1) The Pneumococcal Conjugate Vaccine and Pentavalent vaccine may be given via the three intramuscular injection sites in the body, namely:
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Muscle Name: Gluteus medius
Origin: Ilium
Insertion: Greater trochanter of femur
Action: It abducts thigh at hip joint and medially rotates thigh.
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Muscle Name: Deltoid muscle
Origin: Acromial extremity of clavicle, acromion of scapula, and spine of scapula
Insertion: Deltoid tuberosity of humerus
Action: The lateral fibers abduct the arm at the shoulder joint, the anterior fibers flex and medially rotate arm at shoulder joint, and the posterior fibers extend and laterally rotate arm at shoulder joint.
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Muscle Name: Vastus Lateralis muscle
Origin: Greater trochanter and linea aspera of femur
Insertion: Patella via quadriceps tendon, and then tibial tuberosity via the patellar ligament
Action: It extends the leg at knee joint.
By locating these three intramuscular injection sites, the whole area must be exposed to accurately identify the part on where to penetrate the skin and subcutaneous layer. It is important to also palpate to check whether the site is ready to be injected by the vaccines.
2) As nurses, it is crucial to identify the area of injection sites on various patients. Different age groups receive injection from different intramuscular sites. For the 65-year-old grandfather of the baby, it is best to choose the Deltoid muscle at the shoulder joint as an injection site. It has a deep layer of tissue, is not close to any major blood vessels, and most importantly, can be accessed easily.
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Muscle Name: Deltoid muscle
Origin: Acromial extremity of clavicle, acromion of scapula, and spine of scapula
Insertion: Deltoid tuberosity of humerus
Action: The lateral fibers abduct the arm at the shoulder joint, the anterior fibers flex and medially rotate arm at shoulder joint, and the posterior fibers extend and laterally rotate arm at shoulder joint.