Intramuscular injection CLIMAT pathway: a clinical practice guideline

Br J Nurs. 2018 Jul 12;27(13):752-756. doi: 10.12968/bjon.2018.27.13.752.


The intramuscular (IM) injection has been part of nursing practice since the 1960s. Over the past 60 years, the practice of aspiration during IM injection has been controversial and understudied. In 2016, a study by Thomas et al identified that blood aspiration does occur during injection. This article introduces a clinical practice guideline for safe and effective aspiration during IM injection, as a follow-up to the findings of that study. The proposed guideline acknowledges the correct practice of aspiration and identifies considerations that may make aspiration unnecessary. These practices and considerations are presented to the reader using a visual clinical pathway and a narrative clinical practice guideline.

Keywords: Aspiration; Guideline; Intramuscular aspiration; Intramuscular injection; Nursing practice; Pathway.

MeSH terms

  • Humans
  • Injections, Intramuscular / nursing
  • Injections, Intramuscular / standards*
  • Practice Guidelines as Topic*