Rhogam in a very thin patient

klone, MSN, RN · Oct 17, 2014

Our prefilled syringes still come with separate needles that you have to screw on with a leur lock. In that case, I would choose a 1" needle, but I find that at 28 weeks, most women have at least a little padding on their hips and a 1 1/2 still works. If that's not the case, then I would just be very measured when I jab the needle in, and don't put it all the way in to the hub.

Oedgar · Oct 18, 2014

Would you give this ventrogluteal, dorsogluteal, or vastus lateralis? The pt had a bad experience previously with a deltoid injection and probably won't be ok with deltoid site. I thought I read somewhere that deltoid was the ideal for absorption? She is a pretty low bmi.

klone, MSN, RN · Oct 18, 2014

Our facility's preferred sites for IM is VG or deltoid, due to lack of major blood vessels and nerves. However, I would never give Rhogam in the deltoid, so I always give it in the VG. The only time I ever do dorsogluteal is with Depo, and only when they specifically request it (otherwise I say "arm or hip?" and then give it in either the deltoid or ventro). The only time I've ever given an adult an injection in the vastus lateralis is with methergine (faster uptake than with the gluteal region).

Katie71275 · Oct 18, 2014

I never do these anymore since I work L&D, and they get them in PP after delivery or at the clinic at 28 weeks, but when I have had to give them I give them VG. I've never given one in the deltoid, and I am also A- and have gotten them vg with every pregnancy. Also, with the thin patient, I had a similar thing yesterday except it was with methergine and I gave it vastus lateralis, and her legs were TINY, so I didn't insert the needle completely....I would have been to the bone if I had.