Deltoid injection

Only give depot intragluteally, avoid deltoid injections due to pain at injection site... 

The deltoid muscle can be used for i.m. injections in older children, but it is not an option for young infants and children because of their limited muscle mass. Although there are few complications associated with this administration route, nerve injury can occur. The technique is shown in Fig. The area for deltoid administration should be fully visible so that the anatomical landmarks can be visualized. Then the needle for deltoid injection should enter the muscle halfway between the acromium process and the deltoid tuberosity to avoid hitting the underlying nerves. The drug volume that can be administered by this route to older children and adults is 0.1-2ml.The recommended needle length for older children is 1 in. (2.5 cm). 

Sreptomycin. Streptomycin is usually administered daily as a single IM injection. The preferred site is the upper outer quadrant of the buttock or die midlateral thigh. The deltoid area is used only if die area is well developed. In patients 60 years of age or older, the dosage is reduced because of die risk of increased toxicity. 

IGIM should be injected into a deltoid or gluteal muscle. It does not affect the immune response of inactivated vaccines, oral polio virus, or yellow fever vaccine. The administration of live vaccines [e.g., measles, mumps, rubella (MMR) vaccine] concomitantly with IGIM may decrease the immune response significantly thus, MMR and varicella vaccine should be delayed for at least 3 and 5 months, respectively, after IGIM has been administered. Additionally, IGIM should not be given within 2 weeks of the MMR administration or within 3 weeks of the varicella vaccine to maximize the efficacy of the immunization.1... 

The most common adverse effects in adults include injection site reactions (e.g., tenderness, pain, and warmth), headaches within 5 days after vaccination, and fatigue. Local reactions may be minimized by using an appropriate needle length based on the person s age and size and by administering the injection intramuscularly in the deltoid muscle. Children may also have feeding disturbances. Hepatitis A vaccine given... 

Pain at the injection site is one of the most commonly reported adverse effects of vaccination. The reaction is usually mild with complaints of pain and tenderness at the injection site that may or may not be accompanied by erythema. Local reactions tend to be more frequent with repeated doses or booster doses of vaccine. The frequency and degree of the reactions appear to be related to the amount of preformed antibodies and rapid immunologic responses reflective of priming from previous doses. More serious Arthus reactions are infrequently reported. Arthus reactions are classified as type III hypersensitivity reactions, and are characterized by a massive local response involving the entire thigh or deltoid. Arthus reactions are also related to preformed antibody complexes that induce an inflammatory lesion.14... 

DMPA 150 mg administered by deep intramuscular injection in the gluteal or deltoid muscle within 5 days of the onset of menstrual bleeding inhibits ovulation for more than 3 months, and the dose should be repeated every 12 weeks to ensure continuous contraception. A new formulation contains 104 mg of DMPA (Depo-SubQ Provera 104), which is injected subcutaneously into the thigh or abdomen. The manufacturer recommends excluding pregnancy in women more than 1 week late for repeat injection of the intramuscular formulation or 2 weeks late for repeat injection of the subcutaneous formulation. 

In the morning, I injected atropine into each subject s deltoid muscle and waited for the onset of the usual symptoms. Nothing happened for about ten minutes. Then, a loud yell came from Snooks cubicle, temporarily bolted to keep him from wandering while disoriented. 

Inject subcutaneously or IM when possible. In older children and adults, inject IM in the upper outer quadrant of the buttocks. In infants and young children, the anterolateral aspect of the thigh or the deltoid region is preferred. When IV administration is unavoidable, inject very slowly, not exceeding 1 mg/min. Anticoagulant-induced prothrombin deficiency in adults 2.5 to 10 mg or up to 25 mg (rarely, 50 mg) initially. Determine subsequent doses by prothrombin time (PT) response or clinical condition. If in 6 to 8 hours after parenteral administration (or 12 to 48 hours after oral administration), the PT has not been shortened satisfactorily, repeat dose. If shock or excessive blood loss occurs, transfusion of blood or fresh frozen plasma may be required. 

Repository injections To minimize the likelihood and severity of atrophy, do not inject subcutaneously, avoid injection into the deltoid, and avoid repeated IM injections into the same site, if possible. Repository injections are not recommended as initial therapy in acute situations. 

