Intramuscular injection of vitamin B12
NMC OSCE practice station

The task

You are a nurse in a GP practice treatment room. Grace Adeyemi, aged 66, has vitamin B12 deficiency anaemia and her GP has prescribed hydroxocobalamin injections. She is here for the next injection today. The prescription and ampoule are in the patient folder. Check the prescription, prepare the injection and give it into a suitable muscle site, explaining each step to her. Say aloud and show what you do. Complete the record.

What this station tests

• Follow local policy on filter needles for glass ampoules, and change to a new needle before injecting.
• The ventrogluteal site is often preferred and the deltoid suits small volumes; avoid a sore or lumpy site and involve the patient in the choice.
• If you clean the skin, let it dry fully before injecting.
• Never recap needles; use the sharps bin straight away.
• Explain after-care and record the batch number, dose, route, site and time.

Sources for the clinical content

• NHS: Hydroxocobalamin
• NICE NG239: Vitamin B12 deficiency in over 16s
• WHO: Hand hygiene in health care
• NMC: The Code

An original practice scenario with invented patients. Not an exam question.

Practise next

• Subcutaneous injection to prevent blood clots
• Giving an inhaler through a spacer
• Collecting a urine sample from a urinary catheter
• Removing a urinary catheter after knee surgery
• Pre-operative checks before a hernia repair