Intramuscular injections

Re: Intramuscular injections

dinny_06 — Mon, 25 Oct 2010 20:18:38 GMT

I would generally inj into the quads, but as said by previous poster it justs depends on the position of the patient. If its in dorsal recumbency and being operated on it can be quite difficult to get at the quads.

Alothough i have recently started injecting into the cervical region and i think it works ok!!. It's just a little bit of confidence that makes the difference, cause if you start doubting yourself thats when you can get problems.

Re: Intramuscular injections

Stella Skelton RVN — Sun, 17 Oct 2010 22:07:24 GMT

I use the quads mostly. i'm not keen on the lumbar muscles...NEVER use the hamstrings....bad idea...

Re: Intramuscular injections

Tracey Louise — Fri, 15 Oct 2010 20:55:13 GMT

i totally agree the lumbar are better tolerated on concious animals, and easier to restrain whilst someone injects. we only use quads on anaesthetised animals, not conscious.

and very true about people not knowing where the quads are lol

Re: Intramuscular injections

SharonSP — Fri, 15 Oct 2010 20:50:25 GMT

Maybe the RCVS have used the quads as a site for IM injections for the OSCE task to ensure students actually know where the quadriceps muscles are....you would be surprised how many students get it wrong!

I prefer the lumbar muscles, I think it causes less discomfort than the quads in a concious animal, very well tolerated.

Re: Intramuscular injections

Tracey Louise — Fri, 15 Oct 2010 09:48:00 GMT

[quote user="Sal (the 1st) Holesworth VN CMH Chyp (M)PNLP"]

The task for student nurses to carry out an i/m injection into the quadraceps - is that suggesting to all training nurses that now the quadraceps is the only site for an i/m injection and that anything else is less than than right? - what happens when they come across a dog on its back on the table undergoing surgery and they cant get at quads and the dog urgently needs i/m ? will it be a case of sorry dog I cant get at your legs?

We are actually losing valuable skills because people are not even prepared to look at another way of doing things or are too quick to discount them.

[/quote]

The student nurses learn all routes of injection during their training, e.g i/m s/c i/v etc and the areas where they can do these injections safely. The practical exam has an i/m task and a s/c task, and that just happens to be in the quadriceps.

I was simply stating that seeing as they are using this area then this is a recognised area to inject into, and not the only area! And another example is that most people inject s/c into the 'scruff' and obviously if this is not accessable for any reason, for example an abscess in or around that area then you must find somewhere else.

It is all about being flexible and knowing a few areas where you are 'safe' to inject and where YOU feel confident, and if you have no access to these then go onto another area. Thats common sense really.

Re: Intramuscular injections

Phrin Vernon RVN — Thu, 14 Oct 2010 20:45:52 GMT

I use epaxial usually, quads in a fat or laterally recumbant patient (such as under ga), and cervical if I have a patient to IM inj and I am on my own.

Just for the record, we were talking about this at college the other day, and there was no preference shown over any site, although the knowledge of anatomy was stressed!

It would be pretty difficult to hit the sciatic nerve giving an IM inj into the quads, unless you were doing something very wrong - ie coming in to the caudal hind leg!!

Re: Intramuscular injections

Kerry Spain — Wed, 13 Oct 2010 23:38:02 GMT

aaah guys don't get me wrong,, I use other injection sites too and only the other week was questioned by a 'vet' who said I was teaching a student the wrong 'thing' (yes I wasn't happy)

I agree things need to be re-addresses and a certain few need to get with the times.

Re: Intramuscular injections

ginny — Wed, 13 Oct 2010 21:12:14 GMT

It was 3 hours of how to do the new "tutorial" using paperwork with what ilooked like types of models of learning given by the RCVS (i don't really do edu-speak,) discussing in groups what we felt we needed to brush up on and having pretend tutorials amongst ourselves using the paperwork discussing this, going through the npl and how it works. I think it was taken as read that we knew what to teach, especially those of us who have been in practice and assessors a while.

Re: Intramuscular injections

Denise — Wed, 13 Oct 2010 20:36:31 GMT

Hi Ginny when you say you 'completed your clinical training' was this an introduction to the new diploma or coaching on how and what to teach?

Re: Intramuscular injections

ginny — Wed, 13 Oct 2010 18:54:42 GMT

I use the lumbar muscles usually, but any port in a storm as they say!

Also i feel a mini rant coming on - i completely agree with Sal - something is going very wrong with all this. I have completed my clinical coach training and there was a bit of emphasis on teaching things the approved RCVS way. I was left wondering just what that was.... and who decides it? Hopefully not the same person who told my Level 3 student that the best dogs to practice endotracheal intubation on were boxers. I shall bow out of this whole training lark if thats the case!!!

