Keep it simple

[hanskung60]

I'm new to this forum, I suppose this topic should go under General Nursing but I had problems finding that area and since I'm a LTC nurse I put it here.

I was taught to give dorsal gluteal IM injections in a very complicated slow way, and I hate giving them. You find the greater trochanter, draw a line to the posterior superior iliac crest, draw a line from posterior superior iliac crest to iiac creast and then put your thumb down from iliac crest, don't ask me to describe this and then give shot there.

But I've seen nurses give dorsal gluteal shots in a much faster way, it looks like they take their hand in a V or U shape, put in over iliac crest as a land marker and somehow give the shot from this point, I know this is probably not how they really give it, but part of the process looks like this, its looks easy fast, any one give shots that resemble this? Can you describe this method?

[Asystole RN]

I almost never give dorsal gluteal injections, in fact I can count on one hand how many I have given them. There are too many problems, real or imagined, with giving dorsal gluteal injections, not to mention that they tend to be more painful since patients are almost always either laying or sitting on the wound.

When giving IM injections I use the Z-Track method. As to location identification, the method you described is correct.

[SHGR, MSN, RN, CNS]

It sounds like you are describing the VG site (ventrogluteal) which uses the gluteus medius and gluteus minimus muscles which overlay each other, rather than the dorsogluteal. The VG has vast support in the literature for its use over that of the DG (psych patients who may have behavior problems and are receiving IM depot injections being the one exception) due to less risk of complications (could hit the sciatic nerve or cause hemmorhage) and generally thinner adipose layer over the VG site compared with DG; the VG site has less subjective landmarking used to find it.

Do you have access to AJN? There was a rather nice article with clear diagrams how to landmark and administer into the VG site in the Feb 2010 issue-

AJN, American Journal of Nursing:

February 2010 - Volume 110 - Issue 2 - pp 60-61

doi: 10.1097/01.NAJ.0000368058.72729.c6

Otherwise, if you have the Perry and Potter clinical skills text, it is explained in that text.

[hanskung60]

Everyone one gives DG where I work, when I take my wife to Kaiser for migraine she gets DG

[hanskung60]

No, it's DG.

Well I know about the landmarks, it just seems other nurses find the landmarks in a more efficient manner

[SHGR, MSN, RN, CNS]

All the nurses with whom I work use DG too. I started looking into it when I had to lead an inservice that opened up a HUGE practice argument...our policy is VG, our practice manual does not even address or describe DG, and every evidence-based practice reference and resource I can find is clear- in almost every instance, use VG. I still need to get comfortable with it, myself.

I am curious about the DG landmarks you describe, hanskung60. Have you asked your coworkers and the Kaiser staff about it?