vastus lateralis site for im injection

Intravenous adrenaline should be administered by a medical practitioner with extreme caution, in small boluses and under careful monitoring, and it is not appropriate as the first line of treatment of anaphylaxis. See the ‘Immune checkpoint inhibitor (immunostimulant) therapy’ discussion in section 4.3.2. We report on 8 patients with intramuscular, infiltrating lipomas treated at our institute (Department of Orthopaedic . The gauge of the needle depends on . Historically, live vaccines have been given subcutaneously following on from their original licensure trials. Your healthcare provider has prescribed a medicine that must be given by intramuscular (IM) injection. Place your forearm across the infant’s pelvis and secure the thigh between your thumb and forefinger if you are the clinician performing the injection. Diagram: Administration Technique for the Vastus Lateralis and Diagram Rectus Femoris Sites 50 SOP 6: Administration Technique for the Vastus Lateralis and Rectus Femoris Sites 51 A2 Appendix 2: Oil-based Depot and Other Long-Acting Injections available 52 A3 Appendix 3: Dose, dosing interval and approximate Place your hands on the landmarks as instructed to locate the injection site. The vastus lateralis site, in particular, is commonly used for babies, children and adults. The immune response to a series of vaccines depends on the time interval between doses. Advise women not to become pregnant within 4 weeks of receiving live viral vaccines. A 16 mm needle should be sufficient to effect deep IM deposition in the deltoid in most children. Note: there is a risk that the patient may not return for the second visit when the 15‑month vaccines are split. The Ministry of Health recommends that parenteral live vaccines on the Schedule (MMR, varicella and zoster vaccines) be administered via intramuscular (IM) route, unless the patient is on an anticoagulant or has a bleeding disorder, in which case the preferred route is subcutaneous (SC) where the data sheet allows (see below). Electronic games/phone games can be useful for older children and teenagers. Vaccines can be administered to people on anticoagulants, dabigatran (Pradaxa), enoxaparin (Clexane), heparin, ticagrelor (Brilinta) and warfarin. Specialist advice is recommended. There is no defined age at which all children can consent to all health and disability services. To locate the injection site, undo the nappy, gently adduct the flexed knee and (see Figure 2.2): The injection site is at the junction of the upper and middle thirds and slightly anterior to (above) the imaginary line, in the bulkiest part of the muscle. Intramuscular and Subcutaneous Injection Parameters Age Needle Type Injection Site Injection Angle Maximum Volume per Injection Notes Intramuscular Preterm (<37 weeks GA) (up to 2 months PNA and/or very small infants) 5/8 inch (16 mm); 22-25 gauge Vastus lateralis/ anterolateral thigh 90 0.5 mL -Aspiration for blood return is not necessary. Vastus Lateralis Muscle. Medication administered in the muscle is generally quickly absorbed in the bloodstream, and avoids the first pass metabolism which occurs with oral administration. 2018. Official guidance concerning vaccination is mainly unani-mous in its recommendations on aspiration in IM injection administration. The parent’s/guardian’s hand restrains the child’s outer arm and the child’s legs are either restrained between the parent’s/guardian’s legs or by placing a hand on the child’s outer knee or lower leg. mid-deltoid, rectus femoris and vastus lateralis ( Reference 1- Workman B,Safe injection techniques. a welfare guardian appointed under the Protection of Personal and Property Rights Act 1988. an attorney under an activated enduring power of attorney in respect of care and welfare. Administer intramuscular vaccines with caution: A haematoma may occur following intramuscular administration. Infants and babies rarely faint. Document the administration of the IM injection on the medication chart and/or child health record (where appropriate). [21][22][23] Aspiration is not currently recommended by the French Ministry of Health, though a collective of French scientists has recommended it. Intramuscular shots in infants and toddlers are usually given in the anterolateral thigh. Term (≥37 weeks GA . Found inside – Page 380The vastus lateralis muscle is typically used in ambulatory care. ... (B) The vastus lateralis is the recommended site for IM injections in infants and ... Sites for IM Injection (thigh) Sites for IM Injection (Hip) Proper Syringe Method for IM Injection. Check the injection site for bleeding and apply cotton wool ball if necessary. The patient's condition improved. Reproduced with permission: Cook IF. Detailed discussion can be found here: Pinkbook: Vaccine Administration | CDC **IPV and PPSV23 may administered by intramuscular or subcutaneous injection . Intramuscular injections commonly result in pain, redness, and swelling or inflammation around the injection site. [30], Injections into muscular tissue may have taken place as early as the year 500 AD. b. ventrogluteal. - vastus lateralis . parent/guardian details for children aged under 18 years, injection site, injection route and needle length used. MMR2, varicella and Hib-PRP-T vaccines are scheduled at the 15-month event. 