Intramuscular Injection Sites? - page 4

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   CyndieRN2007
    [quote]
    Quote from florry
    All right; now I understand the language:
    You are from Norway!!!
    Last edit by CyndieRN2007 on Jan 5, '06
  2. by   florry
    [QUOTE=student4life]


    You are from Norway!!!
    :wink2: yes!!! Apology my bad
    English, I hope Y do! What beeing from Norway a supprise!
  3. by   florry
    :wink2: :wink2: :wink2: [QUOTE=florry]
    Quote from student4life
    :wink2: yes!!! Apology my bad
    English, I hope Y do! What beeing from Norway a supprise!
    SORRY; WHAS THAT A SUPPRISE? WOULD YOU IF SO TELL ME WHY? HAVE I MISUNDERSTOD?:wink2:
  4. by   CyndieRN2007
    [quote=florry] All right; now I understand the language: quote]

    Sorry for the misunderstanding, I didnt understand why you made the above statement in your post. I then looked at your location and realized that you are from Norway a probably speak another language. Thats all, I didnt mean anything bad by that. Im sorry!!
  5. by   pvjerrys
    Quote from SweetOldWorld
    6th edition of Potter and Perry's Fundamentals of Nursing states that the dorsogluteal site should not be used because of the danger of hitting the sciatic nerve. I know someone who suffered permanent damage from just this very thing from an injection he received in the ER. I rarely give IMs anymore anyway. Most of our meds are given IV.
    We also use Perry & Potter as basis for practice. Students learn to give IM injections in the ventrogluteal site. They practice locating the site repeatedly in the lab prior to clinical.

    There are advantages to the VG site: large muscle site, lack of nerves or vessels, and, last but not least, the patient can be in supine position during administration. We also teach students to inject with Z-track technique for all injections. Meds are beter absorbed and students get to perfect a technique that they might otherwise not be able to use. I have observed students having minimal problems locating the VG site using Z-track for injections.

    <O</O
    Community practice usually lags behind current theoretical practices, so it is no surprise that nurses still use the dorsogluteal site.

    One last response: Always aspirate for IM. It s not necessary to aspirate for subcutaneous injections as there are minimal blood vessels in this area.

    <O</O
  6. by   DCJ3
    i'm in nursing school now and they are discouraging the use of dorsogluteal site because of the high chances of hitting the sciatic nerve and the preferred site is now the vg. my clinical instructor also taught me that a better way to give all ims is via z track - less pain, better absorption.

    b.
    ------------------------------
    i hear and i forget
    i see and i remember
    i do and i understand~ old proverb
  7. by   florry
    Quote from dcj3
    i'm in nursing school now and they are discouraging the use of dorsogluteal site because of the high chances of hitting the sciatic nerve and the preferred site is now the vg. my clinical instructor also taught me that a better way to give all ims is via z track - less pain, better absorption.

    b.
    ------------------------------
    i hear and i forget
    i see and i remember
    i do and i understand~ old proverb
    in your country or us, would you telling me what a z-track is! i cant find the word translated, and i apressiate if you can explain it! thank you very much!
  8. by   pvjerrys
    Quote from florry
    In your country or us, would you telling me what a Z-track is! I cant find the word translated, and I apressiate if you can explain it! Thank you very much!


    FLORRY - THIS MIGHT HELP.

    Could you please provide a list of drugs that should be administered via the Z-track method.
    18<SUP>th</SUP> January 2001
    We are not able to specify a list of drugs - application of the Z-track injection technique differs from hospital to hospital and country to country. As a general observation, though, the Z-track method is used for intramuscular injections of substances which are known to cause pain to the patient if they seep into the subcutaneous tissues or cause permanent staining of the skin. To reduce the risk of causing irritation along the injection pathway, the needle used to draw up the substance is normally changed before the injection is given. The Z-track technique involves displacing the skin and subcutaneous layer in relation to the underlying muscle so that the needle track is sealed off when the needle is withdrawn, thus minimizing reflux (see diagram above). It is most commonly employed in the administration of parenteral iron solutions such as Iron Dextran (Imferon) and Iron Sorbitex (Jectofer). A drug which is highly coloured in solution may be administered by this method. It is sometimes used in the administration of Heparin into the abdominal subcutaneous tissues. Several studies have been carried out to compare the effectiveness of different injection techniques (eg: Keen, 1986; Quartermaine and Taylor, 1995).
    References
    Johns, M.P. (1989) Drug therapy and nursing care. London: Macmillan Press.
    Keen, M.F. (1986) Comparison of intramuscular injection techniques to reduce site discomfort and lesions. Nursing Research, 35(4), 207-210 (Jul-Aug).
    Potter, P.A., and Perry, A.G. (1993) Fundamentals of nursing: concepts, process & practice (3<SUP>rd</SUP> edition). St. Louis: Mosby-Year Book, Inc (pp 662-663).
    Quartermaine, S., and Taylor, R. (1995) A comparative study of depot injection techniques. Nursing Times, 91(30), 36-39 (Jul 26-Aug 1).

