Intramuscular Injection Sites?

  1. 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 is the preferred site, but we are wondering if you are using ventrogluteal exclusively in the clinical areas or is dorsogluteal an acceptable alternative. We as the instructors feel that dorsogluteal is a good site for new practitioner students who are nervous enough about an IM and need a littel larger "target" for their injections. Are we wrong? Is this a big no-no in the clinical area?
    We would greatly appreciate any feedback, advise or literature/text resources to support one way or another.
    Thank you!
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  2. 59 Comments

  3. by   gwenith
    Can't answer without getting out the books. Can you get a little less technical with your question? Sorry being brain dead here.
  4. by   Nurse Bethie
    Basically what I am asking is: Is the dorso-gluteal site a big no-no in the clinical setting? Is it being discouraged by agencies and ventral gluteal being encouraged? We want to teach our students what is actually being practiced and not the "in an ideal world" theory. I want to send out new nurses who are prepared to fit in with the health care team, not nurses who are stuck in the "but the book says so" mind set.
    Thanks!
  5. by   neneRN
    I generally give all IM injections of more than 1 cc in the dorsogluteal, and I see my co-workers do the same. I don't think I've ever used ventrogluteal, nor have I seen another nurse use that site. I will occasionally use vastus lateralis when I can't get to dorsgluteal, i.e. obese pts who can't roll over, hip Fx, etc. I do recall being told in school about controversy re: dorsogluteal but have not seen this in the real world.
  6. by   celestlyn
    I use dorsogluteal most of the time. Will occassionally use vastus lateralis, also, but people say it hurts more.
  7. by   teeituptom
    Nowadays in the ER we IV everyone and administer everything IV. With the except of Tetanus shots its rare we ever give anything IM anymore
  8. by   VickyRN
    I am a clinical instructor, and when we are on the postpartum floor, we frequently give Depo injections in the dorsogluteal. In fact, giving Depo in the deltoid is contraindicated in anyone 120 pounds or under. We do a lot of vastus lateralis IM injections with newborns in the nursery. I'm sure you're aware that the glut is definitely a no-no for young peds.
    Last edit by VickyRN on Jun 11, '03
  9. by   Noney
    I always use the ventrogluteal unless contraindicated.
    9 times out of 10 the pt thanks me and says " You're right it does't hurt as much when you give it there!"

    I think students should use the site because if you learn it earlir it'll stick.
  10. by   Murt
    As far as i can see the only im being given these days is the 10 day vit b1 (neurobion) given to alcoholics who are sobering up.
    I never came acrss it inthe hopitals.
  11. by   KRVRN
    Dorsogluteal is the butt cheek and ventrogluteal is the hip area right???
  12. by   Nurse Bethie
    Yes...the surrent theory is that students should not use the dorso site but many find it difficult to properly landmark the ventro...they tend to be too far forward...any advice on landmarking to make it easier to explain?
  13. by   nowplayingEDRN
    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
  14. by   Jolie
    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?

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