Struggling with outdated IM injection site information

[DarkestSamus]

Hey all,

While most websites seem to be pretty consistent when it comes to the technique for FINDING the injection sites (deltoid, vastus lateralis, ventrogluteal, dorsogluteal), there's a lot of inconsistency on the following topics:

- Use of Z-track on any/all sites (pulling the muscle in one direction so that upper muscles slide over and cover the lower muscles where the medication is)

- Which sites should be prioritized over others for safety reasons

- Use of massage for comfort (this seems to be most commonly recommended for the Deltoid)

Can you please help me with the most recent information on these topics? Also ANY other IM injection site information would be grand, no matter how basic; this was one of the subjects I got the least experience with in Nursing school.

Thanks!

[mariebailey, MSN, RN]

I came across this site when preparing for an exam that was part of an interview for a weekend urgent care position: NUR103 needle sizes for injections flashcards | Quizlet. It gives examples of drugs & sites for Z-track injections, etc. I know one slide is partially incorrect: aspiration is not necessary for vaccines in addtion to the other meds listed, & there is plenty of evidence to question the utility of the practice altogether. See: Requested PDF Document. This next one may or may not be helpful; it determines vaccine injection site based on age: http://www.immunize.org/catg.d/p3085.pdf

I am not afraid to look at package inserts for manufacturer instructions for the med to be administered. Some practices may depend on your employer's policy too. Hope this helps.

[Anna Flaxis, BSN, RN]

A good, current nurses' drug guide, the package insert, and the pharmacist, can all be great resources in answering these questions. Also check your facility's P&P.

[MandaRN94]

The organization I work for only allows Deltoid or VG for IM inj -less chance of damaging major nerves. Do not need to aspirate anymore -I do out of habit.