Review of intramuscular injection sites in children

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Abstract:

Aim: This study was conducted to determine whether the ventrogluteal site could be used for intramuscular injections in children under the age of 3 and to compare the subcutaneous and muscle layer thickness at the anterolateral, deltoid and ventrogluteal site in the different age groups and in both sexes.

Background: Although recent literature has reported that the ventrogluteal area can be an alternative site for intramuscular injections in children ≤12 months of age, little research-based evidence has been found for the use of the ventrogluteal site in infants and toddlers.

Design: A descriptive study which took place between November 2013–August 2014.

Method: A total of 142 children between the ages of 1-36 months were selected by random sampling and ultrasound measurements were made of subcutaneous and muscle thicknesses in the anterolateral, deltoid and ventrogluteal areas. Measurements were analysed using one-way anova and independent samples t-test.

Results: The subcutaneous tissue thicknesses in the deltoid, anterolateral and ventrogluteal areas in children between 1-12 months old (n = 56) were 5·20, 6·62 and 7·26 mm respectively, while in children between 13-24 months old (n = 42), these measurements were 4·35, 6·72 and 7·98 mm; in children between 25-36 months old (n = 44), the measurements were 5·92, 7·97 and 13·5 mm. The muscle thicknesses in the deltoid, anterolateral and ventrogluteal areas in children 1- 12 months old were 5·86, 9·10 and 8·17 respectively, while in children between 13-24 months old, the measurements were 7·71, 12·92 and 17·32 mm; in children 25-36 months old, the measurements were 9·28, 18·81 and 19·62 mm.

Conclusion: This study found that the muscle in the ventrogluteal site is adequately developed, even in infants between the ages of 1-12 months and that in particular, in children 12-36 months old, the ventrogluteal site is even thicker than the anterolateral.

Reference:

Güneş, Ü.Y., Ceylan, B. and Bayındır, P. (2015) Is the ventrogluteal site suitable for intramuscular injections in children under the age of three? Journal of Advanced Nursing. September 29th. [epub ahead of print].

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