Dorsogluteal injection site


The dorsogluteal, is rarely used due to its risk of  19 Mar 2015 The two most commonly referenced intramuscular injection sites are the dorsogluteal, ventrogluteal sides in the gluteal region for adults. Give the injection into the outer top part of the middle section. Vitamin B-12 shots are usually administered as intramuscular injections, meaning the best B-12 injection sites are predominantly anywhere that muscle is abundant. See the picture. There was wide variation in the volume of diluent used to reconstitute medications. Giving an IM injection is not a benign procedure: the complications reported are muscle fibrosis and contracture, abscess at the injection site, gangrene and  10 Sep 2003 On close questioning of the patient, it was discovered that the “ulcer” had occurred at the site of an IM injection of an antibiotic she had received  at the injection site. 95) mean scores of the nurses regarding the ventrogluteal site injection was statistically significant (P<0. Side Effects Selecting the Most Appropriate Site Choosing one of the approved locations and needle length for an IM injection seems arbitrary, but there is literature available to assist in decision-making. The ventorgluteal (VG) site has less subcutaneous fat and a thicker muscle mass than the dorsogluteal site with an almost certain probability of penetrating muscle with a standard needle. However, there are no measurements regarding the distances of these structures. d. Larkin, T. Therefore, vitamin B-12 injection sites include the upper arms, buttocks and thigh area. Although giving intramuscular (IM) injections to the horse is considered by many shock, infection, injection-site abscesses and ineffective drug administration. DA: 36 PA: 33 MOZ Rank: 13. The dorsogluteal muscle of the buttocks was the site most commonly selected by healthcare providers for many years. Best practice in intramuscular injections 1. A subcutaneous injection is an injection into the fatty tissue. Selecting the injection site requires correct identification of muscle groups by land-marking correct anatomical features (Hunter, 2008). Injection site-related events, including sciatica, neuralgia, neuropathic pain, and peripheral neuropathy, have been reported with FASLODEX injection The administration of intramuscular injections is a common nursing intervention in clinical practice. & Hickey, B. Ventrogluteal versus dorsogluteal site selection: A cross-sectional study of muscle and subcutaneous fat thicknesses and an algorithm incorporating demographic and anthropometric data to predict injection outcome. In their study, Floyd and Meyer (2007) stated that 99% of nurses use dorsogluteal. Potential sites for intramuscular injection: Dorsogluteal site The injection site is in the middle of the deltoid muscle, about 2. An IM injection is a shot of medicine given into a muscle (intramuscular). The dorsogluteal (buttock) site is not recommended for use in any patient population due to its location near major blood vessels and nerves, as well as having inconsistent depth of adipose tissue, with very few injections in this area injected to the correct depth to administer as a true intramuscular injection. Before doctors began using the hip as an injection site, they used the dorsogluteal muscles in the buttocks. 9. Fifty-eight second Ive been reading a lot about this and think I should be doing ventrogluteal instead of dorsogluteal injections. • Pain. , Elgellaie, A. 80±1. The evaluation of dorsogluteal and ventrogluteal injection sites: a cadaver study. 9 kg/m. Most AAS users consider the upper-outer quarter of the buttock, also know as the Dorsogluteal site (illustrated by the shading below), to be one of the best areas for steroid injections. Journal of Clinical Nursing, 25, 1112-1119. The ventrogluteal region has been recognized as a primary intramuscular injection region. 22 Jan 2019 Dorsogluteal injection site information and figures . . Deltoid. Free Returns High Quality Printing Fast Shipping To avoid injection into subcutaneous tissue, spread the skin of the selected vaccine administration site taut between the thumb and forefinger, isolating the muscle. Keep reading to learn about the benefits of ventrogluteal injections and how to The ventrogluteal injection site is the preferred injection site for adults and children over 7 months. The site should not be use in infant under 3 years because the gluteal muscles are not well developed yet. They tend to avoid using these muscles now because of the potential risk of injury to Dorsogluteal site. Coskun, H. - Self-Training and Evaluation of user's performance with Training & Evaluation mode. Authors Traditionally, intramuscular (IM) injection is regarded as a basic skill with tuition based on anecdotal rather than evidence-based research. Why is the dorsogluteal site considered a good location to administer an intramuscular injection to an adult? Definition The gluteal muscles are well developed and can absorb a large amount of medication. 7) I also correlated the depth at both sites with age administration of an IM injection is unnecessary and there is no clinical reason to suggest that these principles may not be applied when using the deltoid, ventrogluteal and vastus lateralis sites in other settings. DA: 16 PA: 4 MOZ Rank: 74 Larkin, T. Intramuscular injection of vaccines and medications into the deltoid muscle is a long-established nursing practice. Most people select the neck area to administer intramuscular injections due to convenience and safety (i. Site of injection. You can administer a Z-track injection through this site. • Asubcutaneous injection involves depositing medication into the fatty tissue directly beneath the skin using a short injection needle. A ventrogluteal injection is an IM injection into an area on the side of your hip known as the ventrogluteal site. Key words: Intramuscular injection, Injection site, Dorsogluteal site, Ventrogluteal site. Ventrogluteal site. The dorsogluteal site is not often used due to the danger of damaging the sciatic nerve (yellow), or hitting the superior gluteal artery (red lines). The Standard Precautions section of the 2007 Guideline for Isolation Precautions pdf icon [PDF – 226 pages] provides evidence-based recommendations for safe injection practices and reflects the minimum standards that healthcare personnel should follow to prevent transmission of infections in healthcare settings. Divide the thigh into thirds; the injection site is in the middle third section. How to Give Yourself a Testosterone IM Injection - 2 - Injection Site Vastus lateralis muscle in the thigh: Choose this site if are injecting to yourself, or if a caregiver gives you the injection. There is a range of types, and people use them in the treatment of diabetes and other conditions. Gloved hands of health care professional administering injection to dorsogluteal area. Uses this site only if no other sites are available. Your Use caution while administering FASLODEX at the dorsogluteal injection site due to the proximity of the underlying sciatic nerve. , Ashcroft, E. The injections are different for different sites, a separate injection is used for the intramuscular sites and different injection is used for the subcutaneous sites. Settings The importance of each evaluation item can be change by adjusting the score of each item. (2017). Hands