Gluteus non approved IM site???

[nkochrn, RN]

I was talking to my cousin this weekend who is also an RN. I mentioned a doc wanting Solumedrol given in her arm (this was the dr. receiving the injection not another patient.) I said it wasn't supposed to be given in the arm because it is a 2 ml injection. My cousin said the gluteus is no longer an approved injection site and they have signs hanging up all over her hospital about it. Am I missing something???? I've never heard of this and was thinking maybe it's just her hospital doing this.

[Double-Helix, BSN, RN]

We learned in school that the gluteus should not be used as an IM site due to the risk of hitting the vagal nerve. We were taught that deltoid, vastus lateralis, and ventro-gluteal were the sites to use. I've only ever used vastus and deltoid in practice, but we don't give many IMs other than immunizations.

[AgentBeast, MSN, RN]

Dorsogluteal is no longer used for injections due to the risk of injuring the Sciatic nerve. Vetrogluteal though is okay.

[darkangel83]

We were told the dorsogluteal site is no longer an approved site for IM injections due to risk of damaging the sciatic nerve if the landmarking is incorrect. We are using the ventrogluteal site at our hospital.

[AgentBeast, MSN, RN]

We learned in school that the gluteus should not be used as an IM site due to the risk of hitting the vagal nerve. We were taught that deltoid, vastus lateralis, and ventro-gluteal were the sites to use. I've only ever used vastus and deltoid in practice, but we don't give many IMs other than immunizations.

You'd need one hell of a long and strange needle to be able to hit the Vagus nerve through the Gluteal region.

[nkochrn, RN]

I've never heard of it being unapproved. I use this site frequently in the ER for injections, mostly toradol. I do know we were taught in school that it was very important to use your landmarks to avoid hitting the sciatic nerve.

[SeeTheMoon]

Ditto to scottE..on both posts!

[Isabelle49]

You'd need one hell of a long and strange needle to be able to hit the Vagus nerve through the Gluteal region.

You sure would and you would probably have to get through some bone to reach it! Too Funny!

[Isabelle49]

I haven't given any IM dorsogluteal, use ventrogluteal as it is safer and never in either of these areas on a child 3 y.o. or less.

A nurse in the ER once gave me Vistaril dorsogluteal and I felt a very powerful electric shock along my leg and bled a lot from it. This was while I was in nursing school. Am sure she hit the nerve and possible artery.

[AgentBeast, MSN, RN]

You sure would and you would probably have to get through some bone to reach it! Too Funny!

Nah, you could just curve it down and slip it up through the Obturator foramen. They probably don't want any of the stuff that runs through there anyways.

[Freedom42]

I was also taught that the buttock is a no-no due to the risk of hitting the sciatic nerve. The other problem is too much junk in the trunk, which is certainly a problem these days. If the patient is heavy, there's a good chance that the injection won't make it into the muscle.

[wooh, BSN, RN]

Hitting the vagal nerve is bad. That's why it's very important to use your landmarks.