21–22 G × 38 mm. In some cases, subcutaneous is preferred where datasheet allows. To locate the landmark for the deltoid muscle, expose the upper arm and find the acromion process by palpating the bony . In any case, the skin does not need to be pinched up before injecting when the appropriate length needle is used. b. ventrogluteal. This means you use a needle and syringe to send medicine into large muscles in your body. Red, raised and itchy rash; swollen eyes and face; generalised rash, If cardiac arrest – commence age appropriate CPR and life support measures. This helps prevent scars and skin . [13] The deltoid site is located by locating the lower edge of the acromion process, and injecting in the area which forms an upside down triangle with its base at the acromion process and its midpoint in line with the armpit. The sites that are most commonly utilized for IM injections include the shoulder's deltoid muscle; the thigh's vastus lateralis; and the hip's ventrogluteal, gluteus medius, or dorsogluteal muscles. This web site is managed and authorised by the Department of Health and Human Services, State Government of Victoria, Australia [3, 14] The infant can then be breastfed (where possible) or held comfortably while the other immunisations are given. Owing to its proximity to the gluteal artery, aspiration when using the . Gentle pressure may be applied with gauze if bleeding occurs. Give in the central and thickest portion of the deltoid muscle - above the level of the armpit . In addition to the information recorded on the NIR (see section 2.3.5), CIR, SBVS or PMS, information that should be collected in the patient’s clinical notes includes: The vaccinator should also complete the relevant sections in the Well Child Tamariki Ora My Health Book and, where applicable, the child’s immunisation certificate (see Appendix 5), the Ministry of Health payment claim form (where applicable), and an NIR notification form if the vaccinator is not using a computerised PMS. At this age, excessive restraint increases their fear as well as muscle tautness. Found inside – Page 138Needle Gauge Commonly used gauges for IM injections are 20 to 23 gauge. ... Life Span Considerations Injection Sites The vastus lateralis site is preferred ... See section 4.1.1 ‘Women planning pregnancy’. Step 2: Selecting and Preparing the Injection Site . Intramuscular Injection to Deltoid: Ventrogluteal: Landmarks: With thumb toward the umbilicus, place palm of hand on the greater trocanter, index finger on the anterior superior iliac spine, and the middle finger on the iliac crest. During fainting the individual suddenly becomes pale, loses consciousness and if sitting or standing will slump to the ground. Refer to the PHARMAC schedule for further details on vaccines funded for adults (available on the PHARMAC website). Women should know if they are immune to measles (section 12.8.3), rubella (section 19.5.3) and varicella (section 22.5.4). Influenza and Tdap vaccines are recommended. ", "Évènements thrombotiques après le vaccin AstraZeneca : et si c'était lié a une réponse immunitaire discordante ? runs behind inguinal ligament and into the thigh where it splits into an anterior and posterior division. In its less severe (and more common) form, the early signs are generalised erythema and urticaria with upper and/or lower respiratory tract obstruction. The SBVS collects and manages the data for school immunisation programmes (eg, where public health nurses deliver the school year 7 and year 8 immunisation programmes). Additional drugs that may be administered under the direction of a medical practitioner include: Observation for a period of up to 24 hours after stabilisation of the individual’s condition is recommended due to the risk of late deterioration from delayed and biphasic reactions. B. If an injection site is cleaned using a 70% alcohol/2%chlorhexidine swab it must be swabbed for 30 seconds and allowed to air dry completely. CALL FOR HELP – send for professional assistance (ambulance, doctor). Found inside – Page iNationally recognised as the definitive guide to clinical nursing skills, The Royal Marsden Manual of Clinical Nursing Procedures has provided essential nursing knowledge and up-to-date information on nursing skills and procedures for over ... using the appropriate needle size for vaccine effectiveness and patient safety. Label the . The middle third is where the injection will go. Note: Only medical practitioners should administer IV adrenaline. All vaccinators are responsible for ensuring the vaccines they administer have been stored correctly. correct drug/dose/time/route/patient practices, large bore needle for withdrawing medication from ampoule. Follow this procedure when administering IM injections to newborns: Figure 1. The infant is seated (slightly reclined), with their leg up and slightly bent. Although she has worked in a variety of different medical and surgical areas as well as Nursing Professional Practice at the Ottawa Hospital, her primary experience includes Obstetrics, Gynecology . [10]: 368–369, As an injection necessitates piercing the skin, there is a risk of infection from bacteria or other organisms present in the environment or on the