Body Mass Index: A Reliable Predictor of Subcutaneous Fat Thickness and Needle Length for Ventral Gluteal Intramuscular Injections

Holliday, Rex M; Gupta, Vivek; Vibhute, Prasanna

doi:10.1097/mjt.0000000000000474

Cited by 9 publications

(6 citation statements)

References 35 publications

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“…However, and mentioned the use of the anthropometric algorithm to select an injection site increases the chances of injection success . Successful injections can also reduce the pain injection by decreasing the chance of subcutaneous injection as well as the risk of bone contact (Holliday et al, 2019;. Possible reasons for disagreement between the results of this study and the proposed theoretical model of and stem from; first, the proposed model also suggests a needle length change for successful injection.…”

Section: Discussionmentioning

confidence: 59%

“…and stated that using body shape patterns to select injection sites increases the chances of successful injection . Thus, since successful intramuscular injection eliminates the possibility of subcutaneous injection and reduces the risk of bone contact, it may possibly reduce injection pain (Holliday et al, 2019;. It seems in the body shape pattern group with the increasing success of injection in gluteal muscle, injection pain has decreased.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the effect of selecting gluteal injection site on the pain injection based on anthropometric indices and body shape pattern: A randomised controlled trial study

Sahebkar

Khosrojerdi

Rad

et al. 2021

Journal of Clinical Nursing

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Aims and Objectives This study was aimed at comparing the effect of injection site selection based on anthropometric indices and body shape pattern on pain injection. Background Pain is one of the common complications of intramuscular injection. Selecting the right place for gluteal injection is one of the challenges of nursing which can increase the safety and success of the injection and thereby reduce the pain severity caused by it. Design Open‐label randomized controlled trial study. Methods In this study, 162 eligible subjects referred to the emergency unit of Vasei Hospital of Sabzevar, Iran were randomly assigned to three groups of control, anthropometric indices and body shape pattern. Subjects in the control group received dorsogluteal injection (traditional way). In the anthropometric group, body mass index (BMI), waist circumference (WC) and anterior superior iliac spine to iliac tubercle (ASIS‐IT), and in body shape pattern group, observed body shape indices (OBS), BMI and sex were used to select the gluteal injection site. Pain injection was assessed using the Visual Analogue Scale (VAS). The CONSORT checklist was used. Results The mean age of the participant was 39.43 ± 13.16 and 43.21% (n = 70) were male. Based on multiple linear regression analysis, the mean pain injection was substantially lower in body shape pattern as compared to the control group (r2: .26; bxy = −0.41; 95% CI: −0.81, −0.01; p = .043). The mean pain injection was significantly greater in the left leg injection than right one (r2: .26; bxy = 0.44; 95% CI: 0.06, 0.81; p = .021). Conclusions Findings of this study suggest that the selection of a gluteal injection site based on body shape pattern in comparison with traditional dorsogluteal injection method has a significant effect on pain injection relief. Relevance to clinical practice Nurses can choose the appropriate gluteal injection site based on the body shape pattern to reduce the pain of the intramuscular (IM) gluteal injections.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Evaluation of the effect of selecting gluteal injection site on the pain injection based on anthropometric indices and body shape pattern: A randomised controlled trial study

Sahebkar

Khosrojerdi

Rad

et al. 2021

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

“…It means that successful or safe IM injection is injected into the muscle and there are no adverse side effects. Recently, studies have been conducted to measure the fat thickness at the injection site or to determine the relationship with BMI for safer IM injection [ 8 , 9 , 13 , 17 ]. These found that sex and BMI influenced subcutaneous fat thickness and muscle thickness and also affected successful IM injection.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies reported that subcutaneous fat thickness and BMI are also related to sex and population groups. Therefore, suitable IM injection sites and techniques such as the size of syringes should be targeted for such groups [ 3 , 12 - 14 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluating the effectiveness of gluteal intramuscular injection sites: a cadaveric study

