B12 injections,can you give it in the arm muscle?

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What is the preferable site for giving B12 injection? I'm a fairly new nurse and I have a pt that is receiving B12 injections. I haven't had much opportunity to practice intramuscular injections. I only gave one to a 3 day old baby in a thigh.

I heard that you can give b12 in the arm, thigh and buttocks.

Am I missing something? You can ? hit the kidneys ? if you give intramuscular injections in the dorsogluteal or ventrogluteal (buttocks)?

In theory you can if you administer the shot too high.But I worry more about the sciatic nerve-especially since I dont have too much experience with IM shots.I mean the deltoid and vastus lateralis doesnt seems hard to locate but the gluteal area gives me chills.

Specializes in PeriOperative.
I wonder if there are meds that cant be given in the deltoid.

Yes, rule of thumb is any injection greater than 1cc should be given in a larger muscle.

Yeah next time I will try a different site and give it in the tigh and then buttocks-I'm sooooo afraid to give it in the behind because the kidney are so close and the nerve.

I'm very confused by this post. IM injections given in the "behind" should be given in the gluteus medius or ventrogluteal muscles. Kidneys are in the flanks. It would be impossible to hit the kidneys giving an injection in the gluteus medius or ventrogluteal muscles. If you are careful to look for anatomical landmarks, your shouldn't have to worry about major nerves or blood vessels.

ETA: If it's really giving you chills, just focus on going below the pelvis. I promise there are no kidneys below the pelvis, even if it is a bariatric patient and you can't really find any landmarks.

Yes, rule of thumb is any injection greater than 1cc should be given in a larger muscle.

I'm very confused by this post. IM injections given in the "behind" should be given in the gluteus medius or ventrogluteal muscles. Kidneys are in the flanks. It would be impossible to hit the kidneys giving an injection in the gluteus medius or ventrogluteal muscles. If you are careful to look for anatomical landmarks, your shouldn't have to worry about major nerves or blood vessels.

Thanks for the clarification.I gave 1000 mcg/ml of Cyanocobalamin (B12).So would vastus lateralis be considered as large as the gluteus medius and ventrogluteal?

Specializes in Med/Surg, Ortho, ASC.
Thanks.I would like to try the tigh next time...

Go for the tigh (sic) if you are comfortable with that. Personally, I would feel more comfortable with considerably more research...

Specializes in PeriOperative.

Thanks for the clarification.I gave 1000 mcg/ml of Cyanocobalamin (B12).So would vastus lateralis be considered as large as the gluteus medius and ventrogluteal?

1000 mcg/ml is not an amount, it's a concentration.

In an adult:

>1cc = deltoid

>2cc = vastus lateralis

>3cc = gluteus medius and ventrogluteal

Specializes in -.

Hi,

I have been having b12 shots for years because of my perenicious anemia. I have always had them in the deltoid. However I have heard a lot of nurses say they prefer giving it in the buttock as it hurts the patient less .

I guess it's up to what you and the patient are comfy with, and what the dosage is.

Specializes in PeriOperative.

roser13, the fact that patient/medication questions should be directed toward a preceptor, supervising nurse, prescribing doctor, or pharmacy has been addressed a number of times.

I do feel sorry for BHN, because it sounds like she never had much of an orientation and is in over her head. I am concerned for her patients because she seems determined to get her training to treat them from an internet forum.

Specializes in Med/Surg, Ortho, ASC.
roser13, the fact that patient/medication questions should be directed toward a preceptor, supervising nurse, prescribing doctor, or pharmacy has been addressed a number of times.

I do feel sorry for BHN, because it sounds like she never had much of an orientation and is in over her head. I am concerned for her patients because she seems determined to get her training to treat them from an internet forum.

I also worry for BHN's patients....very much so.

However, I don't feel sorry for BHN. She is in control of her own nursing destiny/license and has been advised many times on this forum (when she asked for advice) that she is likely in over her head. She tends to disregard such posts.

Hi,

I have been having b12 shots for years because of my perenicious anemia. I have always had them in the deltoid. However I have heard a lot of nurses say they prefer giving it in the buttock as it hurts the patient less .

I guess it's up to what you and the patient are comfy with, and what the dosage is.

I thought it was actually opposite.I thought that the shot in the buttocks hurts more.When gave my patient the shot in the deltoid today he said it didnt hurt him at all..I always though that gluteal area hurts the the most.

I also worry for BHN's patients....very much so.

However, I don't feel sorry for BHN. She is in control of her own nursing destiny/license and has been advised many times on this forum (when she asked for advice) that she is likely in over her head. She tends to disregard such posts.

Oh dont worry my patients are safe-today actually I have gotten a compliment-I was substituting for an experienced nurse and her patient told me she is sorry that I wont be her permanent nurse cause she thinks I'm a very good nurse Did she lie? Maybe but from the tone of her voice and her body language it seems as she really liked the care I provided for her.Dont forget that I had 2 months of hospital orientation.I'm not entirely blue.And yes I did check my drug book and review the sites and the IM injection procedure.I'm so sorry that I'm nervous about my first gluteal injection,I'm sorry that I choose a safer side.The correct site.I guess I wanted a reassurance that I did the right thing.Dont feel sorry for my patients-they are all good and safe.If you dont want to offer an advice dont read my posts.You are very discouraging to the new nurses who seek advice here on forum.LASTLY,I'm sorry that I cant find a gig in the hospital.I'm sorry that the only place that decided to take me under its wings is a home health care.And they are very nice and understanding and treat me humanely,not like a magnet,private hospital that I used to work for.I'm sorry I'm this green grad that you despite so much.

Specializes in multispecialty ICU, SICU including CV.
"I just wanted reassurance that I choosen (sic) a right spot.."

I'm not sure that I would take one patient's advice as golden as to the correct injection site.

It was my grandma. She was less than 2 months from death. I was more than happy to let her decide where she wanted to be poked.

Realizing you weren't responding to my post now. Answer still applies. Why wouldn't you let a patient choose an IM site if absorption hasn't been proven to be better at a specific site? That is the only reason I know of to choose one site over the other provided that you know how to administer in all sites with equal proficiency.

Specializes in pediatrics.
Yeah next time I will try a different site and give it in the tigh and then buttocks-I'm sooooo afraid to give it in the behind because the kidney are so close and the nerve.

I'm sorry, I just have to comment...

Vastus Lateralis = on the side of the thigh, and really, if your patient walks, they shouldn't be having shots in that

Ventrogluteal = the preferred "behind" injection, is far away from the sciatic nerve and kidneys (I'm not sure where you got the fear of hitting the kidneys...)

The other "behind" site, Dorsogluteal, is not recommended anymore because of that high risk of hitting that nerve.

And in my nursing school, we were observed by instructors for our first injections. Anytime you have questions about correct injection sites, or any medication administration, it's in the best interest of you, your pt, and your potential license to ask beforehand! Not on the boards after the fact.

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