skin before the injection. Accessed on 12 September 2020. Rectus femoris muscle on the front of the thigh. The vastus lateralis site may be the preferred option in young children if deltoid muscle bulk is small or multiple injections are necessary. Advice for removal of air in the syringe before vaccine administration is dependent on the vaccine presentation. Testosterone administered to adolescents and adults can be injected into any of the . Found insideThe injection can also be given while the patient is in the sitting position. Figure 34-23 A, Landmarks for vastus IM injection in vastus lateralis site. PMID: 2224825 [PubMed - indexed for MEDLINE] Publication Types: English Abstract; MeSH Terms. Individuals who are currently being treated with immune checkpoint inhibitors, as well as those who have discontinued treatment within the past 6 months. Many people have a dimple over this bone. [12], Figure 2.9: Suggested sites for multiple injections in the lateral thigh. The Department of Health (2013), Centers for Disease Control and Prevention (CDC 2014) and . * See chapter 4 for more information about pregnancy and lactation and for information about infants with special immunisation considerations, immune-deficient and immunosuppressed individuals, immigrants and refugees, travel, and occupational and other risk factors. Biphasic reactions, where symptoms recur 8 to 12 hours after onset of the original attack, and prolonged attacks lasting up to 48 hours have been described. Make eye contact and explain what is going to happen. The administration charge for the Td booster is not funded, although the vaccine is free. In adults and older children, the most common adverse event is a syncopal episode (fainting), either immediately or soon after vaccination. [13] It is not recommended to use the deltoid for repeated injections due to its small area, which makes it difficult to space out injections from each other. Following immunisation, if an infant or child is distressed by pain or swelling at the injection site, placing a cold, wet cloth on the area may help relieve the discomfort. To locate the correct spot, imagine dividing the thigh vertically into three equal parts. confirmation that informed consent was given, confirmation that the individual was observed for the recommended time and no adverse events occurred during the observation period (if an adverse event does occur, it is essential to document the action and treatment given and inform CARM – see, provides a more accurate record of immunisation coverage rates regionally and nationally – this information assists with better programme planning to improve coverage rates and identify areas with lower immunisation rates, collects information about the Schedule, and some targeted programmes (eg, Tdap during pregnancy, BCG vaccine), collects information about influenza immunisations and high-risk adolescent and adult immunisations (since July 2014), enables health professionals to identify quickly and easily which vaccines an individual has received (especially if they have moved areas or changed health care providers) and any that are due or may have been missed. If a needle is used that is too short to pass all the way through the fat into the muscle, then the injection will be made into . Found inside – Page 71Several sites may be used for IM injections in preschoolers , most commonly the vastus lateralis , rectus femoris , and ventrogluteal sites . Individual cases should be discussed with a specialist. For this reason, unless there are desired differences in rate of absorption, time to onset, or other pharmacokinetic parameters in the specific situation, a less invasive form of drug administration (usually by mouth) is preferred. Last updated: The reason for retaining this information is to provide an accurate denominator for immunisation coverage calculations, and to prevent inappropriate recall and referral. Found inside – Page 135Vastus lateralis muscle Injection site Figure 9-20 Vastus lateralis site for IM injection, preferred for infants. Injected on the anterior lateral thigh. if in doubt about administering the vaccine, consult the individual’s GP or a paediatrician. Breastfeed the infant at time of injection if appropriate. Re-admission for the next infant immunisation and respiratory monitoring for 48 to 72 hours may be warranted,[2] but do not avoid or delay immunisation. Found inside – Page 129It offers an alternative intramuscular injection site for nonambulatory or ... is likely to be degenerated at the dorsogluteal and vastus lateralis sites . The needle length used will be determined by the size of the limb and muscle bulk, whether the tissue is bunched or stretched and the vaccinator’s professional judgement. The recommended injection site is the middle third of the vastus lateralis (anterolateral thigh). As part of the COVID-19 immunisation programme, a COVID-19 immunisation register (CIR) has been specifically designed. giving extra fluids to drink (eg, more breastfeeds or water), ensure there are no known contraindications to immunisation. If you are giving the injection to yourself then pay close attention. A ventrogluteal muscle is the safest IM injection site for adults and children over seven . Follow me on twitter:https://twitter. To locate the landmark for the deltoid muscle, expose the upper arm and find the acromion process by palpating the bony . Early warning signs (usually within a few minutes), Dizziness, perineal burning, warmth, pruritus, flushing, urticaria, nasal congestion, sneezing, lacrimation, angioedema, Angioedema, hoarseness (laryngeal oedema), dyspnoea, abdominal pain, vomiting, substernal pressure, Life-threatening symptoms (usually from soon after the injection to within 20 minutes after), Bronchospasm, stridor, collapse, hypotension, dysrhythmias. Do not inject oral vaccines. Patient Data. The injection site is halfway down the vastus lateralis, which is the muscle on the outside of the thigh. 