Optimal Intramuscular Needle-Penetration Depth

Lippert, William C.; Wall, Eric J.

doi:10.1542/peds.2008-0374

Cited by 50 publications

(52 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other potential risks associated with overpenetration includes pain and/or damage to the bone or periosteum and detachment of the needle from the syringe. 5,6 Upper arm intramuscular injections require penetration of the needle into the deltoid muscle layer by 5 mm or more to ensure that the injection is deposited into the muscle mass. 2 Accepted guidelines suggest that the needle should be inserted at 90 to the arm leaving 2e3 mm of needle exposed between the skin and the needle hub to avoid losing the needle within the arm in case the needle breaks at the hub.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Influence of skin-to-muscle and muscle-to-bone thickness on depth of needle penetration in adults at the deltoid intramuscular injection site

Shankar

Saxena

Lokkur

et al. 2014

Medical Journal Armed Forces India

View full text Add to dashboard Cite

Needles Subcutaneous fat a b s t r a c tBackground: The objectives of the study were to estimate the following in adults of Indian origin: a) Gender and side differences in the skin-to-muscle (SM) and muscle-to-bone thickness (MB) at the deltoid intramuscular injection site; b) Correlation of SM thickness with the BMI, age and gender; c) The prevalence of under and over-penetration assuming a standard needle length of 25 mm and following prescribed guidelines for IM injection. Methods: The SM, MB and skin-to-bone (SB) thicknesses were bilaterally estimated in two hundred adult Indian subjects (100 male and 100 female) using an ultrasound probe at a pre-determined point on the upper arms of the subjects. The BMI of each subject was calculated. The unpaired sample 't' test and paired 't' test were used to analyse differences between groups. Pearson's correlation coefficient was used in correlation analysis and suitable linear regression equations were generated. Results: Females had a significantly higher SM thickness and lower MB thickness. The SM thickness was significantly greater on the left side, while the SB and MB thickness were significantly greater on the right. Multiple linear regression equations for both the dominant and non-dominant arms had good model fit properties. Under-penetration would have occurred in 2 (1%) subjects while over-penetration would have occurred in 50% of the subjects. Conclusion: Over-penetration of deltoid IM injections is likely to be more prevalent as compared to under-penetration. Therefore, the technique of IM injection needs to be modified based on the body type of the individual patient.© 2014, Armed Forces Medical Services (AFMS). All rights reserved. m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 0 ( 2 0 1 4 ) 3 3 8 e3 4 3http://dx

show abstract

Section: Discussionmentioning

confidence: 99%

“…Potential risk of over-penetration include pain and damage to the bone or periosteum and detachment of the needle from the syringe. 5,6 A study conducted in the USA used ultrasound to determine the deltoid fat pad thickness in adult males and females. 2 It was found that women had a significantly thicker deltoid fat pad than men.…”

Section: Introductionmentioning

confidence: 99%

Influence of skin-to-muscle and muscle-to-bone thickness on depth of needle penetration in adults at the deltoid intramuscular injection site

Shankar

Saxena

Lokkur

et al. 2014

Medical Journal Armed Forces India

View full text Add to dashboard Cite

show abstract

“…A study of MRI deltoid fat pads by Lippert found that with using 5/8-inch, 7/8-inch, or 1-inch needles for intramuscular deltoid injections would cause 11% (16 of 150), 55% (83 of 150), and 61% (92 of 150) of patients to experience overpenetration, respectively. 6 Based on Lippert's study, corroborated by an ultrasonographic study of deltoids by Koster 7 and…”

Section: Discussionmentioning

confidence: 90%

A "Needling" Problem: Shoulder Injury Related to Vaccine Administration

Barnes

Ledford

Hogan

2012

The Journal of the American Board of Family Medicine

View full text Add to dashboard Cite

“…Lippert and Wall examined needle overpenetration through the muscle and into the bone or periosteum in children 2 months to 18 years old [36] . These authors determined that overpenetration of the deltoid muscle was a risk when immunizing children, and that needle length be selected according to the weight of the child.…”

Section: Overpenetrationmentioning

confidence: 99%

Teaching best-evidence: Deltoid intramuscular injection technique

Davidson

Rourke²

2013

JNEP

View full text Add to dashboard Cite

Intramuscular injection of vaccines and medications into the deltoid muscle is a long-established nursing practice. The deltoid muscle is the preferred site for intramuscular injections to adult clients in community settings, as it requires minimal, generally socially-acceptable, exposure of the client's body, and is easily accessible to the professional administering the injection. Nursing students learning to administer deltoid intramuscular injections raise excellent questions about deltoid intramuscular injection technique, in particular around landmarking technique, the use of bunching or flattening technique, and selection of needle length. Surprisingly little empirical evidence to guide the nurse, or to answer student questions about, administering deltoid intramuscular injections was found in the nursing and allied health literature. This article examines deltoid intramuscular injection practice with particular emphasis on teaching nursing students best practice.

show abstract

Optimal Intramuscular Needle-Penetration Depth

Cited by 50 publications

References 18 publications

Influence of skin-to-muscle and muscle-to-bone thickness on depth of needle penetration in adults at the deltoid intramuscular injection site

Influence of skin-to-muscle and muscle-to-bone thickness on depth of needle penetration in adults at the deltoid intramuscular injection site

A "Needling" Problem: Shoulder Injury Related to Vaccine Administration

Teaching best-evidence: Deltoid intramuscular injection technique

Contact Info

Product

Resources

About