I work in a clinic where I give many intramuscular injections for sexually transmitted diseases. I am mainly giving either Penicillin or Ceftriaxone (Rocephin) IM. My nursing school
training (finished 3 years ago!) teaches me to use the ventrogluteal site but I have some reservations...
From my experience, the ventrogluteal site is FAR more painful than the old dorsogluteal site. I was wondering if this is just my experience or if other people have found this? I find that anything more than 2mL can be very painful for my patients in the ventrogluteal site. I understand the proposed safety advantages of this site but I thing it is far outweighed by the discomfort. I think the muscles under this site are more tense and there is 'less room' for the injection to go causing more pain.
Several weeks ago a young patient with syphillis found her first IM penicillin shot given ventrogluteally exruciatingly painful and I wondered if she would ever return for her subsequent shots. She did, and I used the dorsogluteal site, which she still found painful but much better.
I now use both sites but always use the dorsogluteal for the ceftriaxone shots which patients seem to find particuarly painful.
Doing a literature search I can find many articles arguing that the ventrogluteal site is safer but can't find any research on patient pain.
What do you other thing?