is it necessary to give IM premedication in all patients routinely in this modern era with newer drugs?

Answer:
Yes. Some meds cannot be given IV because of their nature. Sometimes you want a slower absorption which you would get with a IM injection. Big reason: Sometimes you have NO IV access. You gotta get a drug into a patient. There is no oral form of the item, you have no IV access, and subQ just isn't an option. That's what I see IM for most of the time. It may be that they can't gain access, it may be for a simple procedure needing one or two quick shots. Setting up IV access for everyone in an ER or sameday procedure isn't necessary. I just had an IM shot a few months ago. With proper technique, it really doesn't hurt that much. Of course, I can be a real butt so the nurse had lot's to work with.

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Since you ask about premedication, I guess you're talking about medications given before a procedure. In emergency medicine, they're seldom used, so "necessary" isn't the case. "Useful" for pre-operative elective or scheduled procedures, though, is another matter. Oral drugs now take the place of some that were previously given IM, but people are normally kept NPO to limit the risk of aspiration, so they're out. The medications given IM today are the same medications given IM decades ago, and for the most part can be given IV, but they are in %26 out faster that way, and the IM choice remains the better.

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no- in fact, very few premedications used today are given IM.the most commonly used premed today is midazolam, or versed. it's most commonly administered IV, but can also be given orally or intranasally. IM would also work, but there's no obvious advantage to it. the only situation where IM shots would still be used is in adults who are completely uncooperative, and unwilling to drink an oral premed (ie: mentally retarded, or psychiatric disorders). uncooperative kids aren't that big of a deal- you can just gas 'em with a mask and inhalational sevoflurane.

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