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: Lateral side of the thigh
Muscle: Vastus Lateralis muscle
Origin: Greater trochanter and linea aspera of femur
Insertion: Patella via quadriceps tendon and then tibial tuberosity via patellar ligament
Action: Extend the lower leg and knee joint; allow movement of the body of lower leg
How to Locate this area:
Locate the greater trochanter of the femur. The top border of the vastus lateralis muscle can be found a hand width below the groin. The bottom border of the vastus lateralis muscle is found a hand above the knee. The side borders are from mid anterior thigh to the mid lateral thigh. The center of these measures is the ideal site for injection.
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?
Site of injection: Shoulder or Upper Arm
Muscle: Deltoid Muscle
Origin: Acromial extremity of clavicle (anterior fibers), acromion of scapula (lateral fibers),, and spine of scapula (posterior fibers)
Insertion: Deltoid tuberosity of humerus
Action: Lateral fibers abduct arm at shoulder joint; anterior fibers flex and medially rotate arm at shoulder joint; posterior fibers extend and laterally rotate arm at shoulder joint
How to Locate this area:
In locating the deltoid muscle, expose the upper arm and find the acromion process by palpating the bony prominence. The injection site is in the middle of the deltoid muscle, about 2.5 to 5 cm (1 to 2 inches) below the acromion process. To locate this area, lay three fingers across the deltoid muscle and below the acromion process. The injection site is generally three finger widths below, in the middle of the muscle.
References:
undefined [nabil ebraheim]. (2018, June 22). Vastus Lateralis Intramuscular Injection - Everything You Need To Know - Dr. Nabil Ebraheim. YouTube. Retrieved September 23, 2022, from https://www.youtube.com/watch?v=XFog6uSwbuw
Doyle, G. R. (2015, November 23). 7.4 Intramuscular Injections – Clinical Procedures for Safer Patient Care. Pressbooks. Retrieved September 23, 2022, from https://opentextbc.ca/clinicalskills/chapter/6-8-iv-push-medications-and-saline-lock-flush/#:%7E:text=The%20injection%20site%20is%20in,the%20middle%20of%20the%20muscle.