Deltoid intramuscular injection and obesity essay IV opioids have the fastest onset times Morphine: Inject the medication slowly to see the wheal form. Selecting the Most Appropriate Site Choosing one of the approved locations and needle length for an IM injection seems arbitrary, but there is literature available to assist in decision-making.
The advantages of the deltoid intramuscular injection is that as said before is easy accessible and patients are generally a lot more comfortable with exposing their arms as opposed to another body area.
Overall, 5 mL has been cited for adults as the maximum volume for a single IM injection, with lower maximums proposed for adult patients with less-developed or small muscle mass.
Rate of absorption is slower in females than in males because females have more fat. Be aware that rare adverse effects may include: Are currently taking or have been prescribed oral corticosteroids in the last 14 days.
The IV route properties allow it to be the desirable route when treating hyperkalemia given the faster onset allowing for quicker movement of potassium intracellularly. J Clin Pharmacol ; Although the depth of their gluteal intramuscular injection sites may vary from the national average, this study shows that in a significant minority of patients the standard green or blue needles, which are the normal method of delivery, will fail to reach muscle.
If alternative routes are not possible, using longer needles should be considered. The two routes have drastic differences in pharmacokinetics as shown below Table 3: While this data can be left up to interpretation, IM use of epinephrine is the first line especially when utilizing auto injectors.
Subcutaneous dosing produces gentler effects on glucose or electrolytes. The number of patients used in this study was small, and they were recruited only from a local population and did not include the extremes of age.
There are many problems that may occur during a journey such as a service user wondering off, a bus not turning up or a service user having an epileptic fit, there are also many ways to deal with such problems for example is a bus did not turn up there are usually several other buses that can get you to where you need to be.
However, the absorption of SQ injections, whether intended or not intended, can be improved by applying heat or massage.
Verify needle and gauge and placement before giving injection. Draw up the amount of drug to be administered, locate the acromion process and measure down 2 finger widths in the middle of the arm then with a quick darting motion at a 90 degree angleinsert, aspirate to avoid blood stream injection, and inject.
To determine the ventrogluteal site, place the ball of the opposing hand on the greater trochanter and index finger on the anterior superior iliac crest; form a V with the middle finger; the injection site is within the V. Some rescue medications have significant delays in peak plasma concentrations between the two routes.
Case 1 Conclusion No surprise that glucagon was not effective in your presumptive timeline. In addition, lipose-rich subcutaneous tissue is not vascular, so drug absorption is further prolonged if medication is delivered mostly into adipose tissue, and the drug can accumulate in adipose tissue, especially with repetitive dosing.
Currently the most commonly used sites for the rapid delivery of rescue medications are the IV, IM, and subcutaneous sites. The main components of subcutaneous tissue are fat lobules and loose collagenous connective tissue. However, this information cannot be explicitly extrapolated to a syringe used subcutaneously in the upper arm or an intramuscular injection in the deltoid muscle.
The deltoid is a small volume muscle and has longer peak plasma concentration times for drugs like epinephrine.
These injection locations allow for a high degree of safety, reliability and accessibility when a patient is lying supine, prone or in side lying position. Rate of absorption is slower in females than in males because females have more fat.
The dosing and pharmacokinetic differences are noted. Introduction Studies of intramuscular injections have shown differences in peak plasma concentrations of narcotics and in perceived pain relief, depending on gluteal or deltoid injection site. Hold the barrel with non-dominant hand, and aspirate with your dominant hand for seconds to look for blood.
However, she is extremely cachectic, with no IV access, no fat and very little muscle mass.Are IM Injections IM in Obese and Overweight Females?
A Study in Injection Technique Sara Palma, BSN, RN Needle length for intramuscular injection in deltoid muscle.
). Other factors influencing the injection with a 16 mm needle are obesity (which thickens SC tissue) and whether the needle is inserted fully or if a few millimeters. Immunizations - seasonal influenza: Summary and people with morbid obesity. Administer the other influenza vaccines (except Intanza ® intradermal vaccine) by intramuscular injection, unless the person has a bleeding disorder when it should be given as a deep subcutaneous injection.
This video demonstrates the Deltoid Injection Site. Deltoid muscle of the upper arm used for intramuscular injections Intramuscular Injection Sites and Their Landmarks Ventrogluteal site: Is the most comfortable and safest for IM injections.
Aug 01, · This IM injection site is a little different to locate it requires finding the acromion process located on the scapula then measuring 2 to 3 finger widths in the middle of the arm is the location of the deltoid intramuscular injection fmgm2018.coms: Intramuscular Injections The most common sites for an intramuscular injection are the deltoid muscle of the upper arm, vastus lateralis (anterior thigh), and the dorsal gluteal area of the buttocks Musculoskeletal disorders Muscle atrophy Muscle atrophy can occur to muscles used infrequently.
However, this information cannot be explicitly extrapolated to a syringe used subcutaneously in the upper arm or an intramuscular injection in the deltoid muscle. Additionally, the effects of obesity and other absorption anomalies are not clear.Download