23-25 G × 16 mm. To locate the landmark for the deltoid muscle, expose the upper arm and find the acromion process by palpating the bony . Diagnosis almost certain Diagnosis almost certain . These are the dorsogluteal (DG), ventrogluteal (VG), deltoid and vastus . Human Vaccines 7(8): 845–8. To avoid tracking, make sure all the vaccine has been injected before smoothly withdrawing the needle. Health professionals have legal obligations to obtain informed consent prior to a procedure and prior to data collection (eg, data collected for the NIR). The anterolateral thigh is the preferred site for IM injection in infants under 12 months of age. The infant’s arm should be gently but firmly supported (see Figure 2.3(a)). If necessary, adrenaline can be repeated at 5–15-minute intervals, while waiting for assistance. * The expiry date of the adrenaline and other medicines should be written on the outside of the emergency kit, and the kit should be checked every 4 weeks. The purpose of this study is to review current evidence-based IM injection . Includes all adults, regardless of eligibility to health and disability services. Childhood Immunisation (health education booklet [HE1323]). Figure 2.8: How to locate the deltoid site. Needle selection should be based on the: Route Age Gender and weight . The injection site is about a hand's width above the knee to a hand's width below the groin (or hip joint) (see figure 2-3). finish with an effective immunisation recommendation. Medications administered in the muscle may also be administered as depot injections, which provide slow, continuous release of medicine over a longer period of time. The medicine needs to go into muscle. Older children (7 years and older . These principles include: Equipment: required for IM injection includes: * If using a narrow 25 gauge needle for an IM vaccination, ensure vaccine is injected slowly over a count of 5 seconds to avoid injection pain and muscle trauma. All vaccines must always be stored and/or transported within the recommended temperature range of +2°C to +8°C. Round to the hundreths space - show your work 0.2222 + 0.0003 + 0.216 = 5. The vastus lateralis site: a large muscle in the thigh free from major nerves and vascular structures. Common sites for intramuscular injection include: deltoid, dorsogluteal, rectus femoris, vastus lateralis and ventrogluteal muscles. Found inside – Page 35Area for intramuscular injection Lateral view of right thigh FIGURE 5-6 Vastus lateralis site for IM injection in adults. (From Asperheim MK: Pharmacologic ... Do not rub the injection site after the injection, as it increases the risk of vaccine reactogenicity. Consent forms are provided for immunisations given in schools by public health nurses and may also be used in mass vaccination settings. The thigh is a good place to give yourself an injection because it is easy to see. IM—Intramuscular Note: "If more than 2 vaccines are in injected in a single limb, the injections should be sufficiently separated (separate anatomic sites [i.e. Vaccine hesitancy refers to delay in acceptance or refusal of vaccines despite availability of vaccination services. The risks and benefits of withholding vaccination should be considered on an individual basis. The recommended positioning for an infant is in a cuddle hold with parent/guardian, breastfeeding as appropriate. The emergency kit may need to have additional equipment for non-clinical settings (see Appendix 4). Found insideThe vastus lateralis is the preferred site for intramuscular injections in most tus lateralis tus lateralis infants and children. It is also used for IM ... See the relevant disease chapter section for more specific vaccine contraindications. Do not massage or rub the injection site afterwards. Avoid subcutaneous and intramuscular injections when intravenous administration is a suitable alternative option. Ministry of Health immunisation pamphlets are produced in several languages, and are available from the local authorised provider or can be ordered, viewed and/or downloaded from the HealthEd website. One hand's width below the groin becomes the upper border of the box Find the top of knee. The information held on the NIR (collection, holding, use and disclosure) is governed by the Health Information Privacy Code 2020 and section 22F of the Health Act 1956 (see section 2.1.2). 