ACTIVITY 3
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?
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Where are the sites of injection?
The injection site for the pneumococcal conjugate vaccine (PCV) and the pentavalent vaccine (Penta) is the anterolateral part of the thigh. On the other hand, the oral polio vaccine is administered orally through drops in the mouth.
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What muscle is targeted in the injection?
For injection, the targeted muscle is the Vastus Lateralis.
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Write down its origin, insertion and action.
Muscle: Vastus Lateralis
Origin: Greater trochanter and linea aspera of femur
Insertion: Patella via quadriceps tendon and then tibial tuberosity via patellar ligament
Action: Extend leg at knee bone
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How do you locate this area?
To locate the vastus lateralis muscle, place the patient in a supine position or have them held by a parent. Palpate the muscle below the greater trochanter and above the lateral femoral condyle (knee joint). Divide the muscle into thirds and administer the injection into the middle third of the muscle, in the outer anterolateral aspect, lateral to the midpoint of the thigh.
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?
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Which muscle is the preferred site for IM injection in this case?
The preferred site for IM injection in this case is the deltoid muscle.
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Write down its origin, insertion and action.
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.
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How do you locate this area?
To locate the deltoid muscle, find the acromion process by palpating the bony prominence. The designated injection spot is situated at the center of the deltoid muscle, typically found approximately 2.5 to 5 cm (1 to 2 inches) below the acromion process. To locate this area, position three fingers horizontally over the deltoid muscle, just below the acromion process.
References:
Administering pneumococcal vaccine: for providers | CDC. (n.d.). https://www.cdc.gov/vaccines/vpd/pneumo/hcp/administering-vaccine.html#:~:text=The%20preferred%20site%20for%20PCV13,or%20PCV20%20vaccination%20in%20adults.
Polio vaccination: what everyone should know | CDC. (n.d.). https://www.cdc.gov/vaccines/vpd/polio/public/index.html#:~:text=Oral%20poliovirus%20vaccine%20(OPV)&text=Children%20receive%20doses%20of%20the%20vaccine%20by%20drops%20in%20the%20mouth.
Clinical guidelines (Nursing) : Intramuscular injections. (n.d.). https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Intramuscular_Injections/#:~:text=To%20landmark%20the%20vastus%20lateralis,femoral%20condyle%20(knee%20joint).
Seasonal Influenza Vaccine Dosage & Administration. (2020, November). Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/qa/vaxadmin.htm
Doyle, G. R. (2015, November 23). 7.4 intramuscular injections. Pressbooks. https://opentextbc.ca/clinicalskills/chapter/6-8-iv-push-medications-and-saline-lock-flush/
Tortora, G. J., & Derrickson, B. (2017). Chapter 11: The Muscular System. Principles of Anatomy & Physiology (15th ed). John Wiley & Sons, Inc.