Can 2 ml of fluid be administered in deltoid muscle?

[Blackheartednurse]

There are mix opinion about that,just wonder what everyone else would think about that?

Sorry I meant deltoid muscle..

[katkonk, BSN, RN]

I was told 0.5 ML max

Healthstar...who told you that?? Routine vaccinations that are always given in the

deltoid are 1.0 ml each for an adult.

[katkonk, BSN, RN]

In the case of having no other site to inject, and with 1.0 ml being the maximum that is recommended in the deltoid, you would be well advised to

split the dose into 2 injections and use two sites in deltoids. This would

avoid any complications that could arise from localized tissue damage. Two ml

dosages should go deep IM in the gluteal muscle.

Not knowing what medication you are talking about, I would DEFINITELY double check the dosage that you are giving and the order, check it with the pharmacist if necessary. There is a famous liability case that is used for training on medication errors where some neonatal nurses gave a dose that was many times the therapeutic dose to an infant because of an error in a decimal point on the doctor's orders. The infant died, the nurses were prosecuted, etc. etc. No happy endings there. ALWAYS err on the side of safety-for you and the patient!

If it is the correct medication, and you still are faced with having to inject 2ml's worth, see if (the pharmacy-or whatever entity is supplying the med) has a different strength available. If you can get a less dilute mixture, then you will inject less-but without knowing what med you are referring to, unsure if this can be done.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

When Phosphenytoin first hit the market, the drug rep insisted that the deltoid was good for 10cc and dorsalgluteal or ventrogluteal for 30cc! He admitted it'd feel "squishy" for a while getting that much.

I don't know anybody who was ever brave enough to give near that much. On/as a big person I've given/received 2cc in the deltoid with no problem. As always, your mileage may vary.

[chloecatrn]

When Phosphenytoin first hit the market, the drug rep insisted that the deltoid was good for 10cc and dorsalgluteal or ventrogluteal for 30cc! He admitted it'd feel "squishy" for a while getting that much.

Sweet Christmas! It'd feel squishy because the freaking deltoid was replaced BY the med. How crazy!

[chloecatrn]

From Potter & Perry "Fundamentals of Nursing", regarding the deltoid site:

Good call. I suppose I could've visited my friends Potter and Perry since they live downstairs on my bookshelf to give my answer actual backup, but I was lazy. Thank you for actually giving real, live citations. :)

[GHGoonette, BSN, RN]

Another aspect is, what do you do if you have a morbidly obese patient for whom the MD, in his wisdom, has written up IM meds? The gluteus and quadriceps are covered with such a deep fat layer that no needle-except possibly a spinal needle!-is long enough to reach through those rolls and actually penetrate the muscle. I've had situations like that, and the deltoid is the only option.

[leslie :-D]

The gluteus and quadriceps are covered with such a deep fat layer that no needle-except possibly a spinal needle!-is long enough to reach through those rolls and actually penetrate the muscle. I've had situations like that, and the deltoid is the only option.

it has been my opinion that the vastus lateralis, has less fat than the quads, and have opted to inject there vs deltoid.

in a side-lying position, the fat tends to droop towards the quads (on an obese person), making it even a more viable site.

leslie

[tewdles, RN]

I completely agree leslie...that is my preferred site really for any IM injection.

[wtbcrna, MSN, DNP, CRNA]

I have given 3mls injections of steroids in the Deltoid before without any problems, but what really matters is what your injecting into the muscle more than the actual volume. Anesthesia routinely injects 30 mls of local anesthetic into people's necks for interscalene blocks, 40ml into gluteus for sciatic blocks, and/or 30+mls into the axilla for axillary blocks.

[PostOpPrincess, BSN, RN]

Depends on many factors, but generally no.

[GHGoonette, BSN, RN]

I have used the vastus for injections, until a woman came for extensive plastic surgery to her leg; it seems an injection of Voltaren given into the upper leg had been given into the fat layer instead of the muscle, and caused horrific tissue damage. Thank goodness it wasn't given in our hospital!

Ever since then I have been extremely wary of any part of the upper leg.