Intramuscular Injection Sites?

Dorsogluteal primarily and vastus lateralis as an alternative...rarely the deltoid and never the ventrogluteal. I did learn if using the ventrogluteal that the Z tract method should be used when administering IMs in that area

VickyRN,

Do I understand you correctly that you are giving newborns injections in the hip? I've been out of the nursery for about 5 years, so this may be something new, but that sounds quite difficult to me. How do you restrain the infant to get at the site? Isn't the thigh a much easier target? And safer too, without any major nerves or blood vessels to worry about?

ventrogluteal site is relatively free of major nerves and blood vessels, the muscle is large and well defined, and the landmarks are easy to locate. It is an excellent IM injection site in infants. Simply place the palm of your hand over the greater trochanter, index finger over the anterior superior iliac tubercle, and middle finger along the posterior iliac crest. Inject perpendicular into the center of the V formed by the separated fingers.* It has been my experience that this site is less painful than the vastus lateralis.

Sorry, MAJOR brain infarct. What I meant to say was vastus lateralis. No, you would never inject newborns in the ventrugluteal, not safe and wouldn't be able to landmark! Sorry, edited my former post.

We use dorsalgluteal and ventralglutial, as well as vastus lateralus. My problem is the landmarking teqniques. Have they changed much?

I always give ventro gluteal. I learned it in school and have found in practice that most nurses use dorso gluteal so I continue using ventro d/t site rotation. My pts always comment that it doesn't hurt when I give IM vs my collegues.

I think if you learn how to do it in school you will continue and just because it isn't the common practice on the floor doesnt't mean it shouldn't be taught. Think back not so long ago gloves were encouraged not mandatory. Teach them right!

The other perk for pts is that when I worked on a ortho floor with lots of hips and knees I could admin IM much easier with less positioning to aleviate pain.

I agree with hugs,,thats how i learned the landmarks. I also use the vastus lateralis frequently with pain meds in the hospital. Best to rotate sites anyway avoiding affected leg if it is a hip/knee patient.

Great reference sites (the second one has streaming video demos):

http://www.drugguide.com/intraInjectNew.asp

http://www.cotc.edu/Professional/Str...ve/nursing.htm

The posterior superior iliac spine is the prominence of bone on either side of the pelvis underlying the "bikini dimples" on the lower back/upper buttocks.

Dorsogluteal always works best for me. I feel more confident using that injection site than any other, although we were taught all injection sites in nursing school.