IM injections - divide into 2 or keep as 1? - page 4

Okay, I need a bit of good nursing practice know-how. If you have a 2ml IM injection is it better to give it all at once (assuming non-irritating med) or divide it into two, 1ml injections? My thought process is that one... Read More

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    Just a note of caution. In patients who are very large, we all need to remember most of the largeness is not muscle, but fat. To get to the muscle- which is where the med is intended to go, we need to use a slightly longer needle, and it is important to remember that just because someone is large, it does not mean they have a large muscle mass.

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    Quote from rgroyer1RNBSN
    I know this post older and I hate to open it back up here, but, OP stated that drug/ abx to be given was/ is clindamycim, now clindy is abx, my history with abx deep im is that the majority are generally painfull and usually anywhere from 4 to 6 mls/cc's the best place to give an abx deep im, in one injection, in a glute, well diluted by putting some lidocaine in the syringe after you draw upW th e abx.Sincerely,Rod, RN, BSN, Cen, Ccrn, tncc, Cfrn, Nurse manager- ed/ sicu
    Wow! All those iinitials are exhausting.
    rgroyer1RNBSN likes this.
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    Quote from subee
    Wow! All those iinitials are exhausting.
    No kidding! Lol! Thats why I usually dont write or type them lol.
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    Quote from sauconyrunner
    Just a note of caution. In patients who are very large, we all need to remember most of the largeness is not muscle, but fat. To get to the muscle- which is where the med is intended to go, we need to use a slightly longer needle, and it is important to remember that just because someone is large, it does not mean they have a large muscle mass.
    I'm glad you brought that up. Personally I prefer to get all of my IM injections in my DG site. When I ask the nurse what size needle they are using often they say 1". I'm then in an awkward situation of asking her to use a 1 1/2" needle.
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    I recently had to give Rocephin 750mg to a 3 year old who weighted 33 lbs and had a decent size toosh. I choose the DG area as they would be coming back the next day to get another round of the Rocephin and Solumedrol 0.5ml (one injection in each DG). Was this the right site to choose of should the shot have been split and put in the VL. Splitting it would of ment 3 injections for the patient instead of 2. Can someone please give some input on this. Rocephin was mixed with lidocaine. Based on the above post this should have been okay. But because it was Rocephin I am questioning this
    Last edit by jhCMA on Jan 18, '13 : Reason: addition
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    Quote from jhCMA
    I recently had to give Rocephin 750mg to a 3 year old who weighted 33 lbs and had a decent size toosh. I choose the DG area as they would be coming back the next day to get another round of the Rocephin and Solumedrol 0.5ml (one injection in each DG). Was this the right site to choose of should the shot have been split and put in the VL. Splitting it would of meant 3 injections for the patient instead of 2. Can someone please give some input on this. Rocephin was mixed with lidocaine. Based on the above post this should have been okay. But because it was Rocephin I am questioning this
    Welcome to AN! he largest online nursing community!

    Well....This post was referring to an adult. AND some facilities are shying away from the DG for various reasons. For small children however....caution should be exercised and their size, and age, taken into consideration. A three year old hasn't been walking that long so their muscle isn't that developed. Remember just because they have a big toosh....doesn't mean the muscle is that developed.

    If the Rocephin 750 mg reconstituted is 3mgs.......I personally would have given 3 shots....AND I would NOT have used the DG.....I would have used VL for the Rocephin and Deltoid for Solumedrol. Yes it's 3....1.5ml and 1.5ml and the 0.5 in the deltoid...it's 3 shots but that's how it has to be given.

    Administer Intramuscular, Subcutaneous, and Intradermal Injections
    Intramuscular Injections: The volume is not to exceed 5 mL in adults of average weight. Volumes in excess of 5 mL will be given in divided doses at different sites. Maximum volume for infants (birth to 1 year): 0.5 mL; for children 1-2 years: 1 mL; children 2-12 years: 2 mL.
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    Thanks for the input. Rocephin 250mg is reconstituted with 0.9ml and 500mg is reconstitued with 1 ml. so it wasn't over 3 mls. I have searched varies sites on the internet and some say DG is ok for up to 2ml. It definetly isn't a cut and dried route of administration of thie medication IM for children.


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