proper equipment for performing an intramuscular injection includes:

(Video) Intramuscular Injection in Deltoid Muscle with Z-Track Technique

  • Proper size syringe and hypodermic needle
  • Clean exam gloves
  • Alcohol swab
  • Adhesive bandage

The size of the syringe is based on the amount of medication given as measured in milliliters (ml) or cubic centimeters (cc). A milliliter is the same as a cubic centimeter and volume can be expressed using either measurement. The smallest syringe available for the volume of liquid administered is best for proper control and dosing. For example, to administer .5 ml of medication, it is best to use a 1 ml syringe. To administer 2 ml of liquid, it is usually best to use a 3 cc syringe.

Using the appropriate size syringe can help minimize the risk of medication errors. Using a 10 ml syringe for an injection of less than 3 ml of medication could result in accidentally drawing up too much or too little medication.

For example, a 22 gauge needle is smaller than an 18 gauge needle. Thicker and more viscous medications require a larger gauge needle.

The length of a needle is expressed in centimeters (cm) or inches. Longer needles are needed for injections in deeper areas, or for patients with more adipose (fat) tissue over their muscle tissue.

Preparing for the Injection

Once all of the equipment is gathered, the caregiver should wash his or her hands thoroughly for at least 60 seconds. Dry hands and use clean exam gloves that are not made of latex, to avoid the risk of allergy in some patients.

Timing

It shouldn't take more than a minute or two to perform an injection. Using the Z track method does not add any appreciable time to the process of an intramuscular injection.

Injection Sites

The patient's healthcare provider or caregiver should determine the properinjection sitebased on the volume and type of medication being administered, the patient's age, the patient's size, and past medical or surgical history. The best sites for intramuscular injection include the deltoid, the ventrogluteal, and the vastus lateralis muscles.

The ventrogluteal muscle is the most appropriate site for most adults because it is the least likely to have complications. There are fewer limitations in the volume of the IM medication administered at this site. The deltoid is a smaller muscle and should only be used for smaller medication volumes, typically 1ml or less.

Prepare the Medication

Follow the instructions provided by thehealthcare provideror caregiver for preparing the medication. Some medications are provided ready for injection directly out of the vial. Other medications require mixing of either two or more liquids, or by reconstituting a dry powder into a liquid solution. If preparing the medication, make sure to double check medications and dosages to follow the instructions exactly.

Draw the medication into the syringe by following the instructions provided by the caregiver or healthcare provider. Make sure there is no air in the syringe that can be injected into the patient. Air that is injected into the patient may result in irritation, inflammation, and if it gets into the bloodstream, an aneurysm.

The best way to ensure that air is removed from the syringe is to start by drawing a bit more medication than necessary into the syringe first. It's okay if a small amount of air is in the syringe at this point. Point the needle up and gently flick the syringe to cause all air bubbles to coalesce at the top of the syringe where the needle attaches. Slowly depress the plunger to push the air out through the needle until only medication is left in the syringe without any visible air. Continue to push until only the correct amount of medication remains in the syringe and a drop of medication is visible at the tip of the syringe.

(Video) Subcutaneous Injections: Z-Track Method ~ivyVILOs~(Ivy Tech Community College, School of Nursing)

Prepare the Injection Site

Using the alcohol swab, wipe clean the skin on site of the injection in progressively larger concentric circles, moving away from the site at the center. If additional cleaning is necessary, perform that first and make the alcohol swab the final preparation. If needed, an iodine solution may be used to help clean the site prior to using the alcohol swab. Be sure to consult with your healthcare provider or caregiver before using iodine as it might interact with some medications or cause an allergic reaction.

