Need answer quick! IM inj.

I did a quick search and basically if it has to be IM they say you may have to use a 2-3 inch needle in the very obese or the medication will be SQ. Even for deltoid........

we use 2-4inch needles for extream obese patient injections every day in my practice, physician office

We can't seem to stock a longer than 1.5 inch. I called pharmacies, other physician offices, floor at hospital. Where do you get them? We order from PSS.

Also can't give more than 1 mL in the deltoid. I see that Methotrexate comes orally is that an option?[/quote']

You can give up to 2 ml in the deltoid in an adult (I don't, but you can). No, oral methotrexate is not an option for the OP's purposes (I'm guessing it's treatment for ectopic pregnancy?).

OP, what did you end up doing?

Discussed with senior doc. He agreed longer needed. Checked around and couldn't get it. Failing that he agreed deltoid ok. Rationale being this was a larger person. Gave 2.24 ml each deltoid slowly. Pt said it wasnt painful. Worked well as shown by her dropping Bhcg level.

So do you not see many obese patients in that practice? I'm curious that this is the first time you've encountered this. I give VG injections all the time (Rhogam, depo provera, ceftriaxone, etc), and it does necessitate using a longer needle.

Yes we have other obese pts. Drives me nuts because our rhogam comes in pre filled with needle that can't be changed. Luckily I don' have any obese pts on depo. Have only had to give one rocephin so far. I really want access to some longer needles. Our supply salesman from PSS says anything longer than 1.5 inch is a spinal...

my pss/ now mckesson, provides us with 3.5-4.5 inch needles

which we routinly use for obese patients

and yes it looks like a spinal needle

I am going to have to approach this again with our supply person!!