Pediatric IM injections

[aedwards14]

Hi all!

I've been a nurse for 5 years and currently work in urgent care. I have had 0 experience giving IM injections to peds patients. At our clinic, about the only IM injections we give would be dexamethasone, rocephin, clindamycin, solumedrol, benadryl, or zofran. Can anyone give me the preferred sites of IM injections for kids of different ages? Like I have no idea when to use the glute muscle vs versus lateralis.

[Jory, MSN, APRN, CNM]

Just google a pediatric injection site diagram. Generally it doesn't matter for most meds if it is the arm or thigh. If the child is old enough, you give them a choice. With infants, they don't have enough fat in the arms which is why thighs are the preferred sites.

I think it is important with infants to z-track the injection because the amount of the medication is small and it minimizes bleeding. In fact, some don't bleed more than a tiny drop if you do it right.

[Guest219794]

Unrelated-

IM steroids is a practice that should be questioned. AFAIK, no advantage, at all, over PO.

In truth, I question the validity of any of those meds IM, particularly in your setting. SL Zofran works great, and with creativity can be done on any age.

Parenteral ABX is so prevalent, that I kind of want to believe there is some point to the practice, but I have yet to find it. Maybe some that are not available PO like ceftriaxone, but I think it is rare for somebody to have an organism only susceptible to parenteral meds.