up if you were taught to perform it using a Step 2: Prepare to Give Injection Injection Site . • VENTROGLUTEAL (VG) - Gluteus Medius Muscle The VG site is defined in some nursing literature to be an option for IM injection delivery, for volumes up to 4-5 ml. Injection site is in the middle of triangle formed by femur trochanter, anterior. Change sites for the injections: It is important to use a different site each time you give an injection. TearPad™ contains 50 sheets and is a cost-effective handout that can be given to each student. How do I choose the best place for a subcutaneous injection? Keep track of where the injections are given: Make a list of the sites you can use. Intramuscular injections can be futile if the exact site where it is administered is not conducive to the ready absorption of the drug. contraceptive injection via the ventrogluteal site compared to the dorsogluteal site? Getting Evidence in Clinical Practice: General Practice Nurse Evidence Based Practice (CAT group) Injection Sites Anatomical site of administration may need to be determined by individual patient assessment and circumstance. unlikely to get kicked). Figure 16a: The vastus lateralis site of the right thigh, used for intramuscular injections. We were told that the ventrogluteal site is superior because of location like you mentioned in your post. I know how to find it on someone else but i too was having an issue finding it on myself. Retrieved September 15, 2019 from www Pediatric injections administration is a very crucial and responsible work done by the medical assistant. Monina Hernandez Gesmundo, RN October 12, 2011 Auckland, New Zealand 2. 52 If the injection is administered into the gluteal region, use of the whole dorsogluteal region (commonly known as the upper outer quadrant of the buttock) lacks precision; the injection is less likely The TearPad™ has a second side that directs procedure steps for each injection site location. OUT: The Dorsogluteal IM injection site. The injection goes three fingerbreadths below the process. Results: The dorsogluteal site presents a risk of complications occurring during the injection procedure, attributable to the sciatic nerve and superior gluteal artery lying in this region. The ventrogluteal muscle area is often preferred for the administration of intramuscular injections, as it allows for the rapid absorption of the injected medication. This prevents scars ventrogluteal site reduce the risk for complications compared to using the dorsogluteal site? Summary of Key Evidence: Study #1 The aim of this literature review by Cocoman and Murray (2008) was to “review the practice of intramuscular injection and administration and also to evaluate injection sites and The reasons for preference of dorsogluteal and ventrogluteal regions were compared. The dorsogluteal site was identified using the quadrant method (Cocoman and Murray, 2008) and the ventrogluteal site was identified using the V method (Greenway, 2004, Nicoll and Hesby, 2002). This review was organized with the aim to compare reasons for the preference of dorsogluteal and ventrogluteal regions and to explain the basis of evidence. How do I choose the best place for an intramuscular injection? Keep track of where the injections are given: Make a list of the sites you use. Wrap the tourniquet around your arm just above the injection site. Figure 1. The ventrogluteal site is considered superior to the dorsogluteal site because it's farther from major nerves and muscles and provides faster medication uptake. Position client in supine or sitting position. Find patient medical information for Penicillin G Benzathine Intramuscular on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. An imaginary line is drawn between the two landmarks. 1 Steps for administering an intramuscular injection at the ventrogluteal site1,2 1 Instruct your patient to lie on his or her side and bend the knee of the leg chosen for injection. 00). Skip navigation Sign in. Write down the date, time, and the site each time you give an injection. Common sites are: Ventrogluteal- buttocks with landmark greater trochanter and anterior superior iliac spine; Dorsogluteal- buttocks with landmarks greater trochanter and posterior iliac spine Administer by DEEP INTRAMUSCULAR INJECTION in the upper, outer quadrant of the buttock (dorsogluteal) or the ventrogluteal site. Caution should be taken while administering fulvestrant at the dorsogluteal injection site due to the proximity of the underlying sciatic nerve [see Dosage and Administration and Adverse • Consider administering the medication by SC injection (NIAC 2013, DoH, UK 2013). to deliver medications to the dorsogluteal and ventro- gluteal muscles of healthy adults with a BMI of more than 24. The deltoid site The ease of access, especially in an outpatient setting, possibly adds to the frequency with which the deltoid site is used for IM injections. Caution should be taken while administering FASLODEX at the dorsogluteal injection site due to the proximity of the underlying sciatic nerve [see The dorsogluteal site using the gluteus maximus muscle, the traditional site in the UK (Campbell 1995). • Bleeding. There is no evidence for the need to aspirate the plunger when using the VG site. There are different sites such as ventrogluteal, dorsogluteal that can be used for gluteal injections. Gauge: Diameter of the lumen of the needle, which is usually between 16 and. (A) Dorsogluteal (posterior view): lateral, slightly superior to midpoint of Traditionally, nurses have been trained to inject large volumes into the dorsogluteal site; however, the ventrogluteal site is evolving as a safer IM injection site (see TABLE 1 for an overview of both methods). Dorsogluteal site: This site is never used in infants and small children. 26 Results The findings reveal that 50. Using the ventrogluteal site for intramuscular injection T HE EXTENT to which the ventrogluteal site is used in the UK for administering intramus-cular (IM) injections is unknown (Rodger and King Therefore, when a medication is administered to the ventrogluteal site, injection length should be determined and administrable amount of medication should be calculated depending on the sex and body mass index. Cleanse the site with an alcohol or antiseptic swab. I understand the site location but I have 2 questions: 1. How to Give an Intramuscular Injection. Withdraw the needle and apply light pressure to the injection site for several  11 Feb 2016 Aims and objectives The aim of this study is to measure the thickness of the muscles in the dorsogluteal and the ventrogluteal injection sites  The Dorsogluteal (often referred to as the Upper Outer Quadrant) has been Detail and illustrations below of four commonly recognized injection sites are  Sites of intramuscular iron injection or calcium injection extravasation. IM injection model. Considering the work on the subject done by Engstrom et al (2000); it have been found that majority of nurses prefer the dorsogluteal site in injection practices. • Tissue necrosis. 3. Since intramuscular injection an important duty of medical personnel, it is expected that this review will be useful to update their knowledge on this issue. Dorsogluteal muscles of the buttocks. 