IM injections deltoid and dorsogluteal location?

[Wheaties]

i'm a little confused where the acromion process is at since the book didnt really explain it, and my anatomy book only shows a picture of the scapula in a bad angle too. where is the acromion process? is it the corner of the shoulder?

so basically its place 3 fingers width starting from the acromion process, and the injection is 3 fingerswidth down? my teacher said no to that, i was confused since then, and i just need clarification. the teacher said 3 fingerswidth down is the base of the triangle. but we need to give the injection in the center of that triangle. thats what the teacher said. and it felt like i was giving the injection away from the deltoid muscle, to the muscle below it.

the pictures dont help since the teacher sort of confused me now.

for the dorsogluteal muscles, how do i assess which site do give it in? is it from greater trochanter to the posterior iliac spine, draw a line between those two and the injection is 2 inches above it?

the book i was looking at called that the ventragluteal injection site. now i'm confused again.

[wonderbee, BSN, RN]

The acromion process is basically the uppermost part of the shoulder joint. We measure 3 finger breadths from that point for a deltoid injection.

[Lys]

hey wheaties,

attached is a journal article from the nursing standard regarding use of the ventrogluteal (gluteus minimus)injection site, evidently it's preferred over the dorsogluteal. my nursing text (potter & perry (2001) candadian fundamentals of nursing) quotes a couple of sources which reinforce this. the same text instructs us to landmark for this site by taking the left hand (on the client's left) pointing the thumb toward the groin, placing the first finger on the iliac spine, and spreading the first two fingers to create a v shape in which to put the injection approximately in the middle.

as for the deltoid, i've also heard that using the three fingers is advisable, but that placement should be approximately where the 3rd finger is (i have thin fingers mind you). but basically the injection site should be 1-2 inches (2.5-5cm) below the acromion process.

much luck with the injections

Using the ventrogluteal site for intramuscular injection.doc

[purplekath]

Hopefully I'm going to be able to relay this properly! lol

For the dorso gluteal, if you put the butt of your hand on the top of the femur and your thumb on the little piece of hip bone that sticks out, then splay your fingers as far as they will go across the pt's butt cheek, then the needle goes in 1/2 way between your thumb and your pointy finger. That's 1/2 way between the top of the "V" you make with your splayed fingers.

You can check the right location because it is a little "meaty" bit off the side of the pt's hip. Even thin patients have a little bit of fatness there - underneath the fat is the muscle you need....so it's a good way to check before you go inserting needles!

Best of luck!

[Ruylupez]

hey wheaties,

attached is a journal article from the nursing standard regarding use of the ventrogluteal (gluteus minimus)injection site, evidently it's preferred over the dorsogluteal. my nursing text (potter & perry (2001) candadian fundamentals of nursing) quotes a couple of sources which reinforce this.

in my introductory nursing class they went so far as to tell us that we should never give an injection in the dorsogluteal site unless it was the only site available. they drilled this into us repeatedly. they never even tested us over this site since were were never to use it.

this semester my ob nursing instructor had me actually give my first im injection...a rhogam shot that she had me administer in the dorsogluteal site.

[Lys]

ruylupez same thing happened over here *lol*

but the tutor (clinical instructor) who told me to give the im in that site went off and did some research, and found that article!