Podcast
Questions and Answers
Where is the most appropriate site for IM injections in infants and toddlers?
Where is the most appropriate site for IM injections in infants and toddlers?
What is the preferred IM injection site in pediatric patients 3 years and older?
What is the preferred IM injection site in pediatric patients 3 years and older?
What is the maximum volume of medication that can be injected into the vastus lateralis in adults?
What is the maximum volume of medication that can be injected into the vastus lateralis in adults?
Why is the dorsogluteal not the preferred site for IM injections?
Why is the dorsogluteal not the preferred site for IM injections?
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How can the deltoid muscle injection site be correctly landmarked?
How can the deltoid muscle injection site be correctly landmarked?
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What is one common serious complication of intramuscular injections in children?
What is one common serious complication of intramuscular injections in children?
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Where is muscle contracture more likely to occur after an intramuscular injection in children?
Where is muscle contracture more likely to occur after an intramuscular injection in children?
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What can cause erratic absorption of injected drugs in children receiving intramuscular injections?
What can cause erratic absorption of injected drugs in children receiving intramuscular injections?
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Which is the most frequently reported serious complication of intramuscular injections in the gluteal area?
Which is the most frequently reported serious complication of intramuscular injections in the gluteal area?
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Why is choosing the right muscle important when administering an intramuscular injection?
Why is choosing the right muscle important when administering an intramuscular injection?
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Study Notes
Intramuscular Injections in Children
- Paediatric intramuscular injections must be administered into muscles large enough to accommodate the medication and avoid major nerves or blood vessels.
Complications of Intramuscular Injections
- Muscle contractures occur most commonly after injections in the anterior and lateral thigh.
- Sciatic nerve injury is the most frequently reported serious complication of the gluteal area.
Factors Affecting Absorption of Injected Drugs
- Variability in their chemical characteristics
- Differences in absorption by site of injection
- Variability in muscle mass among children (reduced muscle mass)
- Illness (e.g., compromised circulatory status)
- Immature vasculature resulting in erratic blood flow to and from the muscle, leading to slow absorption rate
- Variability in depth of injection (too deep or too shallow)
Choosing the Right Muscle for Injection
- The IM route allows for rapid absorption of specific medications.
- Selection of the injection site is based on the patient's age, muscle mass, medication volume, and medication viscosity.
Site Selection and Landmarking
Vastus Lateralis
- Preferred IM site for neonates and infants.
- Up to 1ml can be injected into this site in neonates, up to 3mls in children, and up to 5mls in adults.
- Landmarking: palpate the muscle below the greater trochanter and above the lateral femoral condyle (knee joint).
- Administer the injection into the middle third of the muscle, in the outer anterolateral aspect, lateral to the midpoint of the thigh.
Deltoid
- Preferred injection site in children aged 3-18 years when muscle mass is more developed.
- Suitable for small volume injections (up to 2mls).
- Landmarking: palpate the acromion (outer edge of the scapula) and trace an imaginary inverted triangle below the shoulder.
- Administer the injection 3-5cms below the acromion, in the middle of the triangle.
Dorsogluteal
- Not the preferred site due to its proximity to the sciatic nerve and major blood vessels.
- Up to 4mls can be injected into this site.
- Landmarking: locate the muscle in the upper outer quadrant of the buttock, approximately 5-8cm below the iliac crest.
- Confirmation: draw an imaginary line between the posterior superior iliac spine and the greater trochanter of the femur.
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Description
Learn about the administration of intramuscular injections in infants and children, including the importance of selecting appropriate muscles and avoiding complications. Understand common complications such as muscle contractures and nerve injuries.
