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- 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?
The intramuscular (IM) injection sites for infants are typically the vastus lateralis muscle in the thigh and deltoid muscle in the upper arm.
For a 2-month-old infant, the vastus lateralis muscle in the thigh is the ideal site of injection.
Vastus lateralis in the thigh:
Origin: Greater trochanter of the femur and lateral lip of the Linea aspera.
Insertion: Patella (kneecap) via quadriceps tendon
Action: Extends the knees
How to locate:
- Palpate the thigh.
Gently feel the outer side of the thigh for a firm, fleshy area. - Identify the vastus lateralis.
The vastus lateralis is the muscle that extends from the hip to the knee. It's located on the outer side of the thigh. - Divide the thigh into thirds.
Mentally divide the thigh into three equal parts, running vertically. - Choose the middle third.
The middle third of the thigh is the recommended injection site for infants. - Locate the midpoint.
Find the midpoint of the middle third of the thigh.
- Palpate the thigh.
- 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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- 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?
For a 65-year-old adult, the preferred site for intramuscular (IM) injection for influenza vaccine is the deltoid muscle in the upper arm.
Deltoid muscle in the upper arm:
Origin:
Anterior deltoid: anterior border of the clavicle
Lateral deltoid: acromion process of the scapula
Posterior deltoid: spine of the scapula
Insertion:
Deltoid tuberosity of the humerus
Actions:
Anterior deltoid: flexes, medially rotates, and horizontally abducts humerus
Lateral deltoid: abducts humerus
Posterior deltoid: extends, laterally rotates, and horizontally abducts humerus
How to locate:
- Identify the acromion: Locate the bony prominence at the top of the shoulder.
- Measure two inches: Measure two inches (about 5 centimeters) down from the acromion.
- Form a triangle: Imagine a triangle with the acromion as the base and the point two inches below.
- Inject into the triangle: The injection should be given within this triangle, preferably in the outer quadrant.
- 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?