Deltoid Intramuscular Injection
The deltoid intramuscular injection is easily accessible and is only for use with small volumes with a standard dose of 0.5ml and is never to go beyond 1.0ml. The deltoid muscle looks like and upside down tear drop with the muscle it-self being rather large. The actual injection site should be in the center of the muscle allowing for a small area on a large muscle to be the targeted area for the proper deltoid intramuscular injection site. 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 site. The position that the patient is less important for the person, but much more important for the one giving the injection, being that it is more important that the healthcare professional is in a comfortable position. Of course, you want to make sure that whatever position the patient chooses, make sure that they are comfortable. With that being said the patient can be sitting, prone, supine, or lateral lying. The gauge of needle used can be a 23-25 with the length being 5/8-1.5 inches consideration must also be made for the size of the patient. Whether they are large or small will also determine the length of the needle. Once the injection site on the deltoid has been located make sure to inject at a 90 degree angle with a darting movement.
Diagram of deltoid intramuscular injection
Deltoid intramuscular injection
Deltoid Intramuscular injection- Considerations, Advantages, and Disadvantages
The deltoid intramuscular injection site is the preferred site to administer vaccines for infants that are older than 7 months and this is the only site where the Hepatitis B vaccine can be given. 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. Unlike the ventrogluteal injection, a tourniquet can be applied if a hypersensitivity reaction occurs after a deltoid intramuscular injection. Disadvantages to this site are the size of the muscle mass is small in relation to other IM injection sites. The deltoid intramuscular injection is closely associated with nerves and vascular structures; this leaves a small margin for error with departure from the correct IM injection site. A deltoid intramuscular injection is not an apt site for repeated or large-volume injections exceeding 1.0ml.
Deltoid injections exceeding 3 ml cc
This was asked of me the other day "Are deltoid injections exceeding 3 ml cc ok?" Absolutely not, the only thing you might accomplish is causing severe pain in the patient with the volume you are trying to input into the patients arm.
How to administer a vaccine deltoid
With out further delay let's pretend that as a nurse you are about to give a vaccine for Hepatitis B. The first thing you do is wash your hands, dawn the gloves, grab a 24 gauge needle 5/8 inch will do. 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 angle, insert, aspirate to avoid blood stream injection, and inject.