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?
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Site of injection: upper, outer thigh muscle
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Targeted muscle: vastus lateralis
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Origin: great 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: extending the leg at the knee joint and flexing the thigh at the hip joint
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Locating the area: Locate the area below the greater trochanter of the femur, and the upper lateral quadrant of the thigh. Palpate that area of the thigh and separate it into 3 sections— the middle section is often 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?
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Site of injection: upper, outer arm muscle
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Targeted muscle: deltoid
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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 the humerus
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Action: abducting the arm at shoulder joint and medially rotating the arm at shoulder joint
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Locating the area: Locate the acromion process by palpating the shoulder, until a bony point at the end of the shoulder is felt. The typical injection site is approximately 2 inches below the bone, and above the axillary fold.