The relationship between body mass index,  thickness of subcutaneous fat, and the gluteus  muscle as the intramuscular injection site

Sakamaki, Sakiko; Yasuhara, Yuko; Motoki, Kazushi; Takase, Kensaku; Tanioka, Tetsuya; Locsin, Rozzano C.

doi:10.4236/health.2013.59196

Cited by 13 publications

(17 citation statements)

References 12 publications

(11 reference statements)

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“…[2,11,[44][45][46] Critical assessments of patient weight, BMI, gender and injection site, needle length, volume of medication before administering IM injections is important and therefore should drive practice change.…”

Section: Injection Depthmentioning

confidence: 99%

Evidence calls for practice change in intramuscular injection techniques

Strohfus

Paugh²,

Tindell³

et al. 2017

JNEP

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Background and Objective: Intramuscular (IM) injections are administered to patients in all health care settings. Even though this procedure is invasive and the evidence supporting the process of administration is extensive, techniques and procedures vary throughout the literature and in practice. The purpose of this descriptive correlational study was to 1) investigate the literature on current evidence-based IM injection procedures pertaining to gender, patient weight, injection site, needle length, and technique, 2) compare surveyed healthcare personnel self-reported IM injection practices, and 3) query respondents on informational resources they access, continuing education they receive, and their years of healthcare experience and higher education. Methods: The Intramuscular Injection Questionnaire (IIQ) was sent via email to various professional healthcare facilities and their respective social media sites. Two hundred and six (206) healthcare personnel of various healthcare backgrounds and educational levels accessed the IIQ via a link to Qualtrics software. SPSS Version 24 was used for data analysis. Results: Most respondents were registered nurses with 4 -15+ years of experience. Seventy-eight percent of respondents considered their IM injection knowledge at above average or expert levels. Gender was not considered an important factor when selecting an injection needle among 75% of participants. Of all respondents, 61% use z-track technique, 59% use the ventrogluteal site and 34% always bunch or stretch the skin during injection. IM injection education was not provided in 75% of healthcare facilities. Conclusions: IM injection practices vary among respondents and in the literature; some reported practices are contrary to current evidence-based practice. While the evidence provides some sound recommendations, some procedures are not well-documented or supported including in nursing texts. Nurses and other healthcare personnel must critically analyze the site, depth, needle, volume, medication, vaccine, and whether to bunch or stretch, according to evidence-based practice. Healthcare facilities should provide IM injection education routinely to ensure safe practices. Future studies (Level 1 and 2) are needed to further demonstrate the best evidence leading to safe and effective IM injections.

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Section: Injection Depthmentioning

confidence: 99%

Evidence calls for practice change in intramuscular injection techniques

Strohfus

Paugh²,

Tindell³

et al. 2017

JNEP

View full text Add to dashboard Cite

show abstract

“…Sakamaki et al [9] measured the Four and Three-way split positions of healthy subjects by ultrasonography. Their study showed that the mean value of the DEB were, in the case of persons with BMI of <21 kg/m 2 , 67.46 mm on the right buttocks, and 63.76 mm on the left buttocks, and, in the case of persons with BMI ≥ 21 kg/m 2 , were 73.34 mm on the right buttocks and 70.17 mm on the left buttocks.…”

Section: Discussionmentioning

confidence: 99%

“…In Japan, Yasuhara et al [5], Sakamaki et al [9], and Tanioka et al [10] measured by ultrasonography the optimal injection needle length for dorsogluteal IM injection sites among Japanese volunteer subjects. Similarly, Takahashi et al [11] measured the subcutaneous tissue thickness of Hochstetter's site.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Gluteal Muscle Intramuscular Injection Sites of Japanese Healthy Subjects: Considerations for Optimal Insertion of Injection Needle Length

Masuda¹,

Yasuhara²,

Tanioka³

et al. 2016

OJPsych

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Long Acting Injectable (LAI) medications for patients with schizophrenia is commonly administered to relieve their symptoms. Through shared decision-making and clinical evidence-based, psychiatrists should systematically offer LAIs to all patients requiring long-term antipsychotic treatment as a first-line treatment. Gluteal intramuscular (IM) injection requires accurate insertion of needles into the specific muscle area, often the outer upper quadrant of the buttocks, in order to achieve the required blood concentration. The purposes of this study were to compare the "Distance from the Epidermis to the Under-Fascia (DEUF)" and "Distance from the Epidermis to the Iliac Bone (DEB)" of the buttocks IM injection sites at the dorsogluteal and ventrogluteal sites among healthy Japanese volunteer subjects, and to identify the optimal insertion injection needle length. The DEUF and DEB at the gluteal regions were measured by ultrasonography. Welch's one-way analysis of variance was used to compare the DEUF and the DEB at the gluteal IM injection regions. There was no statistically significant difference observed between the right and left mean values of DEUF for Hochstetter and Clark's point at the ventrogluteal sites, and the Four and Three-way split or Double Cross point at the dorsogluteal sites. However in the DEB, the Hochstetter's point (P < 0.01) at ventrogluteal site on the right side, and Clark's point (P < 0.05) were significantly shorter than the Double Cross point at dorsogluteal sites (F = 4.38). The left buttocks S. Masuda et al. 204 Hochstetter's point was significantly shorter than the Double Cross point (F = 4.38, P < 0.01). These results, however, did not establish a statistically significant difference in the DEUF among injection sites. It was considered that the difference in the DEB depended on muscle volume and thickness in the gluteal injection sites.

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“…Bu komplikasyonların çoğunda da uygulamanın dorsogluteal bölgeye yapıldığı bilinmektedir (36) . Literatürde kanıta dayalı çalışmalar, ventrogluteal bölgenin büyük kan damarları ya da sinirleri barındırmaması ve kemik dokusundan uzak olması nedenleri ile güvenle kullanılabileceğini gös-termektedir (37)(38)(39) . Fakat ülkemizde bu bölgenin kullanımı henüz yaygın değildir.…”

Section: Imventro-sim (Ventrogluteal Bölge Intramüsküler Ilaç Uygulamunclassified