During the Injection

To perform the injection using the Z track method, follow these steps:

  1. Gently but firmly use your non-dominant hand to pull the skin in one direction away from the site of the injection.
  2. With the exact amount of prepared medication already drawn into a syringe, insert the needle into the injection site at a 90-degree angle to the skin, while continuing to hold the skin with your other hand. Your healthcare provider will tell you how deep to insert the needle.
  3. Slowly and gently depress the plunger of the syringe to inject the medication into the patient's muscle. Make sure you do not push needle in further while you are pushing the plunger. Continue to hold the skin with your other hand.
  4. Once the syringe is empty, remove the needle by pulling the entire syringe straight out of the muscle in the same angle that it was inserted.
  5. Now release the skin to allow it to return to its original position. Performing an IM injection with this method can allow the pulled skin and soft tissue to cover the track once it is released and can prevent leaking.

Throughout the Procedure

It is important for the patient not to move during the injection. Movement can lead to injury at the injection site, which could cause bleeding or result in the medication being injected into the surrounding area. If enters the bloodstream, it could cause abnormally rapid absorption of the medication.

Some providers will pull back on the plunger after the needle is inserted and before the medication is given. This is to ensure that the medication was not being injected directly into a vein. However, this is not tyically needed for intramuscular injections and in some cases can increase the chance of irritation or damage to the surrounding tissues.

Post-Procedure

Do not rub the site after the injection. That can force medication to leak out of the injection site.

After the Injection

Once you have completed an intramuscular injection using the Z track method, cover the site of the injection with an adhesive bandage. Keep any injection site clean and covered. Look for signs of irritation or infection such as swelling, an injection site that is hot to the touch, and redness. If any signs of irritation are noted, be sure to contact your healthcare provider for guidance.

A Word From Verywell

This guide is intended to be a reference and to support the instruction you received from yourhealthcare provider. It is not intended to replace any instruction you may have received. The Z track method is a useful technique for administering intramuscular injections with as little leaking as possible, but the safety and success of an injection relies on adherence to general protocols surrounding the injection. Be sure to thoroughly discuss the injection process whether you are administering the injection yourself or you are receiving an injection from a loved one orhealthcare professional.

What Is Cellulitis?

3 Sources

(Video) Administering an IM injection using the Z track method

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Kara D, Yapucu güneş Ü. The effect on pain of three different methods of intramuscular injection: A randomized controlled trial. Int J Nurs Pract. 2016;22(2):152-9. doi:10.1111/ijn.12358

  2. Gordy S, Rowell S. Vascular air embolism. Int J Crit Illn Inj Sci. 2013;3(1):73-6. doi:10.4103/2229-5151.109428

  3. Sepah Y, Samad L, Altaf A, Halim MS, Rajagopalan N, Javed khan A. Aspiration in injections: should we continue or abandon the practice?. F1000Res. 2014;3:157. doi:10.12688/f1000research.1113.3

Additional Reading

What Is Z Track Method for Injection? (2)

By Rod Brouhard, EMT-P
Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.

(Video) Z track IM injection skills training

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FAQs

What does the Z track method do? ›

THE Z-TRACK METHOD of I.M. injection prevents leakage of irritating and discoloring medications (such as iron dextran) into the subcutaneous tissue. It also may be used in elderly patients who have decreased muscle mass. Lateral displacement of the skin during the injection helps seal the drug in the muscle.

Why is Z track technique used in administering injections? ›

To prevent leakage, an injection should be performed with the Z-track insertion technique with a thin needle in the cutaneous tissues.

When is the Z track method recommended in parenteral medication administration? ›

Medication absorption in the muscle is different than in the subcutaneous tissue, so it is important that medications designed to be absorbed through the muscle stay in the muscle. The the Z Track method is only used is for intramuscular injections, and not other types of injections.

What is the aim of Z tracking when injecting a medicine intramuscularly? ›

Z- tracking: A technique used to prevent medication leakage, particularly for oily injections. Displace the skin and subcutaneous tissue by pulling the skin laterally or downward from the injection site. Holding it taut, quickly and smoothly insert the needle into the muscle at a 90-degree angle.

