Examination of the utility of a new tool for intramuscular injection points into the deltoid muscle and the safety of the points decided by a method using it

DOI Open Access
  • Komatsu Emi
    Graduate Course of Nursing Science, Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University
  • Mukai Kanae
    Graduate Course of Nursing Science, Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University
  • Nakajima Yukari
    Graduate Course of Nursing Science, Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University
  • Ozaki Noriyuki
    Department of Functional Anatomy, Graduate School of Medical Sciences, Kanazawa University
  • Nakatani Toshio
    Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences

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Other Title
  • ご遺体での三角筋筋注部位の位置決め器具の有用性と決定した筋注部位の安全性の検討

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Abstract

Our previous studies proposed new sites for intramuscular injection into the deltoid muscle instead of an injection site three finger breadths below the acromial lateral edge. They were determined as follows: The distance between the midpoint (a point) at the lateral edge of the acromion and the intersection point (b point) where the perpendicular line from the a point crossed the anteroposterior axillary line (b point) was measured using a tape measure along the surface of the deltoid muscle, divided into three and two equal segments (upper 1/3ab, 1/2ab, lower 1/3ab points), and the upper 1/3ab, 1/2ab, and b points were regarded as new sites for intramuscular injection. We invented a new tool like a carpenter's iron square for easy determination of the intramuscular injection sites. In this study, we compared whether the upper 1/3ab, 1/2ab, and lower 1/3ab sites determined using the tape measure were the same as those using the new tool, with 11 male cadavers aged 83.6 ± 9.3 and 8 female cadavers aged 84.3 ± 10.9. In order to discuss the safety of the intramuscular injection sites, gel was injected at the 1/2ab site determined using the tape measure and the relationship between the axillary nerve and the gel was observed. The muscle thicknesses at upper 1/3ab, 1/2ab, and b sites determined using the tape measure were also measured and compared. The upper 1/3ab and 1/2ab sites measured using the new tool were lower by about 5.8 mm in males and about 7.0 mm in females, and about 4.4 mm in males and about 5.3 mm in females, than those using the tape measure, respectively. The lower 1/3ab sites using the tape measure and the new tool were almost the same and the axillary nerve was observed at this site. The 1/2ab site using the tool was higher by about 14.8 mm in males and 13.5 mm in females than the lower 1/3ab site where the axillary nerve was situated. Gel injected into the 1/2ab site spread in an oval shape, and the axillary nerve was not situated in the center of the gel but at the lower edge of gel or quite separate from the lower edge of it. Muscle thicknesses at 1/2ab and b sites were almost the same, and thicker by about 4 mm in males and about 5 mm in females than at the upper 1/3ab site. From these results, the upper 1/3ab site using the tool is suitable for intramuscular injection like that using the tape measure because avoidance of the site of the axillary nerve can be achieved; therefore, the new tool is useful and safe for determining the sites of intramuscular injections into the deltoid muscle. Moreover, since the muscle at b site is thicker than at upper 1/3ab and the distance from b site to the axillary nerve is larger than that at 1/2ab, this site is more appropriate for safe intramuscular injection.

Journal

  • Structure and Function

    Structure and Function 13 (1), 17-24, 2014

    Co-medical Research Society of Structure and Function

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