This position relaxes the muscle and makes the injection less painful. When the gluteus maximus muscle is the site chosen for the injection, the patient should be in a prone position with the toes turned in if possible. The needle is inserted at a 90-degree angle to the skin. The maximum for an infant is 0.5 ml, and the injection is made into the vastus lateralis muscle. As a general rule, not more than 5 ml is given in an intramuscular injection for an adult. The gauge of the needle depends on the viscosity of the fluid being injected. The needle should be long enough to insure that the medication is injected deep into the muscle tissue. The distance is then divided into thirds and the needle inserted into the area identified as the middle third. ![]() The vastus lateralis muscle is located by identifying the trochanter and the side of the knee cap and then drawing a visual line between the two. The area permits multiple injections, is more accessible, and is easier to stabilize, particularly in pediatric patients or others who are restless and uncooperative. Insert the needle at a 90-degree angle and inject all of the vaccine in the muscle tissue. Inject the vaccine into the middle and thickest part of the muscle. Injections into the anterolateral aspect of the thigh are considered the safest because there is less danger of damage to a major blood vessel or nerve. The injection site will be approximately 2 inches below the bone and above the axillary fold/armpit. The deltoid muscle at the shoulder is also used, but less commonly than the gluteus muscle of the buttock care must be taken to insert the needle in the center, 2 cm below the acromion. They should be given with extreme care, especially in the buttock, because the sciatic nerve may be injured or a large blood vessel may be entered if the injection is not made correctly into the upper, outer quadrant of the buttock. Intramuscular injections are given when the substance is to be absorbed quickly. Intramuscular injection injection into the substance of a muscle, usually the muscle of the upper arm, thigh, or buttock.
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