    <!--msthemeseparator-->
  9. by   florry
    Quote from pvjerrys
    FLORRY - THIS MIGHT HELP.

    Could you please provide a list of drugs that should be administered via the Z-track method.
    18<SUP>th</SUP> January 2001
    We are not able to specify a list of drugs - application of the Z-track injection technique differs from hospital to hospital and country to country. As a general observation, though, the Z-track method is used for intramuscular injections of substances which are known to cause pain to the patient if they seep into the subcutaneous tissues or cause permanent staining of the skin. To reduce the risk of causing irritation along the injection pathway, the needle used to draw up the substance is normally changed before the injection is given. The Z-track technique involves displacing the skin and subcutaneous layer in relation to the underlying muscle so that the needle track is sealed off when the needle is withdrawn, thus minimizing reflux (see diagram above). It is most commonly employed in the administration of parenteral iron solutions such as Iron Dextran (Imferon) and Iron Sorbitex (Jectofer). A drug which is highly coloured in solution may be administered by this method. It is sometimes used in the administration of Heparin into the abdominal subcutaneous tissues. Several studies have been carried out to compare the effectiveness of different injection techniques (eg: Keen, 1986; Quartermaine and Taylor, 1995).
    References
    Johns, M.P. (1989) Drug therapy and nursing care. London: Macmillan Press.
    Keen, M.F. (1986) Comparison of intramuscular injection techniques to reduce site discomfort and lesions. Nursing Research, 35(4), 207-210 (Jul-Aug).
    Potter, P.A., and Perry, A.G. (1993) Fundamentals of nursing: concepts, process & practice (3<SUP>rd</SUP> edition). St. Louis: Mosby-Year Book, Inc (pp 662-663).
    Quartermaine, S., and Taylor, R. (1995) A comparative study of depot injection techniques. Nursing Times, 91(30), 36-39 (Jul 26-Aug 1).

    <!--msthemeseparator-->
    :wink2: Thank you, this was wery well illustrated as told! We use some of the same tecknic, but not the "Z" as a term. I am supprised that you in US seem to have that kind of a system, shortenings when doing nursing! Though I have also seen fex. other illnesses as MRSA that sorry to say, is out of control. Certainly we can learn or eacc other, and I appressiate that you took your time to answering me about that issue!!

    Thank you, again!
  10. by   K205
    I work in geriatrics, so I mostly use ventrogluteal. It' difficult to position an elderly and, possibly demented patient. I just find the best muscle pad that I can, since MOST of my pts are cachexic. Hope that helps
    Quote from celestlyn
    I use dorsogluteal most of the time. Will occassionally use vastus lateralis, also, but people say it hurts more.
  11. by   K205
    Vistorol, Iron, and anything caustic to sc tissue.
    Quote from florry
    :wink2: Thank you, this was wery well illustrated as told! We use some of the same tecknic, but not the "Z" as a term. I am supprised that you in US seem to have that kind of a system, shortenings when doing nursing! Though I have also seen fex. other illnesses as MRSA that sorry to say, is out of control. Certainly we can learn or eacc other, and I appressiate that you took your time to answering me about that issue!!

    Thank you, again!
  12. by   florry
    Quote from K205
    Vistorol, Iron, and anything caustic to sc tissue.
    :wink2: Thank you again!

    If I do understand the issue in the way the terms or description for IM AND SC is used. I understand us are using the term VENTROGLUTEAL OR DORSOGLUTEAL if giving IM.
    And of course iron an B12 require deep IM injection.

    I understand the Z-track method, too, that we also use described in an other way, beause the language.

    Though I DO HAVE MANY DICTIONARIES RELATED TO HOSPITAL ENGLISH, - I STILL CANT FIND THE WORD VENRTO- AND DORSOGLUTEAL. I AM NOT SURE I UNDERSTAND THAT THAT IS IN MUSCULUS GLUTEALIS, BOTH OF THEM, OR IF ITS EITHER THE M. QUADIPPLEX OR THIGH? Would anybody try to give me an answer in that?

    Sorry that my language is that bad, but you dont learn, if you dont ask. I certainly know and educate norwegian studenst in that par of nursing, but we use norwegian as a language...:wink2: I REALLY DO APRESSIATE YOUR MANY ANSWERS, THANK YOU FOR TAKING TAME FOR DOING THAT:wink2:

    I am only interested in learning the Terms!!
  13. by   florry
    :wink2: [QUOTE=student4life]
    Quote from florry
    All right; now I understand the language: quote]

    Sorry for the misunderstanding, I didnt understand why you made the above statement in your post. I then looked at your location and realized that you are from Norway a probably speak another language. Thats all, I didnt mean anything bad by that. Im sorry!!
    :wink2: Its all right!! I apology my bad English! I tell my self: If you dont ask, you dont learn..So my intention was to learn! Yes, I speak norwegian, and are from Norway, and have a terrible English. I dont mean to offend anybody!!!!:wink2:

close