5,12,15,16 location was within the reported triangular ventrogluteal Hip (Ventrogluteal) Site For IM Injection 1. After an injection, swelling and irritation (inflammation) can occur at the site where the needle entered the skin. Alternate the injection site each time you inject to avoid soreness at any one sight. • Assist the patient to the proper position, and ensure his or her comfort. A. 6. Another common site for injection is the Ventrogluteal area of the Gluteus/Buttock region. (I'm not a Dr. Nurses in clinical practice continue to use and instruct student nurses in the use of the dorsogluteal (the large gluteal muscle in the buttocks) injection site as the  The sites that are most commonly utilized for IM injections include the deltoid muscle of the shoulder; the vastus lateralis of the thigh; and the ventrogluteal,  6 Aug 2019 Z track technique; ventrogluteal injection site; deltoid injection site; vastus lateralis; dorsogluteal injection site. Administering Intramuscular Injection Gloved hands of health care professional administering first stick of injection to dorsogluteal area. The upper buttock area is the area where most people have received injections. It is the knobby top portion of the long bone in your upper leg (femur). 4. Draw 4 lines to connect all the nine dots without lifting your pen from the paper. The dorsogluteal (buttock) site is not recommended for use in any patient population due to its location near major blood  However, this site is not common for self-injection, because its small muscle mass limits Vastus lateralis muscle of the thigh. Results: It was found that 34. Forthepurposeofthisreview,wehavefocussed on gluteal injection sites only (dorsogluteal and ventrog-luteal). 12 Sep 2013 Abstract. One method to locate the correct site is: Clinical Skills - Intramuscular injection sites for adults Find patient medical information for Morphine Intramuscular on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. administered to the ventrogluteal site would feel less painful than those administered to the dorsogluteal site. Owing to its proximity to the gluteal artery, aspiration when using the dorsogluteal site is recommended. The maximum recommended volume to inject in the dorsogluteal (aka "regular buttocks") site is 3 ml (3cc). Therefore, the dorsogluteal site reliably targets gluteus maximus, and the G-method ventrogluteal site was more reliable than the V-method ventrogluteal site to target gluteus medius in terms of presence and thickness. Inject medication slowly (around 10 seconds per ml), remove needle quickly, and gently apply pressure to site for 10 seconds. The ventrogluteal site is located halfway between the hip and the head of the femur. 5. Generally only limited injection volumes can be given by intramuscular injection: 2 ml in the deltoid and thigh muscles, and up to 5 ml in the gluteus maximus. Diagram showing how to locate the Ventrogluteal injection site. In fact, the generally preferred intramuscular injection site is the ventrogluteal muscle, which is easily located and associated with the lowest risk of nerve or blood vessel injury. Dorsogluteal Site ‒This site is no longer the preferred site for IM injection due to the presence of major nerves and blood vessels, the relatively slow uptake of medication compared to other sites and the thick layer of adipose tissue commonly associated with it ‒If the patient prefers to stand, they should toe-in on the leg to For infants, the IM injection site is the front outer side of the thigh. The injection will go in outer middle third. Affected individuals usually present with foot drop and this results in varying degrees of motor disability. When preparing to give an IM injection, examine the site to determine that there is adequate muscle tissue. Beyea and Nicholl (1995) cited several studies that have used * palpate the posterior superior iliac spine; place hand on site * draw an imaginary line to the greater trochanter, this line is parallel to the sciatic nerve * the injection site is lateral and superior to the line in the outer LUQ of the buttocks * can be injected to the left or right upper outer quadrant of the buttocks IN: The Ventrogluteal IM injection site. deliver the injection very slowly (preferably over two to three minutes), distracting the child throughout the injection. In last years, the ventrogluteal site is accepted as a more safe and suitable injection site than dorsogluteal site. An intramuscular injection will be successful: using a 32-mm needle at the ventrogluteal site for all males and normal-weight females and using a 38-mm needle for all females at the ventrogluteal site, and for all males and at least 98% of females at the dorsogluteal site. e. Because of the proximity to the sciatic nerve it is only used as a last resort in adults. Through the WHO Injection Safety programme and the Safe Injection Global Network (SIGN – whose secretariat is hosted by WHO), the organization demonstrates its commitment to preventing injection-related disease transmission for patients, health workers and the community at large, through the rational and safe use of injections. this site is composed of the thick gluteal muscles of the buttocks and can be used for adults and children with well-developed gluteal muscles: dorsogluteal site: who should this site not be used on? children under 3 yrs unless the child has been walking for at leat 1 yr. Allows the site to dry before administering the injection. (2011, May 9). 8. 2. they face. The injection site id lateral and superior to this line. Artwork showing the correct site for a dorsogluteal injection. Alternatively, you may administer the injection with the patient in a seated position. To determine whether subcutaneous fat, muscle, and total tissue thicknesses differ between the dorsogluteal and ventrogluteal sites, and whether theoretical injection outcome (intramuscular, subcutaneous, or bone contact) can be predicted by demographic and anthropometric data and described by an algorithm. Gloved hands aspirating syringe at dorsogluteal site of injection. This change in practice was communicated through CRC, - Ventrogluteal and dorsogluteal site injection practice; both side - The skin is made of soft silicon that leaves no needle marks with self-healing system - Fluid injection and Automated drain - Advanced Education method with touch screen & color display. The VG site is also sparse of any major innervating nerves or blood vessels whilst remaining Results: It was found that 34. and Senture, C. Injections are among the most common health care procedures throughout the world. (To determine the ventrogluteal site, place the ball of the opposing hand on the greater trochanter and index finger on the anterior superior iliac crest; form a V with the middle finger; the injection site is within the V. Of the four possible sites for IM injection, the authors found only one-the ventrogluteal-that had not been associated with any adverse effects whatsoever. Introduction Today, injection applications are the most commonly used forms of pharmacological treatment (Chung et As defined by the World Health Organization, a safe injection does not harm the recipient, does not expose the provider to any avoidable risks and does not result in waste that is dangerous for the community. • The administration of medication via the IM route. One of the most popular location choices for IM injections is the dorsogluteal site. 5 to 5 cm (1 to 2 inches) below the acromion process. As a result complications (numbness, pain, paralysis) occurred if the nurse injected a medication near or into the sciatic nerve. The appropriate injection site for the IM injection must be selected. It avoids the sciatic nerve which could be affected from a dorsogluteal injection. Injection site related events including sciatica, neuralgia, neuropathic pain, and peripheral neuropathy have been reported with FASLODEX injection. Special arrangements will need to be discussed and agreed and these special arrangements documented in the notes and on the prescription. Vertisis Custom Pharmacy is invested in the health and wellbeing of our patents and we are happy to offer videos and instructions on how to properly use and administer our products. Publication Details. Dorsogluteal site. Draw an imaginary line from the posterior superior iliac spine to the greater trochanter. Absorption is anyway poor with intramuscular injections, especially when you compare with intravenous injections, so wrong choice of site can easily lead to wastage. A, subcutaneous injection sites. First: Technically no difference, they are probably the same. There are dangers associated with erroneous performance of this task, particularly with dorsogluteal injections. You may have received an Locating The Dorsogluteal Injection Site. Search. 22 Feb 2013 Intramuscular injections offer improved treatment adherence, ease in monitoring of adverse effects, and multiple administration sites. 2, although the dorsogluteal site may be used for overweight and obese men, and the ventro- Position the client similar to the ventrogluteal site b. Home > Medical Reference and Training Manuals > > Figure 2-1. Nurses are required to perform gluteal intramuscular (IM) injections in practice. 40±6. Lippincott Williams & Wilkins 2003 ** Prior to administering an IM injection, refer to your procedure manual to determine the injection site utilizing body landmarks. INTRAMUSCULAR INJECTION. Locating the VG site. What i did was lie on my side and pulled my knee up towards my face. This is now the #1 injection site to use when giving an injection to a patient as there are the least amount of nerves and blood vessels in this area. The vastus lateralis site: a large muscle in the thigh free from major nerves and vascular structures. Divide one butt cheek into quadrants (fourths), halfway down the middle and halfway across. The dorsogluteal site is not to be used for intramuscular injections; instead, the ventrogluteal site is the preferred intramuscular injection site for adults and children. painful locations to receive an injection. Intramuscular shots are given at a 90° angle, in other words  IM injections are deeper than injections given under the skin. x 11 in. This injection site should also be accessed with the help of a partner. Including both Learn and Test modes, the online simulator offers three scenarios that test your ability to administer intramuscular injections into The ventrogluteal region is farther than the dorsogluteal region from neurovascular structures. The dorsogluteal injection site is in the upper outer quadrant of the buttock. That said, proper technique can at least minimize the possible damage. what should be avoiding when giving an injection at the dorsogluteal site? Gluteus medius was the thickest muscle at each injection site, and thicker at the G-method than the V-method ventrogluteal site. THAT is a remarkable statement. This allows the medication to be absorbed into the bloodstream quickly. The dorsogluteal site is not often used due to the danger of damaging the sciatic nerve. Ventrogluteal Im Injection Site Landmarks Hochsetter was the first who recommended the use of ventrogluteal injection in 1954 place of injection is easy to find, because it is based on anatomic landmarks. The injection site is generally three finger widths below, in the middle of the muscle. It is an IM injection site (Appendix SOP/PD/230_01/A1b). Contact with sciatic nerve Contact with the superior gluteal artery Too much fatty tissue – poor absorption rates. Find the lower edge of the acromial process and the point on the lateral arm in line with the axilla. To locate this area, lay three fingers across the deltoid muscle and below the acromion process. Commonly used for administering medications deep into the muscle tissue. There really is no debate in the medical community. A framework for safe practice is included, identifying important points for safe technique, patient care and clinical decision making. With an alcohol wipe draw a horizontal line Firstly, the dorsogluteal (DG) site as this is the site I used when giving IM injections in line with the local trust policies and procedures. Look at your thigh and divide it horizontally into 3 equal parts. Additional  31 Aug 2015 Not getting an IM injection right can lead to a number of problems, depending on the patient, site of injection and volume of drug administration. DEUF and DEI measurements were made above and outside a line drawn from the posterior superior iliac spine to the greater trochanter of the femur. Or, divide the buttock into quadrants and inject in the upper outer quadrant, about 2” to 3” below the iliac crest. Ventrogluteal vs Dorsogluteal The dorsogluteal approach Risks associated with an IM injection to the dorsogluteal site. While dorsogluteal muscle is associated with sciatic nerve injury it remains an option in practice (Wynaden et al, 2006; Small, 2004). c. Discover how to locate the vastus lateralis injection site and other IM landmarks when giving lipotropic B12 intramuscular injections. For the ventrogluteal injection administered from the same side, total thickness of the muscle was 22·22 ± 5 mm, distance to the superior gluteal artery was 13·87 ± 16 mm and distance to the superior gluteal nerve was 11·82 ± 14 mm. Cleanses injection site with alcohol prep pad (or other antiseptic swab) by circling from the center of the site outward. Complications. Administering Intramuscular Injections An intramuscular injection will be successful: using a 32-mm needle at the ventrogluteal site for all males and normal-weight females and using a 38-mm needle for all females at the ventrogluteal site, and for all males and at least 98% of females at the dorsogluteal site Understanding Post-Injection Inflammation. • Abscess. An intramuscular injection is a technique used to deliver a medication deep into the muscles. Dorsogluteal. The dorsogluteal muscle is in the upper outside quadrant of the buttock. Injection site is the middle third and anterior lateral aspect of the thigh. The thigh is a good place to give Although the dorsogluteal region is frequently used for intramuscular injections, the ventrogluteal region is suggested as a more secure injection site due to its distance to the neurovascular structures. 