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.
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Where are the sites of injection? anterolateral thigh
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What muscle is targeted in the injection? Vastus lateralis muscle
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Write down its origin, insertion and action.
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Origin - Greater trochanter and linea aspera of femur
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Insertion - Patella via quadriceps tendon, and tibial tuberosity via patellar ligament
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Action - extend leg at knee joint
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How do you locate this area? It is below the greater trochanter and above the lateral femoral condyle. For injection, divide that area into three. The area for injection is in the middle.
2) 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.
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Which muscle is the preferred site for IM injection in this case? Deltoid muscle
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Write down its origin, insertion and action.
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Origin - Acromial extremity of clavicle (anterior fibers), acromion of scapula (lateral fibers), and spine of scapula (posterior fibers)
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Insertion - Deltoid tuberosity of humerus
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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? The deltoid is near the acromion process. For injection, locate the acromion process, and put your two fingers below it. Then use your hand to make an inverted triangle, so that you do not go below the axillary fold. The area for the deltoid is in the center of the inverted triangle.
[HSE National Immunisation Office, Ireland]. (2021, April 10). Landmarking and administration of deltoid injection technique intramuscular [Video]. Youtube. https://youtu.be/Y7cZZL2MzYo?feature=shared