Re: Intramuscular injections

Mac Feather — Wed, 13 Oct 2010 13:42:18 GMT

[quote user="Sal (the 1st) Holesworth VN CMH Chyp (M)PNLP"]whatever is the most easily accessible and safe at the time.[/quote]

Good point

Re: Intramuscular injections

BengalcatRVN — Wed, 13 Oct 2010 13:31:21 GMT

I give IM injections into the lumber muscles, having hit a vein the first time I ever tried the leg! In the case of crush cage cats (inc my own) I often try wherever I can get to, pretty convinced it goes intra-cat rather than IM! lol! Maybe the other vet thinks their way is safer/easier/better and maybe it's worth discussing WHY they do this rather than just saying its/everyone else/you are wrong. You might learn something you didn't know before. :) Do the student nurses have to give im inj into the quadraceps only? Where does it say this? is it in the new "portfolio" lantra thingy? I've not even seen the occupational standards yet :o/

Re: Intramuscular injections

Sal the 1st — Wed, 13 Oct 2010 10:49:23 GMT

I have been following this thread with interest - btw I use epaxial,quads, cervical or whatever is the most easily accessible and safe at the time.

To me this thread typifies the inflexibility that is creeping into veterinary practice. Ok I will be the first to admit that things progress and that some of what has happened in the dim and distant past is more than overdue for change but just because somebody does something differently and is able to demonstrate that they can do it safely does that really make them them wrong? The original poster stated that the vets she works with with the exception of the new vet also give an i/m injection in the same place - so golly gosh I suppose it means that those vets are wrong too?

We are actually losing valuable skills because people are not even prepared to look at another way of doing things or are too quick to discount them.

Re: Intramuscular injections

Kim Buckley — Wed, 13 Oct 2010 08:44:45 GMT

I also used quads or lumbar as that's what was the norm in my old practice. I now actually really like using the neck muscles. Especially when you are by yourself because you can control the head whilst you are injecting.

Re: Intramuscular injections

Vicky RVN — Tue, 12 Oct 2010 20:55:07 GMT

We use quads if going into the leg. I generally use lumber though.

Re: Intramuscular injections

Kerry Spain — Tue, 12 Oct 2010 20:38:15 GMT

I think the quads are fine if done properly just remember your anatomy, I think unless your using a harpoon the length of a barge pole your not going to cause any damage

Re: Intramuscular injections

Tracey Louise — Tue, 12 Oct 2010 20:30:20 GMT

We use the quadriceps in anaesthetised animals too, mainly for antisedan. you shouldn't hit the sciatic nerve in those.

Student nurses now have a practical task to perform an intramuscular injection in the quadriceps so it is obviously a reognised area to be injecting into.

We also use the lumbar, and on rare occasions the cervical.

Re: Intramuscular injections

Gillian Mostyn — Tue, 12 Oct 2010 20:24:17 GMT

we usually use the quads - I would have a big hissy fit if I saw anyone putting a needle caudal to the femur!

Also happy to use epaxials (lumbar muscles) if restraint is an issue. I avoid the neck if possible - just remember what my arm felt like after i/m tetanus so don't like to give them a stiff neck! Not really a good reason though....

Re: Intramuscular injections

dinkyd — Tue, 12 Oct 2010 20:18:36 GMT

If you inject into quads though your are not going to damage the sciatic nerve- think this is why this vet is having issues about where they injecting as by the sounds of it ,it aint the quads they are injecting.

Re: Intramuscular injections

Nick Shackleton — Tue, 12 Oct 2010 20:15:46 GMT

[quote user="dinkyd"]

I only ever use hl's when patient anaesthetised and then its always the quads- I also tend to use neck/lumbar too.Run the risk of damaging the sciatic nerve otherwise.

[/quote]

I was always taught to use either cervical or lumber muscles for this reason.

Re: Intramuscular injections

dinkyd — Tue, 12 Oct 2010 20:10:59 GMT

I only ever use hl's when patient anaesthetised and then its always the quads- I also tend to use neck/lumbar too.Run the risk of damaging the sciatic nerve otherwise.

Re: Intramuscular injections

Sandra Taylor RVN, MBVNA — Tue, 12 Oct 2010 20:05:27 GMT

I dont use the hindleg muscles, I was never very confident in it tbh, but you can use the quadriceps femoris or the hamstring(never tried that one) I use the lumbar or neck muscles.