Ventrogluteal Injection

The ventrogluteal injection site is the preferred injection site for adults and children over 7 months. The muscle that is injected into at the ventrogluteal injection site is the gluteus medius. The advantages to a ventrogluteal injection are that it is reasonably free of major nerves and vascular branches. The bony landmarks such as the greater trochanter and the iliac spine make this injection site easy to locate. The muscle mass at the ventrogluteal injection site is adequate enough for deep IM or Z-track injections. The last advantage of this Intramuscular (IM) injection site is it can be administered from numerous patient positions such as the supine, lateral (left or right), and on the abdomen. Don't forget to tell the patient to relax the muscles prior to injection, as this can reduce the chances of bruising and more importantly, reduce pain or discomfort. The only major knocks against this IM injection site is that if hypersensitivity were to take place a tourniquet would not be possible to apply to delay absorption. Of course the other disadvantage to this site would be a healthcare professional's unfamiliarity with the ventrogluteal injection site.

First things first, to a patient this location could be considered a private area as the pants need to come down a bit to be able to locate the IM injection properly. The procedure should be explained so that the patient understands what is going to happen so they are not startled or if an alternate location needs to be considered. Once past that point remember that the volume of drug that can go the ventrogluteal route is 1.0 - 4.0 ml for well developed muscles, but a child under 2 years old should receive no more than 1 ml in the ventrogluteal site. The gauge of needle can be 21-25, with a length of 1.5 inches for the average sized adult; the needle would be much shorter for skinny individuals and children. Larger patients may require a needle that is larger than 1.5 inches to make sure the needle makes it through the adipose tissue (fat). Be sure that the angle of all ventrogluteal injections is 90 degrees.

First you must determine which hand you will use to locate the IM injection site by the position the patient is in, for example if the patient is on their right side you would use your right hand to find the landmarks. So using the example, a person is lying on their right side so you would take your right hand and place it on their greater trochanter, depending on the length of your fingers you would then place your index finger on the anterior superior iliac spine or point your finger in that direction with the thumb pointed at the groin, all other fingers should be pointed at the patient's head. Once your hand is in position move your middle finger back along the iliac crest towards the buttock as far as you are able to go. This forms the triangle with the index and middle finger and the center of that triangle is the injection site for a ventrogluteal injection.