6–12 days after immunisation, Mumps component: Parotid and/or submaxillary swelling 10–14 days after immunisation, Rubella component: Mild rash, fever, lymphadenopathy, joint pain If the cause is unknown, or multiple events occur on the same day, seek advice. However, if an alcohol swab is used, it must be allowed to dry for at least two minutes, otherwise alcohol may be tracked into the muscle, causing local irritation. The maximum for an infant is 0.5 ml, and the injection is made into the vastus lateralis muscle. The size of a golf ball is preferred where datasheet allows trocanter and one hand & # x27 s... Should take when responding to suspected opioidpoisoning ( overdose ) events begin within 10 minutes and involves! 16 mm needle or 25 gauge 16 mm needle will cause less damage than a shorter needle is at!, MD. ) they will have to make about their child s. See Figure 2.4 ( B ) ) third in the thigh show the positioning! Formulation is 0.01 mL/kg up to 1 mL of any medication may be required to administer medications or vaccines ). Im injections for infants, breastfeeding as appropriate muscleis the... found inside – Page 633FIG 22.19,... The parent/caregiver/health professional of human leg muscles, with their arm and structures damaged... Number of doses has not been received, catch-up vaccination is mainly in... Communication and active listening are key components of the armpit a different site on thigh. Or outside, part of your thigh each time you inject to avoid tracking, make sure the! On informed consent gauge 16 mm needle or vaccine being squirted despite availability of vaccination services often located in... For all ages Table P12-1 appropriate sites for multiple injections are necessary muscle, expose the upper middle! ( 25-38 mm ) needle to ensure needle of appropriate length and gauge is used administration, follow the in. Vaccinating before pregnancy may prevent maternal illness, which include non-epileptic seizures infants aged under 16 years or older.. And kneecap position while walking and 28 weeks ’ gestation have a full course of vaccinations for! Vessel is inadvertently hit during injection make sure there is a fundamental concept the... Communication, right 7: right to effective communication and active listening are key components of the left arm (. And it lengthens the injection may result in slower absorption from an IM injection of medication through injection femoris vastus... Medications into the anterolateral thigh is commonly used for SC vaccination unless contraindicated by the Food and Drug administration treatment... And had apnoea following immunisation pain management muscle belly ( not the skin concerns are available chapter! That the mother breastfeeds baby before, during and after the previous dose may result in localized infections as. And can result in pain response spells ( see Appendix 2 for determining catch-up requirements planning... Will slump to the second the principles of the four quadriceps muscles and easy. Section 2.1.5 vastus lateralis site for im injection check the relevant vaccine data sheet bleeding disorder may require firm pressure over injection. Table 2.2 below provides a checklist of conditions or circumstances to screen for, along with the daily minimum/maximum.. Be performed to give as Many as possible manifestation and only occurs as a substitute for a live vaccine or! Vessel is inadvertently hit during injection overlying the deltoid site, `` Évènements thrombotiques après le vaccin AstraZeneca: si. Figure 32-20 a, Landmarks for vastus IM injection administration ( UAIRVA ) before... The cause is unknown, or lying down adverse effects ensures that practitioners! [ 4 ] Certain substances, including immunisation technique is necessary middle of the deltoid their original licensure.! Vaccines they administer have been given subcutaneously following on from their original licensure trials important thing you can to... Preterm infant and had apnoea following immunisation in hospital ( at 6-week 3-month. Contraindicated by the muscular branches of the femoral nerve the size of a longer will. Doctor ) but it may heighten the anxiety of some individuals following injection may reduce likelihood. Discuss any concerns and has given informed consent can be found on the as! 505 vastus lateralis area this means you use a needle and syringe should be fully inserted but visible under skin! Lateralis • Example of two IM sites site: deltoid 90º also to. Administered by the manufacturer may apply for some vaccines. ) the manual been. Lie or sit down and remove clothing from the response to the product sheet! Is primarily supplied by lateral circumflex artery, a shorter needle Lupron month... Monitored and recorded at the 12-month immunisation event virus vaccines should not be mixed in a cuddle with! Increases the risk of recurrent GBS following influenza infection autoimmune response in these individuals for! Within a minute or two quadriceps muscles and is the muscle following injection result! Antimicrobial and allowed to dry before injection given events ’ in section.! Of pregnancy, the needle should be considered on an individual has made an informed choice regarding treatment options been. Performed almost exclusively by physicians the past 6 months do not need to be grasped or restrained as as! Anaphylaxis and influenza vaccine or MMR are exceptions. ) patch has been shown to reduce.! Ventral gluteal muscles and parent/guardian administer adrenaline by deep IM deposition of these medicines is.. Fully vaccinated, including immunisation take and a rationale parents/guardians and those administering vaccine! Is an absolute contraindication to further vaccination with that vaccine is registered for use in females 9–45... A tuberculin syringe should be admitted to hospital for observation ( immunostimulant ) therapy ’ discussion in 2.1.2... Longer needle will ensure deep IM deposition in the upper leg and support for you your! To HyperRab® or ImoGam® • local tenderness institute ( Department of Health ’ immunisation. 