IM 300 mg. The deltoid muscle is preferred. Avoid intravascular injection. Use only the 10% solution for IM injection. 

Absorption/Distribution - Lidocaine is ineffective orally it is most commonly administered IV with an immediate onset (within minutes) and brief duration (10 to 20 minutes) of action following a bolus dose. Continuous IV infusion of lidocaine (1 to 4 mg/min) is necessary to maintain antiarrhythmic effects. Following IM administration, therapeutic serum levels are achieved in 5 to 15 minutes and may persist for up to 2 hours. Higher and more rapid serum levels are achieved by injection into the deltoid muscle. Therapeutic serum levels are 1.5 to 6 mcg/mL serum levels greater than 6 to 10 mcg/mL are usually toxic. Lidocaine is approximately 50% protein bound (concentration-dependent). 

Use the deltoid area only if well developed, and then only with caution to avoid radial nerve injury. Do not inject into the lower and mid-third of the upper arm. 

Optimal sites for injection are the right and left deltoid and anterior thigh... 

The soluble substances, mild irritants and suspensions can be injected by this route in the large skeletal muscles (deltoid, triceps, gluteus maximus, rectus femoris etc.). These muscles are less richly supplied with sensory nerves and are more vascular, so irritant solutions can be injected. Small volumes (up to 2 ml) are injected into the deltoid muscle, and small or large volumes (up to 10 ml) are injected into the gluteal mass. 

Adults 1 ml by IM injection into the deltoid muscle repeated one month and six months later. 

Administration This is for IM use only. In adults the injection should be given in the deltoid region in neonates and infants the injection should be given in anterolateral thigh. Dose for adults and children above 10 years is 20 meg and for neonates, infants and children below 10 years the dose is 10 meg. Three doses are given as above. For rapid immunization the... 

Ronte of administration Lantus is administered by subcutaneous injection once daily at bedtime. Intravenous administration of the usual subcutaneous dose could result in severe hypoglycemia. As with all insulins, injection sites within an injection area (abdomen, thigh, or deltoid) must be rotated from one injection to the next. 

Hydroxyzine intramuscular injection should not be given in the lower or mid-third of the arm and should only be given in the deltoid area if it is well-developed... 

Absorption of i.m. administered medications depends on the injection site because perfusion of individual muscle groups differs. For example, drug absorption from the deltoid muscle is faster than that from the vastus lateralis that is more rapid than from the glu-teus. In addition, lower perfusion or hemostatic decompensation, frequently observed in ill neonates and young infants, may reduce i.m. absorption. It may also be decreased in neonates who receive a skeletal muscle-paralyzing agent such as pancuronium because of decreased muscle contraction. In addition, the smaller muscle mass of neonates and young infants provides a small absorptive area. 

The name of this route means within the muscle. Intramuscular injection requires a deeper penetration than the subcutaneous method but is associated with a faster absorption rate when the drug is prepared in a water solution and there is a good rate of blood flow at the site of administration. Absorption rates may differ depending on the rate of blood flow to the muscle group the drug is injected into in practice, the most common muscle sites are the deltoid, thigh, and buttocks. The absorption rate can also be modulated by the solution that the drug is prepared in fV>r administration. 

Drugs in aqueous solution are absorbed rapidly following intramuscular (i.m.) injection, although this varies depending on factors such as the blood flow to the injection site. In humans, absorption from the deltoid or vastus lateralis muscles is faster than from the gluteus maximus. Absorption from this site is slower in females than in males. This has been attributed to sex differences in the distribution of subcutaneous fat, since fat is a relatively poorly perfused tissue. 

Route of Administration Intravenously is nearly instantaneously absorbed. Intramuscular has slower absorption depending on the amount of blood vessels at the injection site. Subcutaneous tissue injection sites have a slower absorption rate than muscles. (Hint Medication is absorbed faster in the deltoid [arm] muscle than the gluteal [backside] muscle because there are more blood vessels in the deltoid muscle.)... 

Locate the acromion process of the scapula and the deltoid. Measure two to three fingers below the acromion process on the lateral midline of the arm to identify the proper site. Inject at a 90-degree angle. 

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