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?
- Anterolateral thigh
- Oral intake, achieved by putting drops in the infant's mouth
- What muscle is targeted in the injection?
- Vastus lateralis
- Write down its origin, insertion and action
- Origin. Greater trochanter and linea aspera of femur.
- Insertion. Patella via quadriceps tendon and then tibial tuberosity via patellar ligament.
- Action. All four heads extend leg at knee joint; rectus femoris muscle acting alone also flexes thigh at hip joint.
- How do you locate this area?
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By determining the bulkiest part of the vastus lateralis, the thigh muscle, which is at the intersection of the upper and middle thirds of the said muscle.
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- Where are the sites of injection?
- 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?
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Deltoid muscle in the upper arm; otherwise, if unavailable, the vastus lateralis muscle in the anterolateral thigh may be an alternative.
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- Write down its origin, insertion and action
- Origin. Anterior, lateral, and posterior fibers.
- Insertion. Deltoid tuberosity of humerus.
- Action. (1) Lateral fibers abduct arm at shoulder joint; (2) anterior fibers flex and medially rotate arm at shoulder joint; and (3) posterior fibers extend and laterally rotate arm at shoulder joint.
- How do you locate this area?
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By determining the central and thickest portion of the deltoid muscle, located above the level of the armpit (approximately 2-3 fingerbreadths) and below the acromion process.
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- Which muscle is the preferred site for IM injection in this case?
References
- Intramuscular injections for neonates | Safer Care Victoria. (n.d.). https://www.safercare.vic.gov.au/clinical-guidance/neonatal/intramuscular-injections-for-neonates
- How to Administer Intramuscular and Subcutaneous Vaccine Injections [PDF File].
- Rotavirus vaccination: what everyone should know | CDC. (n.d.). https://www.cdc.gov/vaccines/vpd/rotavirus/public/index.html#:~:text=The%20first%20dose%20of%20rotavirus,drops%20in%20the%20infant's%20mouth.
- Tortora, G., & Derrickson B. (2017). Principles of Anatomy and Physiology (15th ed.). Wiley.