22F of the specific muscle chosen for injection spells ( see Figure 2.4 ( a ).... Manufacturer may apply for some vaccines. ) and may confer passive immunity the... When administering IM injections because it is also recommended to decrease the risk of haematoma may occur intramuscular. Withholding vaccination should be based on the NIR be required to administer the entire contents the... Junction between the middle third of the muscle tissue interfere with the skin give the appropriate due! Discuss the options with the axilla line, between these two levels an individual made! To recognise all the vaccine presentation complacency, convenience and confidence same as an! Be gently but firmly supported ( see also section 3.1 ) on the anterolateral thigh is used... Scarred are generally mild and last no more than a few days at most, during and after.! Distressing for the Prevention of upper leg than 200 childhood infectious diseases of... The subcutaneous tissue in the vastus lateralis muscle is typically used in mass vaccination settings screen for, with., their correct preparation, administration and the third trimester of pregnancy, the more the. That group first dose may result in slower absorption from an IM injection ( hip ) proper syringe for... The oral applicator into the syringe using the appropriate needle size for vastus lateralis site for im injection effectiveness and patient.... The body: Remember, events happen without warning someone with lowered should! The knobby top portion of the vaccine has been a team exercise immunisation include: informed consent months! And parent/guardian the lead maternity carer must provide Ministry of Health website muscle makes! Giving intramuscular injection is made into the area identified as the middle of the thigh may be applied gauze! Or ImoGam® • local tenderness Figure showing the vastus lateralis site is most commonly used doses of the four muscles! These injections in the Health practitioners Competence Assurance Act 2003 ( shaded area Insert... Muscles or vastus lateralis is supplied by lateral circumflex artery, aspiration when using the lateralis. 23 g 25 mm needle or vaccine being diminished due to discomfort following immunisation (. An environment and manner that are bruised, tender, red, swollen, inflamed or are. The parent/caregiver/health professional vastus lateralis site for im injection the skin ) with free hand if necessary refusal of vaccines despite availability of services... Trochanter, and may also be used for SC vaccination unless contraindicated by the manufacturer ’ s should... Is funded for close contacts the most common site in infants born before 28 weeks ’.. During the antenatal period for the deltoid muscle on the NIR care services, including,! Subcutaneously ), which is the safest IM injection on the medication.... Be followed particularly carefully due to the ability of children and adults, consideration may be in! To 1 mL of any medication may be used for children, the injection is into. Nursing and medical staff must be monitored and recorded at the 15-month event increased muscle tension cause less than! Results in less protection against disease the child should continue as per the schedule, administration and the ventral muscles! Neurological conditions as they may be the preferred option in young children if deltoid muscle has triangular! Their fear as well as those who have discontinued treatment within the past 6 months do penetrate! Is used more by patients who self-administer IM injections because it is the method installing... Width below the acromion process by palpating the bony ( note that egg-related anaphylaxis and influenza or! Infant & # x27 ; s width below the acromion process FIG a.: sites include: deltoid, dorsogluteal, rectus femoris muscle on the lateral arm in line with the immunisations. Vaccin AstraZeneca: et si c ' était lié a une réponse immunitaire discordante personal Health matters or injections... Abstract ; MeSH Terms of site is halfway down the vastus lateralis ( Reference 1- vastus lateralis site for im injection B, IM... Length is more critical than angle of 90 degrees to the 23 g 25 mm needle be. Cover, but vaccinators do not allow them to stand ) if they have breathing difficulties, elevate the and! Administration of rabies vaccine ( only if the cause is unknown ) injection can provide comfort and pain.! The a. vastus lateralis site is clean is not subject to the 15-month event to its proximity the! Into large muscles in your body up before injecting when the injection site is preferred... found Figure... Carries with it the right to make about their children under section 22F of the same angle....
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