1.) It is immunization day at the health center. The first patient is a 2-month old well female infant who is scheduled for the following vaccinations: pneumococcal conjugate vaccine (PCV), pentavalent vaccine (Penta) and oral polio vaccine. PCV and Penta are given via intramuscular route. Where are the sites of injection? What muscle is targeted in the injection? Write down its origin, insertion and action. How do you locate this area?
Site of injection: anterolateral thigh
Muscle targeted: vastus lateralis
> Origin: upper intertrochantic line; base of greater trochanter; lateral linea aspera; lateral supracondylar ridge; and lateral intermuscular septum
> Insertion: lateral quadricepcs tendon to patellas, via ligamentum patellae into tubercle of tibia
> Action: extends knee
Locating the area: locate the greater trochanter of femur and patella; draw an imaginary line between the landmarks down the front of the thigh and divide into thirds; the correct injection site is located in the middle third and on the outer aspect of the imaginary line
2.) The baby’s 65-year-old grandfather also came to the center because influenza vaccine is being offered to senior citizens. The flu vaccine is given intramuscularly. Which muscle is the preferred site for IM injection in this case? Write down its origin, insertion and action. How do you locate this area?
Muscle: Deltoid (upper arm)
> Origin: clavicle; acromion; spine of scapula
> Insertion: deltoid tuberosity of humerus
> Action: maintains stability of the shoulder joint; elevates the arm and enables a full range of motion of the arm along the shoulder joint
Locating the area: feel for the bone at the top of the upper arm; there is a triangular muscle two finger-widths below the bone; and the needle should enter the triangle's center