How is the Z-track injection given? ›

Holding it taut, quickly and smoothly insert the needle into the muscle at a 90-degree angle. Continue to hold the skin taut with your nondominant hand. With your dominant hand, aspirate for 5 to 10 seconds. If no blood returns with aspiration, slowly inject the medication (10 seconds/ml).

What is the purpose of using the Z-track method of intramuscular injection quizlet? ›

Intramuscular. The Z-track technique is used for intramuscular injections to prevent leakage of medication into the needle track, thus minimizing discomfort.

What is the Z-track method nursing? ›

The 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). During the procedure, skin and tissue are pulled and held firmly while a long needle is inserted into the muscle.

When administering an IM injection using the Z-track method which action is appropriate? ›

Using the Z-track technique, the skin is pulled laterally, away from the injection site, before the injection; then the medication is injected, the needle is withdrawn, and the skin is released. This method can be used if the overlying tissue can be displaced (Lynn, 2011).

Can you Z-track a subcutaneous injection? ›

Subcutaneous Injections: Z-Track Method ~ivyVILOs~(Ivy ... - YouTube

What are the types of injection? ›

What are the different types of injections?
  • Intravenous (IV) injections. An IV injection is the fastest way to inject a medication and involves using a syringe to inject a medication directly into a vein. ...
  • Intramuscular (IM) injections. ...
  • Subcutaneous (SC) injections. ...
  • Intradermal (ID) injections.
2 Nov 2021

What are the 5 injection sites? ›

IM injections are administered in five potential sites: deltoid (commonly used for adult vaccinations), dorsogluteal, ventrogluteal, rectus femoris, and vastus lateralis3,10,11 (Figure 1).

When do you not use Z-track? ›

The rectus femoris and vastus lateralis remain the recommended sites for volumes up to 5 ml in adults. A maximum of 2 ml is recommended for older adults and thin patients. . The Z-track method should not be used with infant vaccinations where skin is compressed.

What is the best method for locating the site of injection for an intramuscular injection? ›

To locate this site, feel for the bone (acromion process) that's located at the top of your upper arm. The correct area to give the injection is two finger widths below the acromion process. At the bottom of the two fingers will be an upside-down triangle. Give the injection in the center of the triangle.

For which circumstance would the nurse use the Z-track technique to administer a medication? ›

Z-track Method for IM injections

Evidence-based practice supports using the Z-track method for administration of intramuscular injections. This method prevents the medication from leaking into the subcutaneous tissue, allows the medication to stay in the muscles, and can minimize irritation.

How do you give an injection? ›

How to Give Yourself an Intramuscular Injection - YouTube

How do you give an injection in the arm? ›

Identify the thickest part of the deltoid muscle by having the person raise their arm to define the muscle. Once defined, have patient relax arm and proceed. Insert needle at a 90o angle to the skin with a quick thrust. Retain pressure on skin around injection site with thumb and index finger while needle is inserted.

Should we rub after IM injection? ›

Following a Perseris injection, patients should be advised that they will have a lump at the injection site which will decrease and disappear over time. They should not rub or massage the injection site or allow belts or waistbands to tightly constrict the area (Karas, Burdge, & Rey, 2019).

What is the Z-track method quizlet? ›

The Z-track method of intra-muscular (I.M.) injection is used primarily when giving dark-colored medication solutions, such as iron solutions, that can stain the subcutaneous tissue or skin. It is also the method of choice when giving I.M.

Which of the following is the An advantage of the Z-track injection? ›

It's pretty simple: The Z-track is a better injection technique. It's been shown to reduce leakage of medication through subcutaneous tissue and decrease skin lesions at the injection site. Plus, it doesn't hurt patients quite as much as a regular I.M. injection.

Which parenteral route of administration uses the Z-track method quizlet? ›

Which parenteral route of administration uses the Z-track method? The Z-track method is recommended during intramuscular injection to minimize local skin irritation by sealing the medication in muscle tissue.

