Intramuscular Injection Sites? - page 2

We are having a bit of a debate at the school of nursing where I teach. We are having difficulty getting the students to properly landmark. Although a majority of the texts state that ventrogluteal... Read More

  1. by   Huq
    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.
  2. by   VickyRN
    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?
    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!:imbar Sorry, edited my former post.
  3. by   Norma56
    We use dorsalgluteal and ventralglutial, as well as vastus lateralus. My problem is the landmarking teqniques. Have they changed much?
  4. by   shammy
    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.
  5. by   meownsmile
    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.
  6. by   VickyRN
    Quote from Norma56
    We use dorsalgluteal and ventralglutial, as well as vastus lateralus. My problem is the landmarking teqniques. Have they changed much?
    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.
    Last edit by VickyRN on Nov 21, '05
  7. by   mayzeegrl
    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.
  8. by   sharann
    OK, help me out. I never heard of Dorsogluteal? I give all my injections in the ventroglut or the deltoid if small and nonirritating.
  9. by   deanaRN
    LOVE that streaming media site, THANKS!

    Quote from VickyRN
    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.
  10. by   mandana
    At one of our clinical sites Dorsogluteal injections are no longer allowed due to the risk of sciatic nerve damage. Ventrogluteal is preferred at that specific location. At this facility, RN's are also not allowed to give dorsogluteal injections. I guess they had a specific issue.

    We are only allowed to give IM shots to infants in the vastus lateralis.

    All of our other clinical sites allow us to choose the area based on size of dosage, characteristics of med, size of person.

    Amanda
  11. by   Simba&NalasMom
    I just graduated LPN school this past Feb, and their preferred site was vastus lateralis (yes, on adults)...*****!?! I've only seen that site used once and it was because the gentleman was very thin and in end-stage Parkinson's, so turning him was difficult for the nurses and painful for himl; also, he was very thin and had more "meat" on his vastus than his dorsus. The most common site I've seen used in practice (for adults) is the dorso-gluteal.
  12. by   JennRN&Mom23
    I always use dorsogluteal, it is what I feel most comfortable with. That is the site that most of the people I work with also use.
  13. by   DG5
    I always use the dorso gluteal. I was taught to find the superior iliac crest, go 5 cm diagonally from there into the dorso gluteal muscle and thats the mark. Is that still ok?

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