1% use the VG site and 23. Inexperience with injection techniques and inaccurate landmarking can result in injection-site pain or injury if a dorsogluteal injection is given too low. The following are sites for injections. The video above and the information provided will help you by providing step by step instructions on how to self-administer an intramuscular (IM) injection. The arm site can only be used for a very small amount of medicine. Hirnle, 4th ed. The 8-1/2 in. 3 Injection Site Reaction Injection site related events including sciatica, neuralgia, neuropathic pain, and peripheral neuropathy have been reported with fulvestrant. Complications from IM injections can include abscess formation, induration or a lump at the site, redness, persistent pain, bruising and bleeding. Use an alcohol pad to prepare the injection site by cleaning in the center and working Review of the literature on relevant injection procedure found that injury to the sciatic nerve is associated with use of the dorsogluteal site for injection, because the sciatic nerve commonly Intramuscular dorsogluteal injection site. 19 Sep 2018 This muscle is a very safe injection site for adults and infants more than 7 avoid self-administering medications into the dorsogluteal muscles. ) It is able to safely handle a 5cc injection, according to JAMA. A Ventrogluteal injection can be one of the most useful spots for a health professional to use. A different clinical practitioners often preffer dorsogluteal site. specific medication, injection into the dorsal gluteal is not recommended since this site is close to the sciatic nerve. In medical care, an injection is the introduction of a drug, vaccine, contraceptive or other therapeutic agent into the body using a needle and syringe. vastus lateralis, is recommended as a choice of site for intramuscular injection in infants up to seven months of age (2,3,8,15) because it is well de-veloped at birth (1). Which of the following should the nurse consider when giving an injection in this location? Injecting medication at this site may cause damage to the sciatic nerve The registered nurse identified, and marked on the skin, the ventrogluteal and dorsogluteal injection sites bilaterally for all participants. The ventro-gluteal injection site is the site of choice for ANY intramuscular injection. Injection techniques Good injection practice relies on accurate site selection using anatomical markers. This Life/form® Intramuscular Injection Simulator is manufactured by Nasco and sold by GTSimulators. When selecting injection sites, health providers think about the patient's general health, the type of medication being One reason dorsogluteal injuries are so common may be the subjective nature of locating this injection site. The upper outer quadrant of this area must be used to avoid any damage to the sciatic nerve. dorsogluteal injection site. Intramuscular injection sites: dorsogluteal site (a), ventrogluteal site (b), vastus lateralis site (c) and deltoid site (d) - "Intramuscular injection CLIMAT pathway: a clinical practice guideline. It should not be forgotten that among potential complications of IM injection are abscess, cellulites, tissue Giving an IM injection into the Vastus lateralis site. Caution should be taken while administering Fulvestrant Injection at the dorsogluteal injection site due to the proximity of the underlying sciatic nerve [see Dosage and FIGURE 64-8 · Intramuscular injection sites. To locate the site, the nurse draw an imaginary line from the greater trochanter to the posterior superior iliac spine. A nurse chooses the dorsogluteal site on a patient in which to administer an intramuscular injection. If a series of injections are to be given, the injection site is usually varied or rotated. This site been used by nurses for years as the target of choice for IM injections. Caution should be taken while administering FASLODEX at the dorsogluteal injection site due to the proximity of the underlying sciatic nerve [see To mark this site, place the palm of your hand on the shoulder and spread your thumb from the other 4 fingers in an upside down V shape. It was determined that the difference between pre-training (12. 5cm below this. Knowledge regarding safe injection practice is therefore vital for nursing students. C Carefully select the site for injection to miss blood vessels and nerves. " Step 2: Selecting and Preparing the Injection Site . 0 comments: Post a Comment. Injection Site Reaction Injection site related events including sciatica, neur algia, neuropathic pain, and peripheral neuropathy have been reported with FASLODEX injection. This helps prevent scars seen as an alternative site and the disadvantages of dorsogluteal site with the results of studies and literature reviews. Unfortunately complications are associated with this site as there is a possibility of damaging the sciatic nerve or the superior gluteal artery if the needle is misplaced. In the past the dorsogluteal site was very popular, however due to potential complications such as sciatic nerve injury or superior gluteal artery injury it is now not recommended. because shots to the butt arent recommended anymore! The dorsogluteal site for IM injections is the one nurses have the most experience using, as this is what is traditionally taught in nursing schools and covered in nursing textbooks. Vastus lateralis reason for pulling back on the syringe's plunger during an injection as well as the most common site for an 12-­­14 The ventro-­­gluteal IM injection site is now suggested as the safer region for gluteal IM injections, although the dorsogluteal site does remain popular in the mental health sector and by many other clinicians. Drug and biological product administration via intramuscular injections using hypodermic needles has been a common medical practice for several centuries and is not going anywhere soon —from vaccines, antibiotics and insulin to an experimental injectable male contraceptive in development. Find the trochanter. 1 The main ventrogluteal site when the dorsogluteal site presents a challenge. The deltoid muscle is the preferred site for intramuscular injections to adult clients in community settings, as it requires Injection-related bacterial infection may cause cellulitis (subcutaneous fatty tissue inflammation) or abscesses, for example, subcutaneously or intramuscularly. BACKGROUND Although the dorsogluteal region is frequently used for intramuscular injections, the ventrogluteal region is suggested as a more secure injection site due to its distance to the neurovascular structures. It was reported that a lot of health staff is not aware of the advantages of ventrogluteal region. 6 The dorsogluteal site is the upper outer quadrant of the buttock. Biography Injection site related events including sciatica, neuralgia, neuropathic pain, and peripheral neuropathy have been reported with fulvestrant injection. ScienceDaily. 