15 month old getting 750mg Rocephin

Pediatric Critical Care Columnist · Jul 27, 2013

The preferred site for IM injections in infants and toddlers is the vastus lateralis. Small children who aren't walking well yet don't have much muscle mass in their little bums and it's too easy to accidentally hit the sciatic nerve.

KelRN215, BSN, RN · Jul 27, 2013

IM injections in a 15 month old should be administered in the vastus lateralis. I have never used the buttocks for an IM injection in a child of any size.

Meeh619 · Jul 27, 2013

In our peds clinic with split and give in the thighs. We also try to have two ppl & inject at the same time. Military they have different ideas lol

xoemmylouox, ASN, RN · Aug 5, 2013

I have given plenty of rocephin. I would have split the dose and give it in the thighs as well.

RNJEN818 · Aug 6, 2013

I agree, the vastus lateralis is the way to go. Current research shows, the ventrogluteal site is always preferred over the gluteas medius (buttock) because of the possibility of hitting the sciatic nerve. In general, I would never give a buttock IM.

dansamy · Aug 6, 2013

Vastus lateralis. 2 shots.

RunnerRN2015, ASN, RN · Aug 7, 2013

On my floor we have 2 nurses give the injection simultaneously in each thigh.

Maladroit, BSN, RN · Aug 9, 2013

I'm a peds nurse (new grad) and have never given Rocephin IM, so I'm glad I came across this thread. Now I know and will be ready when I encounter this. Split into two doses, go for the VL. Thanks!

Sensibility, BSN, RN · Aug 13, 2013

Hey guys!
Ok, so I have asked my friend who has been a pediatric nurse for a while if I am ok, but I still want some clarity. I work in a pediatric doctors office. Today I had a 15 month old that needed rocephin 750mg IM. I drew it up and got all my stuff together. I had given rocephin quite a few times, just not to someone this young (I have given it to bigger kids, like 8 years old and older) I always gave it in their buttocks. So this time I did the same thing. I split it up and gave two injections. Everything went fine, of course he cried, but that was to be expected, and I asked the parents to just wait about 15 minutes so we can monitor him since this was his first time ever receiving the abx. As I was charting on EMR, the nurse who will be giving him the second dose of rocephin tomorrow asked if I split it up, and if "I gave it in both the thighs" I kind of got nervous that this is the only place I should have given it? He did not have any reaction, was a some-what happy boy when leaving. Did I do anything wrong by choosing this site? I did good technique, so I know the injection was correct, but I just want some input from others. Thanks for advise!

We mix ours with lidocaine to cut the pain of the injection.

LadyFree28, BSN, LPN, RN · Aug 13, 2013

I agree the vastus lateralis is the way to go. Current research shows, the ventrogluteal site is always preferred over the gluteas medius (buttock) because of the possibility of hitting the sciatic nerve. In general, I would never give a buttock IM.[/quote']
^THIS.
I was informed of this when I went back for the RN...if you go for the buttock area on a big kid, etc it's the ventroglueal, no more gluteus medius.
For a 14 month old, or any kid, my first choice is now vastus lateralis; less risk.

LadyFree28, BSN, LPN, RN · Aug 13, 2013

^THIS.
I was informed of this when I went back for the RN...if you go for the buttock area on a big kid, etc it's the ventroglueal, no more gluteus medius.
For a 14 month old*, or any kid, my first choice is now vastus lateralis; less risk.

I mean 15 month old.