IM injection help: maximum amount given in ventrogluteal site

[christine2005]

Help!!! I drew up 1gm of Rocephin per Dr's order. Mixed it correctly with 3.6 ml's of sterile saline. Told the Dr. I thought it should be given in split doses. Dr. said he didn't want it split. Wanted it given in one dose. Went into the room (I work in a Dr's office), had the pt. stand (no tables just exam chairs in rooms), administered in Rt. hip. Pt. had tensed leg muscle bracing for injection and immediately got a cramp in the hip. He hobbled around the room, was in a lot of pain. I got him an ice pack and stayed with him. Within 5 mins he was somewhat better but I could tell it still bothered him. I told him 1 gm of rocephin is a hefty dose because of the abscess he had. He said that was okay, whatever the Dr. wanted him to have. I have worried myself sick since yesterday about this. I told the Dr. and he said it was fine. Has anyone else had this type of reaction? Was 3+ ml's too much to inject into the ventrogluteal area? In pediatrics we always did 1ml in each vastus lateralis muscle - 2 injections. Help!!

[mandaa4]

GrumpyRN63 said:

he orders it, he (many times) doesn't know how to administer it

We had a sundowning pt that refused care by females (there were no males on the floor). we asked the Dr. to administer the ativan IV push and he had no idea how to even begin doing it! HAHA!

[csmall]

First of all you should reconstitue Rocephin in Sterile water unless the patient is allergic to zylocaine. It says on the directions to mixe with zylocaine, also you should give it deep IM with Z-track method.

Rocephin is a very painful medication and I had a patient actually pass out. She was allergic to zylocaine and I tried to talk the Dr into a different antibiotic, but he refused to change his order but he would not.

So next time use zylocaine instead of Sterile water.

[psu_213, BSN, RN]

steelcityrn said:

No one is coming near me with a 10 ml im injection, thats for sure!

Then don't get bit by a stray dog! Rabies IG is approx. 10 ml and it gets injected IM (albeit divided into several shots--although some of it is given as multiple shots around the bite--so it is given in so weird sites).