Needle difficult to insert in injection site

[Brian Fields]

I work in psych nursing and I encounter a patient whose deltoid muscles are very dense and fibrous. This patient has been getting IM psychotropic meds for many years and refuses to switch to the gluteal IM sites. Is this from years of IM injections?

[TriciaJ, RN]

Are we talking depo injections?  I think the preferred site is gluteal and now we see why.  I've never encountered anyone whose muscle I couldn't inject, but I have had a couple bounce off the skin if the patient is tense enough.

That's really interesting.

[Brian Fields]

Yes, after years of anti-psychotic IM injections, The other nurses have experienced the same issue. It goes in but it's unusually difficult.