SubQ sites

[angelsfire]

It used to be acceptable to give subcutaeous injections (insulin) in the back of the shoulder (trapezius). It is no longer listed as a site. Does anyone know what the evidence-based reason(s) for this is? I am trying to help an older nurse change her ways! She wants reasons to stop a practice she was taught in school. Any help would be greatly appreciated. I have tried to research this, but can find no info.

[Reno1978, BSN, RN]

I don't have any information about injecting in the back of the shoulder.

I was taught to use abdomen, back of upper arms or outer thigh because absorption is the best from these locations, and there's usually ample subcutaneous fat there.

[angelsfire]

As was I, but this nurse also learned upper shoulder. It requires a 'from behind' approach, which is useful for some members of longterm care facilities who are already up in wheelchairs and wearing sweaters. It is an easy approach. But, it has apparently been negated as a site, because it is no longer mentioned. I did find it in a procedure manual from about 20 years ago. So they must have found some evidence-based reason to stop the practice.

[NamasteNurse, BSN, RN]

If she's been doing it forever it probably works, don't ya think? Let it go.

[nursynurseRN]

I was taught that anywhere ther is FAT a SQ can be given....

[Suethestudent]

I have found it, and you do not have to change her ways. It is in Taylor 6th ed, Fundamentals of Nursing Care, page 794. There is a diagram (fig 29-10) that shows a rear view and the whole back from the scapula to the last rib is shaded in. It states that the upper back is an acceptable subcutaneous site.

[Ebbrewer84]

I was just looking that up too in the Taylor book!

[Scarlette Wings]

i was taught that anywhere ther is fat a sq can be given....

fat?? omg i am a living pincushion all over my pudgy body.