shots to peds

[rebels25player]

im new to the er only been doing it for about 3 months now. i came from home health and this is really new to me. one of the most unadept areas for me is peds. you almost never see peds in our home health agency. being that i was not a new nurse my "preceptor" has basically just been like "here is a map come to me when u got any questions." for the most part it has been on problem. when **** gets crazy i go to her and she guides me through it (DKA, CODES and things like that). but she looks at me stupid when i ask questions that are not high risk situations.... so here is my question.....at what age is it to young to give a child a shot in the hip? we give almost all our er meds in the hip or iv. the only exceptions is tetnous. other than that its all hip. i gave a 5 year old a shot in the hip without thinking yesterday and it went well i think and there seemed to be adequate muscle there but afterwards her mother was like "she never gets them in the hip always in the leg or arm"......she was big to be 5...she it got me thinking...what is the guidlines on that? google search gave me just a bunch of mixed results not really addressing the question i am trying to ask...thanks for you input

[glutton4punishment]

I typically give kids their IM injections in the thigh. It's a large muscle, and usually can give quickly in this area.

[rebels25player]

yeah but what are the guidelines where u can quit doing the thigh and just hit the hip?

[mariebailey, MSN, RN]

I gave childhood immunizations for 3 years. The vastus lateralis (medial aspect of the anterolateral thigh) is the ideal site of injection for infants, toddlers, and even many preschoolers. For vaccines, you never administer in the ventrogluteal b/c of diminished absorption. When they reach 4 or 5, their deltoid is developed enough to administer them in the arm. However, it all depends on the child's body mass, not really their age. That requires some clinical discretion. I doubt a 6 month old who can't walk has a sufficiently developed ventrolguteal muscle, but your big 5 year old probably does. The medication to be administered should be considered when choosing the site as well.

[Esme12, ASN, BSN, RN]

A baby that has been walking for a year and up....if they are not walking they get their injections in the thigh.

Here is the guideline from the CDC

http://www2.cdc.gov/nip/isd/immtoolkit/content/products/HowToAdministerIM&SCInjectionsChildren.pdf

[mariebailey, MSN, RN]

A baby that has been walking for a year and up....if they are not walking they get their injections in the thigh.

Here is the guideline from the CDC

http://www2.cdc.gov/nip/isd/immtoolkit/content/products/HowToAdministerIM&SCInjectionsChildren.pdf

That was a tool developed primarily as a guide for administering immunizations, although it may be helpful with other meds. I just want to re-emphasize that you NEVER administer immunizations in the ventrogluteal muscle, regardless of whether or not they can walk.

[DC Collins, ASN]

That was a tool developed primarily as a guide for administering immunizations, although it may be helpful with other meds. I just want to re-emphasize that you NEVER administer immunizations in the ventrogluteal muscle, regardless of whether or not they can walk.

Thank you mariebailey, I have been an ED nurse for two years and didn't know that (I would always ask first anyway since we don't get peds that often in our ED, but its good to know!)

DC :-)