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  #1  
Old 10-17-2007, 10:12 PM
jojodow
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Default The Dorsalgluteal site

There's a debate going on at work and I wanted to get some opinions from ya'll.

I was taught in Nursing school to avoid the Dorsalgluteal IM site for injections. We were taught how to do it....but to avoid it if possible.

The reasoning behind this was because there have been reported cases of Nurses using the DG site and hitting the sciatic nerve...causing nerve damage and then getting sued.
They've discovered that some patient's physiology changes through weightloss,gain, or pregnancy and the sciatic nerve can shift to where it's not supposed to be.

At my clinic we give Hormone injections and Sandostatin IM injections that have large amounts of viscous solution (1-3 mLs).
Now my vote would be for the Vastus Lateralis or Ventralgluteal sites....but every nurse in my clinic thinks I'm crazy and it's absurd to do them anywhere but the DG site.

The Sandostatin literature states to use the DG site as well.

What do ya'll think?


I just found some articles about this:

http://www.medscape.com/viewarticle/551320_3


http://www.allbusiness.com/sector-62...1190724-1.html

http://www.blackwell-synergy.com/doi...9.2006.00082.x

http://www.nysna.org/publications/re...r/research.htm
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  #2  
Old 10-18-2007, 01:31 AM
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I guess I thought the ventrogluteal site was the one where you had to be careful about the nerves.

(I didn't read the links you posted, sorry... bedtime!)

When DH had to give me progesterone, they taught him to inject in the upper outer quadrant.

I sure would not have liked to get those suckers in the arm, I'll tell ya that much.
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Old 10-18-2007, 12:08 PM
MyOwnWoman
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The first dorsalgluteal injection I ever saw given was by a new nurse just fresh out of nursing school. I was taught that the Vastus lateralis and the Ventralgluteal sites were superior due to the lack of nerves that can be damaged. The one thing I remember being stressed the most is that NEVER give an IM injection to a child under the age of two unless it is in the Vastus lateralis because the sciatic nerve is underdeveloped and may not be in the "normal" place.

My preference for IM injections are: 1. Deltoid only if there is a small amount of fluid and the medication is not very thick or irritating. (tetnus). 2. Ventralgluteal if the medication is thick or irritating to the tissue, or there is a larger amount of fluid. (up to 3ml). 3. Vastuslateralis in children under the age of 2 and people who are combative. I also use this injection site for people who are unable or it is contraindicated that the roll for Ventralgluteal site.

Jodi, I'm glad you brought this up because it forced me to look up information. I did not "correct" the new nurse for using the dorsalgluteal site because I figured that since she was brand spanking new she must know something I didn't. Thanks for keeping me on my toes!
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Old 10-19-2007, 02:53 PM
LittleBird
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I just graduated in May, and we were being taught that the ventralgluteal location was going to be the standard site for IM injections, instead of the dorsogluteal. Apparently this change was to be coming out in the next edition of "Perry and Potter" which is pretty much the nursing bible where I went to school and where I work now.
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Old 10-19-2007, 09:47 PM
jojodow
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I printed out that stuff and showed it to my supervisor.

It's a start at least, maybe she'll bring it up at the next Nurse's meeting.
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Old 10-24-2007, 02:30 PM
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I've always used the ventralgluteal location. It just seemed to be a safer area.

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Old 10-28-2007, 09:06 AM
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We were told not to use the DG, but the VG instead, in fact we are no longer taught the DG; but our educator in hospital didn't know the VG (good educator huh) so have only ever given it DG. In mental health depending on the pt it was either deltoid or VG.
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  #8  
Old 10-28-2007, 10:47 PM
capflash
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Default my vote is with your rationale

HI,
Lab teacher here... the most recent research and textbooks totally agree with you...ventral gluteal is best to avoid the sciatic nerve.
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Old 10-28-2007, 10:51 PM
capflash
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Default z-track

...oops...forgot to mention... new literature states Z-track is best for ALL IM shots - less cystic formation, less pain, less loss of fluid
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  #10  
Old 10-29-2007, 01:34 PM
MyOwnWoman
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Quote:
Originally Posted by capflash View Post
...oops...forgot to mention... new literature states Z-track is best for ALL IM shots - less cystic formation, less pain, less loss of fluid

Thanks for the head's up.
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