How to position the buttocks for injections

Intramuscular injection is a relatively common treatment method. During intramuscular injection, the injection site is usually the gluteus maximus. Positioning must be done first. There are two main methods of positioning, one is the cross method, and the other is the wire net. Of course, for experienced nurses, positioning can be achieved through visual inspection. This is also a common treatment method for diseases.

Overview

In clinical practice, intramuscular injections are generally performed in the gluteus maximus, and some injections are performed in the deltoid muscle and biceps brachii. However, as to the specific location for intramuscular injections in the deltoid muscle, it is generally believed that the injection can be performed in the entire muscle. However, we have found in many years of clinical practice that in some cases, improper intramuscular injection sites may lead to damage to the radial nerve and axillary nerve, while in some cases, the radial nerve and axillary nerve may be directly injected into the sacral nerve.

Method 1: Thumb-fixed point: The patient lies prone or stands, and the surgeon places the middle finger of one hand (the surgeon uses the left hand for injection on the left buttocks and the right hand for injection on the right side) on the patient's anterior superior iliac spine. The thumb is parallel and backward and bent, and the point touched by the fingertip is the injection point (approximately 2 to 3 horizontal fingers above the inner side of the greater trochanter). Method 2: Three lines to determine the area: (1) Horizontal line: from the anterior superior iliac spine around the back to the gluteal cleft; (2) Vertical line: draw a vertical line that bisects one buttock and intersects the horizontal line;

Injection positioning

1. Gluteus maximus injection positioning:

(1) Cross method: Draw a horizontal line from the apex of the gluteal cleft to the left or right, then draw a vertical bisector from the highest point of the iliac crest. The injection site is at the upper outer quarter (avoiding the inner corner).

(2) Line method: The injection site is located at the outer and upper third of the line connecting the anterior superior iliac spine and the coccyx.

2. Gluteus minimus injection position:

(1) Side-lying position: upper leg straight and lower leg slightly bent.

(2) Prone position: toes facing each other and heels apart.

(3) Supine position: During the injection, ask the patient to relax his muscles and not to be tense.

(4) Sitting position: Ask the patient to sit well and relax local muscles.

3. Gluteus medius and gluteus minimus injection positioning:

(1) Place the tips of the index finger and middle finger on the anterior superior iliac spine and the lower edge of the iliac spine respectively. The iliac spine, index finger, and middle finger form a triangle. The injection site is within the angle formed by the index finger and middle finger.

(2) Three finger widths lateral to the anterior superior iliac spine (the patient should use the width of his or her own finger as the standard).

4. Vastus lateralis muscle injection positioning:

The area is on the outer side of the mid-thigh, approximately 7.5 cm wide, 10 cm above the knee and about 10 cm below the hip joint.

5. Positioning of the injection method for the deltoid muscle of the upper arm :

The location is on the outer side of the upper arm, 2-3 horizontal fingers below the acromion.