ZTrack Injection Technique

The Z-Track inject technique is used to prevent medication from leaking back in the subcutaneous tissue after the medication has been injected into the patient. This technique is used whenever the medication—such as dextran (iron)—might cause a visible and permanent skin discoloration. The gluteal muscle is the preferred site for a Z-Track injection.

Here's how to administer medication using the Z-Track technique:

• Check the prescriber's medication order.

• Wash hands and then put on clean gloves.

Table 6-1. Injection sites.

Injection Site



• Relatively free of major nerves and vascular branches.

• Well-defined bony anatomic landmarks.

• Locate the site by placing the heel of your hand on the greater trochanter of the femur with the thumb pointed toward the umbilicus. The index finger marks the anterosuperior iliac spine.

The middle finger traces the iliac crest curvature. The space between the index and middle fingers is the injection site.


• Good site for IM and Z-track injections.

• Danger to major nerves and vascular structures near site.

• Easy to give subcutaneously by mistake when trying to give an IM because the fat is often very thick.


• Preferred site for vaccines.

• Easily accessible.

• Muscle mass is small compared to other sites.

• Locate the acromion process of the scapula and the deltoid. Measure 2 to 3 fingers below the acromion process on the lateral midline of the arm to identify the proper site. Inject at a 90-degree angle.

Vastus lateralis

• Preferred site for infants younger than 7 months.

• It has a relatively large muscle mass.

• Free from major nerves and vascular branches.

• Site is a hand's breadth below the greater trochanter and above the knee.

• Inject at a 45-degree angle toward the knee.

• Properly identify the patient.

• Cleanse the area of the site in a circular motion using alcohol or betadine as per the agency guidelines.

• Insert the needle at a 90-degree angle.

• Inject the medication as you hold the skin to one side.

• Withdraw the needle.

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