2% of the nurses use the DG site, 26. If the dorsal gluteal site is selected, aspirate prior to the injection. The deltoid muscle is usually the best site to administer injections in adults, but medications with volumes greater than 2 ml should be injected in a large muscle groups like the ventrogluteal. To determine the proper needle length for your patients’ vaccinations, the first things you need to consider are the route of injection — whether it is intramuscular (IM) or subcutaneous (SC) — and the anatomic site of the injection. Vastus Lateralis Dorsogluteal . You will always want to the injection in the outer, upper quadrant, almost toward the hip. Question lacks the critical detail of injection site since there are four major sites of IM injection (see below from 1), and each has specific I understand the site location but I have 2 questions: 1. Lots of different size and color combinations to choose from. 5 inches in length, adjusted for thickness of site. Most nurses don’t use recommended intramuscular injection site despite potential risks, study finds. - Adminster Intramuscular, Subcutaneous, and Intradermal Injections Dorsogluteal site . Step-by-step guide to administering the intramuscular penicillin injection with lignocaine Equipment needed 1. Symptoms of cellulitis are pain and soreness around the injection site, redness and induration on the injection site, and fever. The Dorsogluteal (often referred to as the Upper Outer Quadrant) has been traditionally the choice site of IMI medication administration (Greenway 2004); however, research Short answer Pain a few days after an intramuscular (IM) injection could mean it wasn't done properly. The injection site is the upper outer quadrant. Your doctor will tell you whether your medication is injected into subcutaneous tissue or intramuscular tissue. The appropriate choice of injection site helps prevent complications—for example, dorsogluteal injection should be avoided in obese patients and to prevent any nerve injury. Or it may be a reaction to both. First, clean the injection site with isopropyl alcohol. It's easy to locate and the muscle mass in that area makes the ventrogluteal injection an ideal site for administering drugs. Key words: injection, intramuscular, dorsogluteal region, ventrogluteal region Dorsogluteal site. Intramuscular Injection Guidelines for Needle Length and Gauge Selection* * Adapted from Fundamentals of Nursing: Human Health and Function, R. This article, the second in a series of two, reviews the evidence base to inform safer practice and to consider the evidence for nursing practice in this area. Mental health areas commonly  20 Apr 2019 Injections are most commonly administered IM (intramuscular) or SC Locate the injection site by placing the heel of your hand over the  needed to make this compilation study for discuss the advantages of use of ventrogluteal site towards dorsogluteal site in intramuscular injection applications   There are 4 sites we can use for Intramuscular or IM injections, though 3 of them are the most common. Before leaving the patient's room, instruct the patient to immediately report any unusual reactions to the medication, such as injection site pain, redness, or swelling, to the nursing staff. Locate by identifying the greater trochanter and lateral femoral condyle. Furthermore, the results also revealed that neither site should be used in women whose BMI is more than 24. Intramuscular dorsogluteal injection. The volume of medication that can be administered intra-muscularly varies based on the intended site. Quiz & Worksheet - Intramuscular Injections Quiz; Dorsogluteal. It is located by dividing the buttock into four equal quadrants. What Are the Three Muscles Commonly Used As Sites for Intramuscular Injection? Intramuscular injections are given primarily in three locations: the vastus lateralis muscle found in the thigh, the deltoid muscle found in the shoulder and the ventrogluteal or dorsogluteal muscles found in the buttock, according to Healthline. Do not use the inner thigh or back of the thigh. When giving the injection the needle should be held at an angle of 90 degrees. The muscle that is injected into at this site is the gluteus medius. Vastus Lateralis. The size of  Needles for IM injections can be 22-23 Gauge, 1-1. The dorsogluteal site: the injection is administered into the gluteus maximus muscle in the buttock. Both surveys cited an impressive body of literature demonstrating that some complications of IM injection are linked specifically to the injection site. However, this site is close to the sciatic nerve and the superior gluteal nerve and artery. Consumer information about the medication HALOPERIDOL DECANOATE - INTRAMUSCULAR INJECTION (Haldol), includes side effects, drug interactions, recommended dosages, and storage information. B, intramuscular injection site for children in the vastus lateralis muscle. Newer Post Older Post Home. The dorsogluteal area is a common IM injection site (see Fig. Artwork showing the correct site (red square) for a dorsogluteal injection. Shop Dorsogluteal injection site, artwork Golf Balls designed by Science-Photo-Library. Conclusion It can be stated that the majority of the nurses did not prefer the ventrogluteal site for intramuscular injection; the reasons for not preferring this method were a lack of knowledge While it not uncommon to have localized swelling or redness for a day or two following an injection (or even longer for certain types of intramuscular shots), those that are deeply felt, tender to the touch, or accompanied by fever, body aches, or creeping discoloration should never be ignored. Another technique, acceptable mostly for pediatric and geriatric patients, is to grasp the tissue and "bunch up" the muscle. Nurses in Turkey tend Dorsogluteal site. It also highlights the ongoing debate in selection of intramuscular injection sites, predominately the ventrogluteal and dorsogluteal muscles. CAUTION - Injections into the dorsogluteal muscle have been associated with sciatic nerve injury. Most of the nurses used the dorsogluteal site for injections. • Apply pressure to the injection site for 1-2 minutes after the injection (NIAC 2013) Gently pull the skin with your non-dominant hand, 1cm laterally to the injection site Hold this position until the medication has been injected the dorsogluteal site was primarily used for intramuscular injections. Deltoid . Published: 2014 Region: British Columbia (BC) Audience: Health Care Professional Product Type: Video Language: English Population: Adults Organization:  7 Mar 2017 Pain a few days after an intramuscular (IM) injection could mean it wasn't done properly. Then exit the patient's room and thoroughly wash your hands again. This site is not used very much in health care settings due to close proximity to sciatic nerve and major vessels. Objectives. Insert the needle 1 Gluteus medius was the thickest muscle at each injection site, and thicker at the G-method than the V-method ventrogluteal site. Vocabulary words for Injections Sites. Method for establishing the dorsogluteal site for injection . Best Steroid Injection Spots . Ventrogluteal - Definition, Injection site and Technique mddk. Be careful to identify the correct location because permanent damage to the body  31 Jan 2012 However, as a precaution, it is best to cleanse the injection site and use a sterile one-time use syringe or pen needle when administering an IM . You could accidentally inject medication into the superior gluteal artery, leading to increased absorption or hemorrhage. They are usually given by a health care professional in a clinic or office. Chemotherapy . D, injection site in the buttock (dorsogluteal site). You can use the buttock, hip, upper leg or upper arm for an IM shot. Risks associated with an IM injection to the dorsogluteal site Contact with sciatic nerve Contact with the superior gluteal artery Too much fatty tissue – poor absorption rates. Generally, 1 to 4 mL is the accepted volume range, with no more than 1 mL given at the deltoid site. However, if the cortisone injection is not done under an x-ray machine (fluoroscopic c-arm) then it could be that the cortisone injection may be just that an injection into the muscle like a trigger point injection. E, injection site in the anterolateral thigh (ventrogluteal site). The landmarks for this site are the posterior superior iliac spine and the greater trochanter. The dorsogluteal muscle is the large muscle on the rear end or the buttocks. 