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Nursing Procedures and Skills




The z-track injection is a type of intramuscular injection technique. This injection technique is used to prevent leakage or tracking of the injected medication into the subcutaneous tissue. The purpose of the z-track injection technique is to prevent the medication from leaking into the subcutaneous tissue and guarantee that the full dosage is administered. Z-track is used mostly when giving medications that can stain or cause discolouration to the subcutaneous tissue or skin. It is also used in situations where the medication causes irritation to the skin.


1. Verify the drug order on the patient’s chart.

2. Wash your hands.

3. Reconstitute the drug as needed. Check the drug’s colour, clarity, and expiration date.

3. Draw the correct amount of drug into the syringe using aseptic technique.

4. After drawing up the dose, replace the original needle with a sterile needle of the appropriate length for the patient’s size.

5. Put on gloves.

6. Confirm the patient’s identity using two identifiers.

7. Select an injection site: the ventrogluteal or deltoid site in adults, the vastus lateralis site in infants and toddlers, and the vastus lateralis or deltoid site in children.

8. Position the patient so that the muscle at the injection site relaxes.

9. Clean the site with an alcohol pad and let it thoroughly dry.

10. Use your non-dominant hand to pull the skin downward or laterally to displace the tissue about 1 inch (2.54 cm) (see Figure 1).

11. With the needle at a 90-degree angle to the site, pierce the skin using a smooth, steady motion (see Figure 2).

12. Aspirate for 5 to 10 seconds to ensure that you haven’t hit a blood vessel inject the medication slowly.

13. Withdraw the needle with a smooth, steady motion and release the skin to its original position. Use dry gauze to apply very gentle pressure to the puncture site (see Figure 3).

14. Never massage a Z-track injection site. This may cause irritation or force the drug into subcutaneous tissue.

15. Assess the site immediately after administering the injection and again 2 to 4 hours later.

16. Properly dispose of all used equipment, supplies and document.


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