Help- IM injection question!

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Hi!

Help!! I have to give my dad IM injections (vit b12) and haven't had to give an IM injection in quite some time (I currently work in the OR and don't need to administer injections). I've been reading the best site to give it is ventrogluteal, but I'm not that comfortable with that since I've never done that at all.... at least I've done them in the deltoid before - even though it was a long time ago and only a couple times. My dad is super skinny and his muscles have definitely atrophied (hence the vit b12 needed), but he does still have a little more muscle in his deltoid then I anticipated. The pharmacy gave me 22 gauge syringes with 1 1/2 length. My questions are:

-Do you think it's ok to administer in his deltoid vs. ventrogluteal?

-How deep do I actually go in with the needle if he doesn't have as much muscle as an average 66 yr old man? Should I stop at 1 inch? I'm Terrified to hit bone, but want to make sure he gets the med directly into muscle.

-Any other pointers/tips???

Thank you guys so much in advance for your help and advice (I know these are amateur questions, so no judging, please!) =)

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Specializes in Nurse Leader specializing in Labor & Delivery.

Whether deltoid is okay depends a lot upon the amount injected.

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Thank you so much for responding. It's 1ml so the deltoid should be ok in that regard. It's the length of the needle and how far in to go that makes me the most nervous =(

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Thank you so much for responding. It's 1ml so the deltoid should be ok in that regard. It's the length of the needle and how far in to go that makes me the most nervous =(

I would probably avoid the deltoid in someone "skinny" and elderly ...even for 1ml.

1.5 inches may be too far in the ventrogluteal site, but I'd have to see the patient to make that call. Are there any nurses more experienced in your area you could ask for advice? ...or your health care provider?

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Thank you for your feedback and advice! =) Unfortunately, no it's just me. When prescribing the med today his doctor suggested the dorsogluteal site saying that would be the "easiest for him to inject himself" and given the fact that 1) that site is no longer recommended for IM injections and 2) I would think that would be super difficult for anyone to do to themselves in the proper location, I kind of lost confidence in any of her advice. I reassessed his arm and think I feel most comfortable trying the deltoid. I am going to make sure I am in deep enough to get muscle but not too far in all the way. Thank you for responding, I really appreciate it!

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Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.

The provider who wrote the scrip for the injections should also be providing education/information about how to administer the medication efficiently.

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Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.

We posted at the same time.

If the doc won't give info, I would probably do the thigh in someone frail... usually more muscle there than in the arm, unless the person is bedbound.

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Thank you all so much! It's nice to know I can come here for advice when needed =)

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
We posted at the same time.

If the doc won't give info, I would probably do the thigh in someone frail... usually more muscle there than in the arm, unless the person is bedbound.

I was going to suggest the arm as well.

It all depends on the amount of fat & muscle in the arm vs. leg.

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No, you don't have to give your dad IM injections. You are not responsible to administer his prescribed medications, or covered under your licensure to do so.

Discuss this with his provider. Dad needs to go into the office to receive his injections.

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PHEW!!!! Ok, all done-- went in smooth and he has way more muscle left there then I gave him credit for =) Was able to go probably about 85-90% of the 1 1/2 length in and never felt any bone. What a relief! Thanks so much everyone for all your support and advice!! Hope y'all have a great night!

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I'd have to see the patient to give any specific advice, to be honest.

That being said- I wouldn't use a 1 1/2" in the deltoid in your situation. I've hit bone with a 1" on a frail elderly man before.

Go back to the pharmacy and ask for a smaller needle if you're set on a deltoid injection or ask for teaching on ventrogluteal injections- they're pretty simple as long as you know how to landmark.

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