IM sites on babies

Specialties Pediatric

Published

Okay, so I know this seems like a dumb question...but say you have a two month old for routine immunizations. There are 5 to give - DTaP, IPV, Hep B, HiB, and PNC7. So where do you give them all? 3 in one thigh and 2 in the other? Some two month olds are just so little. And I've been told that you have to do each shot in a seperate site, so if there's a reaction you know which shot caused it; but then where do you give them all? As far as I know the vastus lateralis is the only IM site approved for infants that young. I've looked in all my nursing books, but I can't find an answer anywhere.

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Specializes in Nephrology, Cardiology, ER, ICU.

I would question giving five injections in one sitting. There is no way to tell what is causing an allergic reaction. Yes, the vastus lateralis is the only site that I am familiar with for IM injections of babies.

"The acceptable injection sites for infants include both the vastus lateralis (outer thigh) and the ventrogluteal muscle. Unfortunately, many health professionals are unfamiliar with the ventrogluteal or hip site and confuse it with the dorsogluteal or buttock site. The latter should not be used until the child has been walking in order to develop the muscle mass. The dorsogluteal site is dangerously close to the sciatic nerve and is covered with abundant subcutaneous tissue in many people. Its landmarks, especially the outer boundary, are poorly defined. I do not recommend this site unless no other muscle area is available for an IM injection."

EHS: WOW-Ventrogluteal Site for Intramuscular Injections

This is Donna Wong's site who is the author of well-known peds nursing texts.

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Pediarix is a combo vaccine for DTp,HiB and IPV we use now.I use the vastus lateralis

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Specializes in ICU,CCU,ER,Med surg,home health, office.

Do you have alot of reactions using the pedirix? We use to use it but quit, due to high temps and screaming kids. We give up to 5 injections at a time, 3 in one lat and 2 in the other spaced 1 inch apart. You mark which site each immunization was given ( up. down, mid)to track any reactions. I do hate sticking the wee ones 5 times though!

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