Ventrogluteal vs dorsogluteal

[Ruadh]

I recently began working in our county clinic and am giving many IM injections. Not only in the deltoid, but for meds that require injection into a larger muscle & instruct either dorsogluteal or ventrogluteal placement.

Of course, we were always told to aspirate when injecting in the dorsogluteal b/c of the dangers of hitting the bloodstream (and there's PLENTY of talk about that when you research it).

But when I research injecting in the ventrogluteal, I not only find the latest research showing it to be a superior injection site b/c for one thing, NO aspiration required (no fear for patient to need additional poke either!), but we are completely able to avoid some anatomical areas that exist near the dorsogluteal that could cause the patient injury---possibly permanent.

Whew! Now that I've described all that---I'm perplexed by WHY there is such LITTLE talk about this? And why do meds like Aristada & bicillin continue to include instructions to inject into the dorsogluteal only & neglect to mention ventrogluteal (?)----has not the research caught up with EBR?

Just hoping for others input here. Thank you for reading and for responding!

How to give VENTROGLUTEAL injections. – theNursePath

[DesertRosee]

In school when practicing IM injections we were taught both dorsogluteal and ventrogluteal injections. We were told that the ventrogluteal site is superior because of location like you mentioned in your post. It avoids the sciatic nerve which could be affected from a dorsogluteal injection. We were taught in lab to aspirate for all IM injections, but then in the same breath we were told in real world nursing we didn't have to aspirate. So it seems that there is conflicting information out there. As for why some medications require a dorsogluteal injection over a ventrogluteal I don't know why it seems to be outdated thinking.

[klone, MSN, RN]

Any injection that is appropriate for the dorso is also appropriate for ventro. I ONLY give ventro unless the patient absolutely insists. For the reasons outlined above (less risk of hitting nerve and no need for aspiration). The dorso is the only site in which aspiration is required.

I'm guessing why ventro is less commonly used than dorso is that many nurses don't know how to properly landmark it.

[quiltynurse56, LPN, LVN]

We were taught both in nursing school and it was emphasized to use the ventrogluteal over the dorsogluteal for the reasons stated.

Good for you for getting it out there for more nurses to learn about it who many not have in the past.

[magickbubble]

Thanks for posting this! Can Aristida be given in the Vastis Lateralis? That’s my fave site for large volume shots. The site mentions only gluteal and deltoid. After reading this post I think it is probably because they aren’t aware of current injection practices. Thank you!

[FolksBtrippin, BSN, RN]

I was taught vastus lateralis or ventro in nursing school. I do not give long acting injectables in the vastus lateralis though, because the pain is so much worse for the patient. I have consistently seen patients limping around for weeks after a long acting injection in the VL. Short acting too, but if it's an emergency, I prefer to do the VL rather than have staff forcibly flip someone and take down pants, which adds to the trauma of an involuntary IM.

For long acting, some patients also complain of more pain in the ventro than in the dorso. So they get the dorso. I always try the ventro first. Also, I did check with Aristada education to see if ventro is okay and it is.