It might also come down to your preference, as well. There is no one set standard, but you can have sway in the decision if you would like to. There has been some research done on the safety of each site, and in that battle, it seems as though the ventrogluteal site is the most ideal location for safe injection.
So, if safety is of large concern, there are plenty of reasons for you to use that site for your injection. The reason that most medical professionals prefer this site to others for safety is that this site contains no major blood vessels.
This makes it a much more friendly and safe site to injection, as opposed to the dorsogluteal site, which is very close to the sciatic nerve. For this reason and some others, many doctors prefer the ventrogluteal site.
Though this is the preference of many medical professionals, it is hardly proven that it is the best site all the time to do the injection. There are many circumstances in which it would be ideal to use another site, but for the most part, this ventrogluteal injection site is being used.
Dorsogluteal injections are one of the most common ways that doctors and patients choose to administer testosterone treatment injections. Here is some information about this type of injection and why so many people choose to use it. The first thing to understand about the dorsogluteal im site is where it is located. For a visual, you should divide the buttocks into four quadrants. To locate the site of injection you will simply find the upper and outer section of that grid.
It is located high on the buttocks, near the thigh. This is one of the most common sites for injections of all kinds, not just testosterone therapy. Even though other injection sites are preferred for testosterone treatments, this site is still perfectly safe, when done correctly. Like with other injection sites, there are both pros and cons to using the dorsogluteal injection site for your testosterone replacement therapy. Understanding these pros and cons will help to guide you to make the right decision and stay informed throughout the process.
One of the main benefits of dorsogluteal injection site is that it is very easy to locate. This means that even for a beginner to TRT and injections, it will be easy to find the location where you are supposed to put the injection. The location that it is in is hard to reach when self-injecting testosterone replacement therapy. To reach the location to perform the injection, you will have to twist and turn, which is not ideal for some people.
If you do get the injection site wrong due to its difficulty to reach, then it can be quite painful as well. Nobody wants to experience pain with injecting, so those who are unable to get the injection point right on a consistent basis might find this injection site difficult to use regularly.
There is research to back this up that suggests dorsogluteal injections are, by nature, more painful than injections that occur in the ventrogluteal location.
In addition to the pain that is often involved and the hard-to-reach location of the dorsogluteal site, it is also near the sciatic nerve, which means that you will need to aspirate.
This adds time and difficulty to the process, making it less than ideal if you are able to get the same effectiveness out of another injection location. Overall, the dorsogluteal site for injections should work fine for anyone who is able to use the injection site correctly. If you think that you will have trouble using the injection site as directed by our doctors, then we would advise you to inject into the ventrogluteal site.
The other injection site that you can use for testosterone replacement therapy injections is the ventrogluteal site. There are two main sites that doctors and individuals use for these types of injections, and this site and the dorsogluteal site are the two. Ventrogluteal sites are much more commonly used because of the various benefits that they present. The first thing that you are going to want to know about the ventrogluteal im site is the location of this site.
The location of the site is so crucial because it will determine how effective the injection is, how painful it is, and how easy it is to administer the injection. While the dorsogluteal site is very easy to locate, this site is a bit more challenging. This is one potential downside to it, however, with some practice, you should be able to locate it fairly easily after a while.
The ventrogluteal intramuscular injection site is located on the hip at the high part of the hip. To locate this site, it takes a bit of medical training, which we will provide you with. To locate it, you will have to place the palm of your hand on the femur on the part that protrudes. Place your index finger on the anterior iliac crest of the femur and spread your middle and index finger away from each other. Even with some of the added complexity that comes with using an ventrogluteal intramusular injection site for testosterone replacement therapy, it is still the site that most doctors and medical professionals prefer to use when administering testosterone replacement therapy.
That is because it comes with tons of benefits to love. The main benefit of the ventrogluteal injection site is that it is far away from any of the major blood vessels in the leg. This includes nerves, vessels, and the sciatic nerve.
These injection locations allow for a high degree of safety, reliability and accessibility when a patient is lying supine, prone or in side lying position.
The sites can support large volumes from 2 to 5mL and absorb quickly into the bloodstream. The deltoid is a small volume muscle and has longer peak plasma concentration times for drugs like epinephrine. However, the absorption of SQ injections, whether intended or not intended, can be improved by applying heat or massage.
IM injections have more desirable peak effect times when compared to SQ injections Morphine onset IM: 30 — 90 minutes, SQ: 50 — 90 minutes , but are less desirable given risk of hematoma and increased site pain. Most injectable opioids are marketed for IV and IM injections, but the following medications are commonly used SQ: fentanyl, morphine, and hydromorphone. Epinephrine Adrenalin Administration of this drug needs more knowledge than meets the eye.
There are 3 studied routes for epinephrine administration: IM in the deltoid muscle, SQ in the upper arm, and IM in the lateral thigh. IM epinephrine administered in the lateral thigh using an autoinjector has the fastest increase in serum epinephrine compare to SQ administration.
So, IM epinephrine into the lateral thigh is the preferred route of administration. However, this information cannot be explicitly extrapolated to a syringe used subcutaneously in the upper arm or an intramuscular injection in the deltoid muscle. Additionally, the effects of obesity and other absorption anomalies are not clear. While this data can be left up to interpretation, IM use of epinephrine is the first line especially when utilizing auto injectors. Insulin Subcutaneous route of administration is a mainstay for insulin.
The two routes have drastic differences in pharmacokinetics as shown below Table 3 :. The IV route properties allow it to be the desirable route when treating hyperkalemia given the faster onset allowing for quicker movement of potassium intracellularly.
Subcutaneous dosing produces gentler effects on glucose or electrolytes. IV insulin may be ideal for a patient on the threshold of DKA, but not yet ready for an insulin drip. While there are many formulations of insulin, only insulin regular has been studied intravenously. Hypoglycemia treatment is the backbone of glucagon use, but do not forget beta blocker overdose and gastrointestinal diagnostic aids Table 4.
While each route has variable times of onset, peak effects are similar among the 3 groups. The IV route is generally retained for beta blocker overdose and hypoglycemia. Doses greater than 1 mg IV are likely to induce a strong emetic response. IM and SQ dosing are more often utilized for patient comfort. There are a 2 agents approved for intramuscular use in intubation: ketamine and succinylcholine.
The dosing and pharmacokinetic differences are noted. Tables 5 and 6. Besides altering drug absorption and response, this practice can cause injury to SC tissue.
The dorsogluteal fat pad is of inconsistent thickness 1 to 9 cm , whereas the ventrogluteal is more uniform among individuals 3. Despite these reports' finding that the advantages of the ventrogluteal site have been recognized for almost 45 years, it remains the most infrequently used.
Yet the evidence for its superiority over other sites is compelling, and both author groups of these surveys recommend that it be considered the site of choice for IM injections. We're long overdue for putting this research into practice. All rights reserved. Membership is free and comes with many benefits. Note: You must also be a member and log in to purchase articles. Share This. Authors Winslow, Elizabeth H.
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