When administering an I.M. injection to an infant, the nurse in charge should use which site?
A. Deltoid
B. Dorsogluteal
C. Ventrogluteal
D. Vastus lateralis
Correct Answer: D. Vastus lateralis
The recommended injection site for an infant is the vastus lateralis or rectus femoris muscles. Skeletal muscle can accommodate larger volumes of medication than subcutaneous tissue, and absorption is faster because muscle tissue is highly vascular. Muscle has fewer pain-sensing nerves than subcutaneous tissue and is less sensitive to irritating and viscous medications, so pain is lessened.
Option A: The deltoid is inappropriate. The deltoid in infants is not sufficiently bulky to absorb IM medications adequately. The vastus lateralis muscle avoids the thicker layer of subcutaneous fat on the anterior thigh.
Option B: Using the vastus lateralis muscle avoids the risk of sciatic nerve damage from gluteal injection. Also, the vastus lateralis muscle has a larger muscle mass than the gluteal region and therefore has reduced risk of severe local reactions.
Option C: The ventrogluteal site can be used only in toddlers who have been walking for about 1 year. Although recent literature has reported that the ventrogluteal area can be an alternative site for intramuscular injections in children ?12 months of age, little research-based evidence has been found for the use of the ventrogluteal site in infants and toddlers.