Dorsogluteal Injection Site

Dorsogluteal Site

• The major muscle groups associated are the Gluteus Maximus Muscles
• Avoid the superior gluteal artery and the sciatic nerve when using this site
• Posterior means back of the body
• Superior means above or towards the head
• Lateral means farther from the midline of the body
• Bony landmarks are the posterior superior iliac spine and the greater trochanter of the femur
• Locate the posterior superior iliac spine and the greater trochanter
• Draw an imaginary diagonal line betwixt the posterior superior iliac spine and the greater trochanter
• From the midpoint of the imaginary line, go superior 1 inch and lateral 1 inch to inject
• This site is not preferred due to its proximity to the sciatic nerve and major blood vessels
• Bigger nerves in the area may cause more pain
• Useful for large volume medications and easily accessible
• Maximum amount injected is up to 3mL
• Needle length and syringe size include a needle length adult of 1-1½ inches and syringe size of 1-3mL

Ventrogluteal Site

• The ventrogluteal site includes the Gluteus Medius, Gluteus Minimus in the hip
• Major blood vessels and the superior and inferior gluteal artery should be avoided
• Also avoid the sciatic nerve
• Anterior means front of body
• Posterior means back of the body
• Superior means towards the head
• Anatomical landmarks include the greater trochanter, anterior superior iliac spine, posterior superior iliac spine, and iliac crest
• Place the palm on the greater trochanter
• Thumb points facing towards the front of body
• Pointer finger should be placed on the anterior superior iliac spine
• Middle finger should be straight up on the ridge of the iliac crest
• Boundary that keeps from injecting too high is the middle finger
• Boundary that keeps from injecting too low is the greater trochanter
• Palpate the greater trochanter and place the palm of your hand on it with thumb facing towards the front of body
• Palpate the anterior superior iliac spine with index finger and place index finger on the ridge on the iliac crest
• Spread middle finger posteriorly along the bony ridge of the iliac crest towards the posterius crest
• Injection site is at the center of the triangle formed between index and middle fingers
• Disadvantage is that it is difficult to locate the site
• This is the safest injection site because it is free of major blood vessels and nerves
• Maximum amount of medication injected into the is up to 3ml(adults) and up to 1mL(children)
• Needle length (adult) is 5/8-Inch to 1-inch, 20-25 gauge needle based on solution given and syringe size is 1-3ml

Vastus Lateralis Site

• Primary muscle group is the Vastus Lateralis Muscle
• The muscle is located on the lateral side of the thigh
• Inject the lateral side in the middle of the muscle
• Artery to be avoided is the femoral artery
• Nerve to be avoided is the femoral nerve.
• Landmarks for the vastus lateralis site include the greater trochanter and lateral femoral condyle
• Place one hand breadth above the knee at the lateral femoral condyle
• Place one handbreadth below the greater trochanter
• Find the middle third between the greater trochanter and knee
• Inject on the side lateral side in the Middle
• Disadvantage is pain
• Advantages are safe, rapid absorption, and is recommended for injection in infants, children and adults
• Maximum amount injected is adult (1-2ml up to 3ml) and children and infant (0.5ml-1ml)
• Needle length is 1-1½ inch for adults, 5/8-1inch for infants, 1-1¼inch for children and syringe size is 1-3ml

Deltoid Site

• Primary muscle group is the Deltoid Muscle
• Inject into the fullest part
• Shaped like a triangle
• Avoid the branchial artery
• Avoid the radial nerve
• Anterior is near the front of the body
• Posterior is near the back of the body
• Anatomical landmarks include the acromion process, deltoid muscle, and injection site
• The lowest boundary is not lower than the axillary line
• The highest boundary is the acromion
• Find the acromion process, which is the point of the shoulder where the scapula meet the clavicle
• Place little finger on the acromion process and Measure 3 finger breaths down
• Inject at the fullest part of the deltoid, in the Middle of the Muscle
• Disadvantages are risk of injury to the branchial artery and radial nerve
• Only appropriate for small volumes of medication due to the size of the Muscle
• Common site for the injection of small volumes and useful for immunization and nonirritating medication
• Maximum Amount injected 0.5-1mL
• Needle length is 1'inch-1½Inches and syringe size is 1mL

This note defines the dorsogluteal intramuscular injection site, major muscle groups (Gluteus Maximus Muscles) and how to locate the injection site using bony land marks such as the posterior superior iliac spine and the greater trochanter of the femur. This site is not preferred due to proximity to the sciatic nerve and major blood vessels.