ACTIVITY 3
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?
Where are the sites of injection?
Anterolateral thigh
What muscle is targeted in the injection?
Vastus lateralis thigh muscle
Origin
Greater trochanter and attaches also to the lateral lip of linea aspera of femur
Insertion
Quadriceps tendon to base of patella and onto tibial tuberosity via the patella ligament
Action
Work with the other quad muscles to help extend your knee joint
How do you locate this area?
Position the patient lying down then palpate the muscle below the greater trochanter and above the lateral femoral condyle (knee joint) followed by dividing 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
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?
Which muscle is the preferred site for IM injection in this case?
Deltoid muscle
Origin
Lateral part of the clavicle, as well as the spine and acromion process of the scapula
Insertion
Deltoid tuberosity of humerus
Action
Shoulder abduction, stabilize glenohumeral joint, and swinging of arms when walking
How do you locate this area?
To easily locate the area, first find the area of the acromion process (where the humerus and shoulder joint articulates). After palpating the bony structure, proceed to measure around 2.5 inches below the area to identify the injection site of the deltoid muscle
Clinical guidelines (Nursing) : Intramuscular injections. (n.d.). https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Intramuscular_Injections/
Intramuscular injections for neonates | Safer Care Victoria. (n.d.). https://www.safercare.vic.gov.au/clinical-guidance/neonatal/intramuscular-injections-for-neonates#:~:text=The%20anterolateral%20thigh%20is%20the%20preferred%20site%20for%20IM%20injection,middle%20thirds%20of%20this%20muscle.
Intramuscular Injections (n.d). Agency For Healthcare Research and Quality.
https://www.ahrq.gov/sites/default/files/wysiwyg/nursing-home/materials/intramuscular-injections.pdf