2022

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The gluteal region is a frequent target for injecting high volumes. However, the safe intramuscular injection sites have been controversy in this region. This study was aimed to compare the subcutaneous fat and muscle thicknesses at the two gluteal injection sites and to determine the influence of sex and body mass index (BMI) on fat and muscle thicknesses. The ultimate purpose of this study is to suggest the most suitable intramuscular injection site among the ventrogluteal and dorsogluteal regions. Eleven fresh cadavers were injected with colored gelatin using syringes at the two gluteal injection sites. Seven variables were measured at both gluteal injection sites and analyzed relative to sex and the BMI. No variables showed statistically significant differences between the two gluteal injection sites according to sex. In a one-way analysis of variance, total length and muscle thickness had significant difference according to the BMI category. In obese cadavers, the injected gelatin core was located in the subcutaneous layer (average 109.0 percentile), and in the muscle layer (average 78.9 percentile) in the dorsogluteal region. These were found that the success rate of injection in the dorsogluteal region was higher than in the ventrogluteal region, especially when classed as obese. Also, it is suggested that nurses should use the traditional intramuscular injection method. It will also be necessary to consider expanding these findings to other ethnic groups in the Asia-Pacific region and then also education in universities and health providers on selecting the intramuscular gluteal injection site.

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“…The medication pack includes a 23-guage 1.5 inch needle with advice to use a 2 inch needle (not provided) in people with a BMI greater than 30 kg/m 2 . This advice is supported by magnetic resonance imaging studies showing that a 1.5 inch needle would result in injection failure for 70% of women with a BMI greater than 30 kg/m 2 and 60% of men with a BMI greater than 35 kg/m 2 [8]. Other studies have used computerised tomography scanning to show high rates of IM injection failure, though additional staff training can improve success rate [9].…”

Section: Key Pointsmentioning

confidence: 99%

Clinical implementation of long-acting antiretroviral treatment in high-income countries: challenges and advantages

Waters

Sparrowhawk

2022

Current Opinion in HIV and AIDS

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Purpose of reviewLong-acting antiretroviral therapy (LA-ART) brings a paradigm shift to HIV care with injectable cabotegravir/rilpivirine (IM-CAB/RPV) in current or imminent use in several countries. This brings the usual opportunities and challenges of a new therapy, plus requirements to adapt services to reliably deliver injections and ensure patients understand advantages and limitations. We summarise key considerations for implementation in high-income countries.Recent findingsMonthly IM-CAB/RPV is noninferior to oral ART and monthly IM-CAB/RPV to 1-monthly in carefully selected virally suppressed people. The numerically higher virological failure rate on two-monthly IM-CAB/RPV warrants close attention and careful monitoring. Implementation projects report positive experiences for patients and staff, but also barriers. Data is needed in younger people, pregnancy/breastfeeding, and in those with detectable viraemia secondary to suboptimal adherence.SummaryWe highlight a paucity of real-world data and key unanswered questions. Existing data on injection techniques may have implications for training; monitoring of outcomes is crucial to ensure clinical trial results are replicated in real-life. Better understanding of treatment failure, and individualised therapy, is crucial, and it is important to repeat patient preference surveys as new data emerges to ensure decisions are based on the most recent evidence of benefit vs risk.

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Body Mass Index: A Reliable Predictor of Subcutaneous Fat Thickness and Needle Length for Ventral Gluteal Intramuscular Injections

Cited by 9 publications

References 35 publications

Evaluation of the effect of selecting gluteal injection site on the pain injection based on anthropometric indices and body shape pattern: A randomised controlled trial study

Evaluation of the effect of selecting gluteal injection site on the pain injection based on anthropometric indices and body shape pattern: A randomised controlled trial study

Evaluating the effectiveness of gluteal intramuscular injection sites: a cadaveric study

Clinical implementation of long-acting antiretroviral treatment in high-income countries: challenges and advantages

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