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?
Injection Site and Muscle Targeted
Anterolateral thigh:
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For infants, the vastus lateralis muscle is the preferred site for intramuscular injections like the Pneumococcal Conjugate Vaccine (PCV) and the Pentavalent Vaccine (Penta) because it is well-developed and away from major nerves and blood vessels, making it safer (Administering Pneumococcal Vaccine: For Providers | CDC, n.d.).
Vastus Lateralis Muscle:
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Origin: Greater trochanter and lateral lip of the linea aspera of the femur (correct anatomical details).
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Insertion: Tibial tuberosity via the patellar ligament (this is where the quadriceps muscles, including the vastus lateralis, converge and insert).
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Action: Extends the knee joint, which is the primary function of the quadriceps group, including the vastus lateralis.
Locating the Injection Site:
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The recommendation to divide the thigh into thirds and inject into the middle third of the anterolateral aspect of the thigh is the correct method for identifying the appropriate injection site in infants.
Reference/s:
Administering pneumococcal vaccine: for providers | CDC. (n.d.). https://www.cdc.gov/vaccines/vpd/pneumo/hcp/administering-vaccine.html
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?
The deltoid muscle is the standard site for intramuscular injections in adults, and the method for locating the injection site is consistent with established clinical guidelines (Medication Administration: Intramuscular Injections, n.d.).
Deltoid Muscle:
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Origin: The deltoid muscle originates from three points: the lateral third of the clavicle, the acromion, and the spine of the scapula.
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Insertion: It inserts into the deltoid tuberosity of the humerus.
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Action: The deltoid muscle facilitates abduction of the arm (primarily the middle fibers), as well as flexion and medial rotation (anterior fibers) and extension and lateral rotation (posterior fibers).
How to locate the area for injection:
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Expose the upper arm.
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The injection should be given in the mid-deltoid region. To locate the proper area:
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Identify the acromion process of the scapula, which is the bony prominence at the top of the shoulder.
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Measure about 2-3 finger widths (approx. 1-2 inches) below the acromion process.
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The injection is given into the thickest part of the deltoid muscle, in the central portion of the upper arm, at this location.
Reference/s:
Medication administration: intramuscular injections. (n.d.). https://elsevier.health/en-US/preview/intramuscular-injections