IM injections

[Meriwhen, ASN, BSN, MSN, RN]

At our facility, the general tendency is for IMs to be given in the arm. Most of the nurses I've asked say it's fine to do it in the deltoid. I'm not exactly crazy about doing it this way, especially in the thinner/older patients who don't have a lot of deltoid to begin with. In these patients, I'd prefer the vastus lateralis or I'll even settle for a gluetus.

However, I can understand its convenience, especially when it comes to having to ask someone in a psych facility to drop trou: many don't want to (aggressive or court-ordered patients definitely won't), some can't d/t abuse history, I need to find that hard-to-find male staff if the patient is of the opposite sex, etc. Then the patients who willingly drop trou--and then some--are a little frightening in themselves.

I'm wondering how most of you do IMs at your facility, since we give so many of them compared to other specialties

[Whispera, MSN, RN]

If the medication is a psych medication, it's important to give it in a large muscle so it distributed over a large area. The deltoid just doesn't do this. As for finding a male staff member to be present and help when you give a gluteal injection, really, you shouldn't be going into a private area with a male patient to give even a deltoid injection or even pills. I'm assuming you don't give a deltoid injection out in the milieu?

[tewdles, RN]

The site for IM injections will vary with the age of the patient, the medication, the volume of the med, the technique recommended for the medication, and the experience of the nurse. Most elderly patients have adequate deltoid musculature to accomodate most IM injections that would commonly be administered in that site.

[Bowgod's Lady]

Our stand point on our unit depends on patient, age, and volume of the medication. Though primarily it is determined on where can the medication be given safely for the staff and patient. We usually prefer the gluteus but ft for safety or restraints we do use the deltoid also.

[Meriwhen, ASN, BSN, MSN, RN]

If the medication is a psych medication, it's important to give it in a large muscle so it distributed over a large area. The deltoid just doesn't do this. As for finding a male staff member to be present and help when you give a gluteal injection, really, you shouldn't be going into a private area with a male patient to give even a deltoid injection or even pills. I'm assuming you don't give a deltoid injection out in the milieu?

The general consensus is that it might be upsetting to other patients if they saw me wielding a big needle of medication in the milieu. Yet they have no problem if I dole out insulin at the medication station, go fig