How do you give an IV injection? ›

How it works
  1. Inject a needle into the person's vein.
  2. Push a small plastic catheter over the needle and into the vein.
  3. Remove the needle, leaving the catheter in place.
  4. Place an access cap over the catheter, which allows them to administer medications without having to re-inject a needle.
23 Aug 2021

Why do you get a lump after an injection? ›

A bump means you may have injected the insulin just under the skin instead of into fat tissue. The needle may not have gone deep enough, or you may have been pulling the needle out before the plunger reached the bottom of the syringe. Or you may be using the same injection site repeatedly.

What size needle do you use for intramuscular injection? ›

Intramuscular injections are administered at a 90-degree angle to the skin, preferably into the anterolateral aspect of the thigh or the deltoid muscle of the upper arm, depending on the age of the patient (Table 6-2). The needle gauge for intramuscular injection is 22-25 gauge.

Which is the most appropriate site to administer an intramuscular injection to an infant? ›

The anterolateral thigh is the preferred site for IM injection in infants under 12 months of age. Medications are injected into the bulkiest part of the vastus lateralis thigh muscle, which is the junction of the upper and middle thirds of this muscle.

What is the appropriate administration rate for parenteral injections? ›

Research has found that administrating medications at 10 seconds per ml is an effective rate for IM injections. Increasing the rate to 20 seconds per ml did not show any reduction in pain. Always review drug administration rate as per pharmacy or manufacturer's recommendations.

How do you inject an IM injection? ›

Your thumb should point to the person's groin and your fingers point to the person's head. Pull your first (index) finger away from the other fingers, forming a V. You may feel the edge of a bone at the tips of your first finger. Put the injection in the middle of the V between your first and middle finger.

What is injection degree? ›

Angles of Insertion of Injections. Simple drawing of cross section of skin with three needles administering injections at different angles. Intramuscular at 90 degrees (left), subcutaneous at 45 degrees (center), and intradermal at 15 degrees (right).

Do you aspirate im injections? ›

Aspiration is most commonly performed during an intramuscular (IM) or subcutaneous (SC) injection, and is meant to ensure that the needle tip is located at the desired site, and has not accidentally punctured a blood vessel.

What are the 7 steps of medication administration? ›

7 Rights Of Medication Administration
  • Medication administration. ...
  • Right Individual. ...
  • Right Medication. ...
  • Right Dose. ...
  • Right Time. ...
  • Right Route. ...
  • Right Documentation. ...
  • Right Response.
11 Oct 2021

What are the 3 routes used for parenteral medications? ›

The common parenteral routes are intramuscular (IM), subcutaneous (SC) and intravenous (IV). Box 1 outlines the advantages and disadvantages of parenteral routes.

What are the 7 routes of drug administration? ›

Techniques involved in each route of medication administration are different, and some of the important points are summarized as follows:
  • Intravenous Route. ...
  • Intramuscular Route. ...
  • Subcutaneous Route. ...
  • Rectal Route. ...
  • Vaginal Route. ...
  • Inhaled Route.
17 Feb 2022

What are the 4 injection sites? ›

Summary. There are four sites on your body that can be used to give yourself an intramuscular injection. These include the upper arm, thigh, hip, and buttocks.

What is used for injection? ›

Most injections consist of a needle and syringe. A doctor may also use a newer device, such as auto and jet injectors.

What are the three types of injections? ›

The three main routes are intradermal (ID) injection, subcutaneous (SC) injection and intramuscular (IM) injection. Each type targets a different skin layer: Subcutaneous injections are administered in the fat layer, underneath the skin. Intramuscular injections are delivered into the muscle.

Can you give 4 ml im injection? ›

For “deep” IM injections, the recommended volume ranges from 2 to 5 ml. If the patient's available muscle tissue is limited and the dorsogluteal muscle must be used, volumes of up to 4 ml can be administered into this site. The ventrogluteal muscle can accommodate up to 2.5 ml, with a maximum volume of 3 ml.

