Fundamentals of Nursing Q 334
The mid-deltoid injection site is seldom used for I.M. injections because it:
A. Can accommodate only 1 ml or less of medication.
B. Bruises too easily.
C. Can be used only when the patient is lying down.
D. Does not readily absorb parenteral medication.
Correct Answer: A. Can accommodate only 1 ml or less of medication
The mid-deltoid injection site can accommodate only 1 ml or less of medication because of its size and location (on the deltoid muscle of the arm, close to the brachial artery and radial nerve). It is becoming increasingly important for clinicians to identify a safer intramuscular (IM) injection site in the deltoid muscle because of possible complications following the vaccine administration of IM injections.
Option B: However, Cook reported that these 4 injection sites have the potential to cause injury to the subdeltoid/subacromial bursa and/or anterior branch of the axillary nerve with the arm in the anatomical position. Additionally, we showed that the axillary nerve often runs near the site 5 cm below the mid-acromion lateral border, and concluded that this site is unsuitable for IM injection in terms of the high risk for the complications related to this nerve.
Option C: The deltoid muscle has been used in clinical settings because it is easy for clinicians to administer injections at this site and for patients to expose it, and it is the most commonly used site for vaccines worldwide. Four injection sites have been recommended as safer and appropriate IM injection sites in the deltoid muscle: the first site is 1 to 3 fingerbreadths (5 cm) below the mid-acromion, the second is a triangular injection site, the third is the middle third of the deltoid muscle, and the fourth is a mid-deltoid site.
Option D: The following complications have been reported after the administration of IM injections: injection site reactions such as pain, erythema, and swelling due to over-or under penetration by the needle, axillary or radial nerve palsies, musculoskeletal injuries, local sepsis, and vascular complications. Therefore, it is becoming increasingly important to establish a safer site for IM injections.