3 Injection Site Reaction . Bleeding, soreness, or redness at the injection site; Allergic reaction to the medication; Infection  greater trochanter. Although almost all of the nurses indicated that they routinely rotated injection sites, they infrequently used sites other than the dorsogluteal site. Site for 1-4mL injection volume. Large-volume IM injections: A review of best practices intramuscular injections offer improved treatment adherence, ease in monitoring of adverse effects, and multiple administration sites feature | Large-volume IM injections Dorsogluteal site fIGure 1a. DA: 16 PA: 4 MOZ Rank: 74 clinical practitioners often preffer dorsogluteal site. Intramuscular injections require a thorough and meticulous approach to patient assessment and injection technique. This article aims to raise awareness of the use of the ventrogluteal site for administering intramuscular injections. 2 Therefore, when giving gluteal injections Print Injections sites flashcards and study them anytime, injection site is the middle third, anterior lateral (side) aspect of the thigh. The ventrogluteal site is located further from any neurovascular structures and so poses less risk of injury. apply pressure on the injection site with your thumb for 10 seconds before inserting the needle 7. The deltoid 6. •Administer SQ or IM vaccines without aspiration prior to injection (1). , Kilic, C. "Selecting the injection site for the administration of IM medications is very important. An alternative approach is to place four fingerbreadths across the deltoid muscle with the top finger on the acromion process. Palpate the lower edge of the acromial process and inject approximately 2. Dons procedure gloves. Can you inject in both this site AND the dorsogluteal (aka "regular buttocks") site? 2. (2016) The Evaluation of Dorsogluteal and Ventrogluteal Injection Sites A Cadaver Study. When doses are repeated, vary the injection site. 16-18 A Intramuscular injections resulting in nerve damage are fairly common, especially in children. To locate this site you must make imaginary (or draw it if it's easier) lines to split the butt cheek into four equal areas. There are five sites where a IM injection can be administered: dor-sogluteal, ventrogluteal, vastus lateralis, rectus femoris and deltoid[10]. What is the maximum recommended volume to inject The resulting inverted triangle is the deltoid site. Learning to give an intramuscular (IM) injection may become a necessity if you, or a family member, suffer from an illness that requires injections of medication. C, D, and E, intramuscular injection sites for adults: C, deltoid muscle injection site. Ventrogluteal Injection Site: Email This BlogThis! Share to Twitter Share to Facebook. Statistically meaningful difference between the choice of the site and the reasons of the choices is found (p<0, 05). Since the medication was given for pain, I'll assume it was an intramuscular injection. • Cellulitis. but that statement is based on all the reading I've done. Remove the pad and check the site for bleeding or bruises. Selecting the right needle, and in particular its Risks Associated with Intramuscular Injections in the Dorsal Gluteal Site Chelsea Craig and Joanna Huschilt Cedarville University School of Nursing PATIENT CARE ISSUE Background & Significance In the past the Dorsal gluteal injection was considered the preferred intramuscular injection site; however, recent research has suggested that there is Dorsogluteal site. Therefore, care must be taken to identify the site correctly. In school when practicing IM injections we were taught both dorsogluteal and ventrogluteal injections. Anterolateral thigh muscle, m. tion is choosing the site of medication delivery. AIMS AND OBJECTIVES The aim of this study is to measure the thickness of the muscles in the dorsogluteal and the ventrogluteal injection sites and to determine which injection site is farther away from the neurovascular structures. This site is difficult to use for self injection due to the inability for most people to turn around and inject themselves. Give the injection at the middle of the V. Ultrasono- graph probe was held at right angle to the skin at the gluteal region. However, due to the potential for injury to the sciatic nerve, the ventrogluteal is most often used now. 0% of the nurses frequently used the dorsogluteal site for intramuscular injection. The injection site varies with the age of your child. Gluteus maximus, medius and minimus muscles are commonly used as regions for IMI. Make sure that the middle of the arm is centered in your V. Select the best site to administer the intramuscular injection. The deltoid site The ease of access,especially in an out-patient setting, possibly adds to the frequency with which the deltoid site is used for IM injections. Insert the needle at a 90-degree angle above and outside the drawn line. Has the patient lie prone. The buttocks Image credit: British Columbia Institute of Technology (BCIT), 2017. Gluteal = 2 inch needle supplied common to all injection sites, use of the dorsogluteal site that includes the provision of information and education carries specific and additional risks, mainly relating to the to student and qualified nurses and other practitioners, and presence of the sciatic nerve. It is about the size of a golf ball. Use a 22- to 25-gauge needle. Four fundamentals of nursing textbooks and current literature, including literature reviews, were reviewed to compare recommendations for the use of the dorsogluteal site, Z-track method, aspiration and bunching and flattening when administering an intramuscular injection. Intravenous injection technique is considerably more complicated and more dangerous than other types of injection. 7. (2008) also stated that the dorsogluteal site is a site used for intramuscular injection; the adipose tissue in this site is thick and the injection is often applied to the subcutaneous adipose tissue instead of the muscle tissue. 3. Other intramuscular injection sites are located in the lower body. This video demonstrates the dorsogluteal injection site. Dorsogluteal angle Administration of intramuscular injections involves attention to the appropriate site of needle insertion, needle size and angle of injection. The nurses frequently prefer dorsogluteal site for administering IM injection, their knowledge about the complications which may develop in the sites they select for IM injection is insufficient, the unit where the nurses work and duration of experience in that unit affect their selection of site in IM injection administration. 6 Some patients for cultural, religious or personal reasons may be sensitive to the site used for administration and/or the gender of the person administering the injection. Craven, C. giving an IM injection and the reasons behind their choice. (A) Dorsogluteal (posterior view): lateral, slightly superior to midpoint of line drawn from trochanter to Training will be evaluated in detail by the injection site, depth, the accuracy of injection and the checklist according to the own curriculum. The gluteus medius in the buttocks is one option, as is the vastus lateralis in the thigh and the ventrogluteal intramuscular injection site in the hip. Taylor et al. Dorsogluteal Site: Inject above and outside a line drawn from the posterior superior iliac spine to the greater trochanter of the femur. 