Proper placement of any biological is critical to the effectiveness of that biological.
In other words, that vaccine or medication must be placed smack dab in the middle of that Deltoid Muscle - where the muscle is the thickest.
Highly vascularized MUSCLE absorbs the biological into the VASCULAR system, rapidly.
If the injection is placed too low on the arm, the biological may be injected into tendon - the tendinous insertion of the muscle - NOT INTO THE MUSCLE ITSELF.
This hurts; this causes injury to the tissues; and the biological is NOT effective.
In other words, that vaccine or medication must be placed smack dab in the middle of that Deltoid Muscle - where the muscle is the thickest.
Highly vascularized MUSCLE absorbs the biological into the VASCULAR system, rapidly.
If the injection is placed too low on the arm, the biological may be injected into tendon - the tendinous insertion of the muscle - NOT INTO THE MUSCLE ITSELF.
This hurts; this causes injury to the tissues; and the biological is NOT effective.
Here's the Scientific Article about vaccine injections to support this statement:
BMJ. 2000 Nov 18; 321(7271): 1237–1238.
doi: 10.1136/bmj.321.7271.1237
PMCID: PMC1118997
PMID: 11082069
The importance of injecting vaccines into muscle. Different patients need different needle sizes
Jane N Zuckerman, senior lecturer
BMJ. 2000 Nov 18; 321(7271): 1237–1238.
doi: 10.1136/bmj.321.7271.1237
PMCID: PMC1118997
PMID: 11082069
The importance of injecting vaccines into muscle. Different patients need different needle sizes
Jane N Zuckerman, senior lecturer
Where is the correct anatomical spot for any IM (IntraMuscular) injection?
How do you determine where that spot is?
How do you determine where that spot is?
Instructions:
- then, with your naked thumb, slide/glide from the top of the muscle (origin) to the bottom of the muscle (insertion).
The ORIGIN will feel flat and hard - it is - it is a flat tendon [What color are tendons? White. No blood there.]
The INSERTION will feel flat and hard - it is - it is a flat tendon. [SAA]
The BELLY will feel soft, pliable, and in the center it feels THICK. [It is thick, the thickest part of the muscle. And that
muscle is highly vascularized, that's why muscle is red, has lots of blood, has lots of circulation, has lots of
'UPTAKE'/absorption capability.]
2. Once you have located the ORIGIN and the INSERTION, now you LOOK at your two landmarks and 'eyeball' the half way mark in-
between them - dead center on the muscle mass.
THAT is where the injection is to be given.
- You MUST first find the anatomical landmarks of the Deltoid Muscle: Origin / Belly of / Insertion.
- then, with your naked thumb, slide/glide from the top of the muscle (origin) to the bottom of the muscle (insertion).
The ORIGIN will feel flat and hard - it is - it is a flat tendon [What color are tendons? White. No blood there.]
The INSERTION will feel flat and hard - it is - it is a flat tendon. [SAA]
The BELLY will feel soft, pliable, and in the center it feels THICK. [It is thick, the thickest part of the muscle. And that
muscle is highly vascularized, that's why muscle is red, has lots of blood, has lots of circulation, has lots of
'UPTAKE'/absorption capability.]
2. Once you have located the ORIGIN and the INSERTION, now you LOOK at your two landmarks and 'eyeball' the half way mark in-
between them - dead center on the muscle mass.
THAT is where the injection is to be given.
Last but NOT least......
You MUST select the appropriate
You MUST select the appropriate
- needle gauge for the viscosity (thickness) of the biological, and the
- needle length for the thickness of the muscle mass.
Rule of thumb:
Vaccine viscosity (thickness) is always the equivalent of H2O (water). Steroid viscosity is thicker.
Therefore, a very thin (small) needle will work (27g-29g) for thin viscosity biologicals.
The insulin syringe is great for that!
A bigger needle (22g) will be needed for thicker viscosity biologicals.
No need to create a bigger hole, if you don't have to.
Muscle mass will determine what length needle you should be using for the injection.
The smaller muscles (average females/older humans) have thinner muscles.
These muscles may only be an inch and a half thick.
Use a 1/2 inch needle.
The Insulin Syringe is great for that!
The larger Deltoids (bigger men/athletes) have thicker muscles.
These muscles can tolerate and will need a longer needle.
Use the 1 inch needle.
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Vaccine must be placed in the center of the muscle mass to be properly absorbed & to avoid injury to the muscle.
Centered from top - bottom.
Centered from the "inside" - "outside".
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If the biological is NOT properly placed and injected...
there is pain,
there is tissue injury,
there is interference with the uptake.
The injection will not be a good experience
or have a good outcome
- for anyone.
Tip 1: Needle Insertion
Bevel up; 90 degree angle; set the needle to the skin (actually touch), then IN (insert), stabilize the needle; depress the plunger - DONE.
Tip 2: If the sleeve can't be moved all the way up to the TOP of the shoulder, the arm must come out of the sleeve.
The entire Deltoid should be exposed/VISUALIZED to be able to clearly see & feel the Origin, Belly, and Insertion of the muscle; to be able to place the vaccine in the middle of the muscle.
Do it RIGHT, or don't do it.
For CE credit:
If you want 0.5 CE credit for this tutorial - please send request to - [email protected]