Toradol IM Injection.

[nursesearl]

I have always given Toradol in a large muscle because I was told many years ago that it needed to go there. I have recently tried to look this up and can not find any info. We had a patient in our Urgent Care that returned with a lump on his arm, where a Toradol injection was given. Any information on this, or is this just something that is understood?

What I'm asking: is it OK to inject Toradol in the deltoid? I was always told gluteal muscle.

[LDRNMOMMY, BSN, RN]

When I went through nursing school, we were taught if the amount is anything more than 1ML, it should not be given in the deltoid. As pp said, if you are giving 30mg, it would be appropriate to give in the deltoid.

[TeleMeMore]

I've received a Toradol 30mg IM injection in the deltoid. I'm 5'2, 100lbs, a skinny lil thing; it did not hurt. My arm was barely even sore.

I've given it in the deltoid before with no complaints from those pt's - dosage is usually 15-30mg. Never gave 60.

[canoehead, BSN, RN]

People complain it burns, so I give it in a large muscle, no matter the dose. It seems to help, but who knows?

[SkiingCait, BSN, RN]

As the others said, if I am giving 60mg, I always give it in the gluteal b/c it is 30mg/mL. The 1 or 2 times I gave 30mg IM, I gave it in the deltoid, and the pt didn't react.

[allstudentnurses, ASN, RN]

I will typically give Toradol 30mg/1cc in the gluteal area, but I also give in the deltoid, but 60mg/2cc is too much fluid for the deltoid and may cause muscle damage.

When you are giving a deltoid injection, you are putting fluid in the middle of the muscle, therefore, separating the power and causing it to tear; if you put too much liquid in the deltoid, it will cause irreversible damage and will cause excessive pain, which is why it's recommended that no more than 1.5 cc's be pushed into the deltoid, anything more than 1.5 cc's must go into a large muscle, likes the glutes.

[murphyle, BSN, RN]

I've done Toradol (30 mg/mL) in the deltoid on my larger patients (I.e., the ex-football player type with arms the size of most people's thighs) and never had a problem. More minor patients get it in the ventrogluteal, and I warn patients that it will burn anywhere I put it. Amusingly, that advice usually makes them request a deltoid injection - they figure they'd rather have a sore arm than a bitter rear end, and it saves all the questions about why they're now walking funny.

[mybrowneyedgirl, BSN, RN]

Our rule is that all doses greater than 1 mL need to go into a more significant muscle, so no deltoid.

[JennyAS, BSN, RN]

When we give Toradol IM, we offer a dose of 60 mg/2 mL. I agree that 2mL of fluid is too much to inject into a small muscle mass like the deltoid. I usually only use the deltoid for Tetorifice IM (0.5mL) and anything less than 1mL.

[valeriad13]

I work in the ER and give Toradol as an IM injection many times throughout a 12-hour shift that I cannot keep track of. I give almost every single injection of mine in the deltoid. Regardless of where you give it, the medication burns; however, I tell all my patients that it will burn for about 2 minutes and dissipate if they rub their muscles to promote absorption. Doesn't burn nearly as severely as Rocephin IM. There is nothing that I find in the literature stating to use a large force. I only give it in the gluteus or Vastus when the person is skinny and has a tiny deltoid. I was in nursing and a physician assistant school and was drilled that you can use up to 3 ML concentration doses for deltoid, up to 5 in the glut. (of course not if they are small, frail people with little muscles). But I have never had a problem giving Toradol for years as a deltoid injection as long as their power is large enough.

[Murse901, MSN, RN]

2mL is an appropriate dosage for IM injection into a well-developed adult deltoid.

[oldnurse28]

I learned that less than 2 ml in LVN school is the maximum in a deltoid, and I tend to go with the idea 1.5 ml is the max I want to push into that muscle.

My doc tells them they are getting it in their hip, but I always go for the deltoid. Better chance of accuracy, and I rarely get a complaint. People tend to think that anything in their tush will hurt so much more, so it's more of a mental thing. Once I say oh no, it's the AMOUNT that matters more than the med not ENTIRELY accurate, but we don't need to freak patients out about thick meds that hurt like a $!#÷% unnecessarily, they tend to relax and are not so frightened.

[Archana Shrestha, BSN, RN]

Ketorolac tromethamine (Toradol injection) relieves moderate-to-severe pain in adults, usually after surgery. It is in a typical class of NSAIDs and reduces pain, fever, and inflammation (swelling).

Toradol (ketorolac tromethamine) is given as an intramuscular (IM) injection into the muscle or intravenously (IV) into a vein. Intramuscular injections are usually given into the prominent part of the hip (ventrogluteal injection site) or the outer upper arm area (deltoid injection site).

Injection site pain with Toradol is a common side effect in about 1% to 10% of patients. Bruising and stinging at the place of injection may also occur.

Intramuscular (IM) injections like Toradol can be more painful than subcutaneous injections, which are given into the layer of fat right under the skin. However, in most patients, this pain should be transient and short-lived.