Why injections are given on buttocks? ›

That's because the gluteal muscle is a large muscle with a large amount of muscle mass, and it is also a safe place because there are few nerves and large blood vessels passing through. Therefore, doctors and nurses often choose butt injection for drugs that are indicated for intramuscular injection.

Who invented injection? ›

Scottish doctor Alexander Wood is credited with inventing the modern hypodermic syringe in 1853. His goal was to treat pain in just one area of the body. He attached a hollow needle, an earlier invention by Irish doctor Francis Rynd, to a plunger.

What is the Z-track method quizlet? ›

The Z-track method of intra-muscular (I.M.) injection is used primarily when giving dark-colored medication solutions, such as iron solutions, that can stain the subcutaneous tissue or skin. It is also the method of choice when giving I.M.

When do you not use the Z-track method? ›

A maximum of 2 ml is recommended for older adults and thin patients. . The Z-track method should not be used with infant vaccinations where skin is compressed.

Do you pinch the skin when giving an IM injection? ›

Needle insertion

Insert needle at an 45o angle to the skin. Pinch up on SQ tissue to prevent injecting into muscle. Aspiration before injection is not required. Multiple injections given in the same extremity should be separated as far as possible (preferably at least 1” apart).

What are the advantages of injectable method over oral method? ›

Drugs that are poorly absorbed, inactive or ineffective if given orally can be given by this route. The intravenous route provides immediate onset of action. The intramuscular and subcutaneous routes can be used to achieve slow or delayed onset of action.

Which of the following is the An advantage of the Z-track injection? ›

It's pretty simple: The Z-track is a better injection technique. It's been shown to reduce leakage of medication through subcutaneous tissue and decrease skin lesions at the injection site. Plus, it doesn't hurt patients quite as much as a regular I.M. injection.

Which parenteral route of administration uses the Z-track method quizlet? ›

Which parenteral route of administration uses the Z-track method? The Z-track method is recommended during intramuscular injection to minimize local skin irritation by sealing the medication in muscle tissue.

When administering an im injection using the Z-track method which action is appropriate? ›

Using the Z-track technique, the skin is pulled laterally, away from the injection site, before the injection; then the medication is injected, the needle is withdrawn, and the skin is released. This method can be used if the overlying tissue can be displaced (Lynn, 2011).

Is the Z-track method recommended? ›

The Z-track method is not often recommended, but can be particularly 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.

For which circumstance would the nurse use the Z-track technique to administer a medication? ›

Z-track Method for IM injections

Evidence-based practice supports using the Z-track method for administration of intramuscular injections. This method prevents the medication from leaking into the subcutaneous tissue, allows the medication to stay in the muscles, and can minimize irritation.

Can you Z-track a subcutaneous injection? ›

Subcutaneous Injections: Z-Track Method ~ivyVILOs~(Ivy ... - YouTube

What are the 5 injection sites? ›

IM injections are administered in five potential sites: deltoid (commonly used for adult vaccinations), dorsogluteal, ventrogluteal, rectus femoris, and vastus lateralis3,10,11 (Figure 1).

What angle is an IM injection? ›

Use a needle long enough to reach deep into the muscle. Insert needle at a 90° angle to the skin with a quick thrust. Multiple injections given in the same extremity should be separated by a minimum of 1", if possible.

What Colour needle is used for IM injections? ›

21 (green) and 23 (blue) gauge needles are most commonly used. The needle should be held at a 90° angle to the skin (see diagram) and gently aspirated preinjection to ensure that the needle has not entered a blood vessel.

Why IV injection is given slowly? ›

Medications administered by direct IV route are given very slowly over AT LEAST 1 minute (Perry et al., 2014). Administering a medication intravenously eliminates the process of drug absorption and breakdown by directly depositing it into the blood.

Which injectable route is the most rapid acting? ›

Intravenous (IV)

It is the fastest and most certain and controlled way. It bypasses absorption barriers and first-pass metabolism. It is used when a rapid effect is required, continuous administraction and large volumes.

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