Can 2 ml of fluid be administered in deltoid muscle? - page 2
by Blackheartednurse 19,226 Views | 22 Comments
There are mix opinion about that,just wonder what everyone else would think about that? Sorry I meant deltoid muscle..... Read More
- 1Sep 17, '10 by iteachobFrom Potter & Perry "Fundamentals of Nursing", regarding the deltoid site:
The nurse should use this site only for small medication volumes, when giving immunizations, or when other sites are inaccessible because of dressings or casts.
I was personally taught to use no more than 0.5 in a child and 1 mL in a well developed adult deltoid.
- 1Sep 17, '10 by GHGoonetteCan be done, but as pointed out, only in an adult with a well-developed deltoid, if for any reason it was not possible to give the injection in another site. After all, if the nurse is alone, the patient can't turn without assistance, both upper legs are bandaged etc etc, there's not much alternative. Just use an appropriately sized needle and administer very slowly. Not my idea of fun but sometimes it's unavoidable.
- 1Sep 17, '10 by katkonkIn the case of having no other site to inject, and with 1.0 ml being the maximum that is recommended in the deltoid, you would be well advised to
split the dose into 2 injections and use two sites in deltoids. This would
avoid any complications that could arise from localized tissue damage. Two ml
dosages should go deep IM in the gluteal muscle.
Not knowing what medication you are talking about, I would DEFINITELY double check the dosage that you are giving and the order, check it with the pharmacist if necessary. There is a famous liability case that is used for training on medication errors where some neonatal nurses gave a dose that was many times the therapeutic dose to an infant because of an error in a decimal point on the doctor's orders. The infant died, the nurses were prosecuted, etc. etc. No happy endings there. ALWAYS err on the side of safety-for you and the patient!
If it is the correct medication, and you still are faced with having to inject 2ml's worth, see if (the pharmacy-or whatever entity is supplying the med) has a different strength available. If you can get a less dilute mixture, then you will inject less-but without knowing what med you are referring to, unsure if this can be done.Last edit by katkonk on Sep 17, '10 : Reason: addition
- 0Sep 17, '10 by dthfytrWhen Phosphenytoin first hit the market, the drug rep insisted that the deltoid was good for 10cc and dorsalgluteal or ventrogluteal for 30cc! He admitted it'd feel "squishy" for a while getting that much.
I don't know anybody who was ever brave enough to give near that much. On/as a big person I've given/received 2cc in the deltoid with no problem. As always, your mileage may vary.
- 1Sep 17, '10 by chloecatrnQuote from dthfytrSweet Christmas! It'd feel squishy because the freaking deltoid was replaced BY the med. How crazy!When Phosphenytoin first hit the market, the drug rep insisted that the deltoid was good for 10cc and dorsalgluteal or ventrogluteal for 30cc! He admitted it'd feel "squishy" for a while getting that much.
- 0Sep 17, '10 by chloecatrnQuote from iteachobGood call. I suppose I could've visited my friends Potter and Perry since they live downstairs on my bookshelf to give my answer actual backup, but I was lazy. Thank you for actually giving real, live citations.From Potter & Perry "Fundamentals of Nursing", regarding the deltoid site:
- 0Sep 17, '10 by GHGoonetteAnother aspect is, what do you do if you have a morbidly obese patient for whom the MD, in his wisdom, has written up IM meds? The gluteus and quadriceps are covered with such a deep fat layer that no needle-except possibly a spinal needle!-is long enough to reach through those rolls and actually penetrate the muscle. I've had situations like that, and the deltoid is the only option.
- 1Sep 17, '10 by leslie :-DQuote from Christine Cameron-Doit has been my opinion that the vastus lateralis, has less fat than the quads, and have opted to inject there vs deltoid.The gluteus and quadriceps are covered with such a deep fat layer that no needle-except possibly a spinal needle!-is long enough to reach through those rolls and actually penetrate the muscle. I've had situations like that, and the deltoid is the only option.
in a side-lying position, the fat tends to droop towards the quads (on an obese person), making it even a more viable site.