20,23-25 This risk can be I did this as my 3rd site in a rotation. I have also done a video on how to locate this sweet spot on the TRT Hub YouTube Channel. 89) and post-training (21. Places alcohol wipe on patient’s skin outside the injection site, with a corner pointing to the site. Intramuscular injection sites Good diagram, but note: dorsogluteal is no longer a preferred site due to the sciatic nerve. Accidental injection into the sciatic nerve may cause pain and temporary or permanent paralysis of the lower This is the preferred site for infants and children 7 mo. The dorsogluteal muscle is the large muscle located in your buttocks. Question lacks the critical detail of injection site since  IM injection site - horse's neck Injection site in a horse's neck, marked by the cross in the triangle formed by the scapula (red line), cervical spine (green line) and  The following are sites for injections. se tissue is thinner than the dorsogluteal site (8,15). Answers from doctors on dorsogluteal injection. The reaction may happen right away. To use the dorsogluteal site, assist the client to a side-lying or prone position. This is "Dorsogluteal IM injection" by Low T Training on Vimeo, the home for high quality videos and the people who love them. Some people needing injections The dorsogluteal injection site I want to especially highlight the fact that they do recommend aspiration for the dorsogluteal muscle, as I have injected here before and published videos on this injection site. The aim of the study was to examine the effect on pain of medication administered by intramuscular injection to the dorsogluteal and  The aim of the study was to examine the effect on pain of medication administered by intramuscular injection to the dorsogluteal and ventrogluteal sites, and to  25 Nov 2010 An intramuscular (IM) injection is giving medicine with a needle into the muscle. Dorsogluteal Muscles Gluteal intramuscular injection sites — the dorsogluteal and ventrogluteal — combine with the upper arm's deltoid muscle and the thigh's vastus lateralis to provide eight potential sites for an IM injection. The Nasco Life/form Intramuscular Injection Simulator offers both visual and tactile learning and is always available for class demonstrations or practice by groups of 1 to 30 students. How to Give an IM Intramuscular injection in the Buttocks | Dorsogluteal Hip Injection Technique The effect of air-lock technique on pain at the site of intramuscular injection. This site is difficult to use this site for self-injection and not recommended. This teaching aid will enhance intramuscular injection skills teaching and training. This requires complete exposure of the selected site. Wiley-Blackwell. Review of the literature found that injury to the sciatic nerve is associated with use of the dorsogluteal site for injection. Nurses in clinical practice continue to use and instruct student nurses in the use of the dorsogluteal (the large gluteal muscle in the buttocks) injection site as the site of choice for intramuscular injections, despite abundant evidence regarding the complications associated with using this site. To inject into the site, the needles must be 16mm to 22mm long. Secondly I will discuss the ventrogluteal (VG) site, as recent literature has shown this site to be the safest to use when administering IM injections. 6 Jul 2017 ABSTRACTIt is becoming increasingly important for clinicians to identify a safer intramuscular (IM) injection site in the deltoid muscle because  The skin at the injection site should be visibly clean prior to administering a vaccine. But I am wondering if anyone has tricks for making sure you have the right landmarks. This is a reaction to the needle or to the medicine that was injected. Arrows point to approximate locations of the injection sites  9 May 2011 Seven out of ten hospital nurses who took part in a Canadian study used the dorsogluteal (DG) buttock site to administer intramuscular  3 Aug 2018 Some medicines need to be given into a muscle to work correctly. In neonates, infants and small children, the midlateral aspect of the thigh may be preferable. Five videos have been produced to assist in locating the four accepted intramuscular injection sites using anatomical markers as well as the Z track technique which should be used with all injection sites. Definition The ventrogluteal area is the area in which intramuscular injections are performed. However, the muscles in the  Below are some more details surrounding the common sites used for IM injections, however these are brief notes and therefore  The CDC recommends against aspirating during IM injection of vaccines (2017). Key words Intramuscular injection, Ventroglueal site, Dorsogluteal site, Pain 1 Introduction Intramuscular injection (IM) is a common practice which causes pain and discomfort to patients [1]. Be careful to identify the correct location because permanent damage to the body can occur if the injection reaches Previously, the dorsogluteal site was widely accepted and used, but current evidence has demonstrated that it is not acceptable due to its high risk for injury. But nearly three-quarters of nurses injected at the dorsogluteal site, even though they knew the potential for nerve damage when using the site. Removes the needle cap. com This module explains how to prepare for and administer intramuscular injections into the various sites (deltoid, vastus lateralis, dorsogluteal, ventrogluteal) using powdered and liquid medication. Avoid any areas with lesions, trauma, inflammation, or bony prominences. Sites for IM (Intramuscular) Injection (Shot) The medicine you are taking is to be given into muscle (IM) as an injection or shot. The less-developed muscles ofchildren and elderly people limit the intramuscular injection to 1 to 2 mL INJECTION SITES. The most common approach to finding the injection location is to divide the buttocks into quarters and target the upper outer quadrant. • There are 3 Gloves are often worn when injecting cattle i) for cleanliness . To locate the best place for an injection site in the buttock muscle, expose one entire buttock. Visit the page on CDC’s role in safe injection practices. Intramuscular injection site in the buttocks (upper, outer quadrant). The advantage to this site is that it is reasonably free of major nerves and vascular branches. The recommended injection site is the middle third of the vastus lateralis  17 Jan 2017 While intramuscular (“'IM”) injection in the buttock region is a commonplace the ventrogluteal site is preferred to the dorsogluteal site. 6%use both sites. Or it may only begin hours after the injection. Dorsogluteal Site 7. Sound nursing judgment needs to be exercised when choosing an appropriate injection site, however. Before administering the medication, aspiration should be applied taking into account of the characteristics of ventrogluteal site. VG is a great spot, One of the best things about this injection site is that it offers you the freedom to inject when ever you want, with almost any amount of compounds per injection. • Locate the proper site for the injection. It is found in the area of the superior lateral aspect of the gluteal muscles, commonly known as the upper outer quadrant. dorsogluteal injection site

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