Assessment
■ Be Safe! Always palpate the landmarks and the muscle mass to ensure correct placement of the needle.
Key Points
Ventrogluteal Site
■ Ask the patient to assume a side-lying position with the legs straight, if possible. Alternatively, use a supine position.
■ On adults, the site is a triangle formed between your fingers when you place your palm on the head of the trochanter, index finger on the anterior superior iliac spine, and middle finger pointing toward the iliac crest.
Deltoid Site
■ Be Safe! Completely expose the patient’s upper arm.
■ Remove the garment; do not roll up the sleeve. Incomplete exposure of site and landmarks creates a risk of injecting into other than muscle tissue.
■ Locate the lower edge of the acromion process (knobby part of shoulder), and go two to three fingerbreadths down (3 to 5 cm).
■ Draw an imaginary line from the anterior axillary crease to the posterior axillary cease. The deltoid site is the resulting inverted triangle.
■ An alternative approach is to place four fingerbreadths across the deltoid muscle, with your top finger on the acromion process. The injection goes three fingerbreadths below the process in the midline of the upper arm.
Vastus Lateralis Site
■ Be Smart! Position the patient lying supine or sitting. The patient may perceive the injection as less painful if supine because he cannot see the needle enter his leg. For some people this provokes anxiety and intensifies pain.
■ Locate the greater trochanter and the lateral femoral condyle.
■ Midlateral thigh: On adults, one handbreadth below the head of the trochanter and one handbreadth above the knee. The site is the middle third of this area, slightly lateral to the midline of the anterior thigh.
■ Be Safe! The vastus lateralis site is safe for patients of all ages and is the recommended site for children younger than 7 months.
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| Locating the ventrogluteal site |
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| Locating the deltoid site |
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| Locating the vastus lateralis site |
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