questionable IM injection

[guest974915]

I recently switched specialties from surgery to corrections and recently observed a fellow nurse administer a viscous depot injection (4ml) into the deltoid muscle of a adult, small-built male. This seemed wrong to me but since I graduated from my primary nursing school almost 26 years ago and hadn't given many IMs in the past while working in surgery, I attempted to review current guidelines. However, I became more confused by the conflicting information on the internet (some sources suggest 5mls to be the maximum, some sources 4mls, some 2mls)? At any rate, I don't think the deltoid would have been the preferred site for this particular drug and I personally would have split the volume into two injections or opted for Ventrogluteal, Dorsogluteal, or Vastus Lateralis. What are your thoughts please?

[djh123]

I know what viscous means; I just hadn't heard of a viscous shot, nor have I heard of 'depot' related to any kind of injection. But my experience is *somewhat* limited.

[guest894451]

I work in acute psych (I give a lot of IM) and never give more than 2mL in the deltoid.

[TriciaJ, RN]

I know what viscous means; I just hadn't heard of a viscous shot, nor have I heard of 'depot' related to any kind of injection. But my experience is *somewhat* limited.

Depot injections are long-acting meds. My first experience with them was working in mental health and many antipsychotic meds are administered that way to outpatients. They're effective, fairly painless, and the patient doesn't have to remember to take a pill every day.

They're also used for hormone shots, like depo-provera which is a popular form of birth control for women, used in men to curb sexual deviance. Depo-testosterone is used for men with low testosterone levels and used for women who complain of low sexual arousal.

These are the uses I'm most familiar with. No doubt others have more information.

[klone, MSN, RN]

Interesting! I had no idea that's what "depo" or "depot" meant!

[JKL33]

Depo-Medrol another common one...

[prmenrs, RN]

I was thinking perhaps the pt. was restrained in such a way that his arm was the only available site?

[TriciaJ, RN]

I was thinking perhaps the pt. was restrained in such a way that his arm was the only available site?

He still has 2 arms. It would have been a lot faster to give two 2 ml shots simultaneously than to inject 4 mls of syrup. Also very unlikely that a restrained patient would be receiving a depo injection.

[Kooky Korky, BSN, RN]

I work in acute psych (I give a lot of IM) and never give more than 2mL in the deltoid.

I haven't either, except one pt who refused Haldol D 3 ml. in bigger muscle. He said he always got it in deltoid, and other nurses said they always gave it in his deltoid, and I didn't want him to not get it.

Turned out OK.