YETİŞKİNLERDE VENTROGLUTEAL İNTRAMUSKÜLER ENJEKSİYONLARDA CİNSİYET VE BEDEN KİTLE İNDEKSİNE GÖRE İĞNE PENETRASYON DERİNLİĞİ
Öz
Amaç: Bu çalışma, yetişkinlerde ventrogluteal bölgeye intramüsküler enjeksiyon sırasında cinsiyete ve beden kitle indeksi (BKİ) dikkate alınarak iğne penetrasyon derinliğini belirlemek amacıyla yapıldı.
Gereç ve Yöntem: İlişki arayıcı türde yapılan araştırmanın örneklemi 232 hastadan oluştu. V ve G yöntemleri ile ventrogluteal intramusküler enjeksiyon alanı belirlendi ve bu noktalar ultrasonografi altında incelendi. Cinsiyet ve BKİ dikkate alınarak deri altı doku, M. gluteus medius ve M. gluteus minimus kalınlıkları saptandı. Veri analizi, aritmetik ortalama, standart sapma, frekans, yüzde, bağımsız örneklem t testi ve ANOVA kullanılarak yapıldı.
Bulgular: İğne penetrasyon derinliği zayıf kadınlarda 20-48 mm, normal kilolularda 18-53, kilolularda 29-62 mm, obezlerde 26-88 mm arasında; zayıf erkeklerde 23-37 mm, normal kilolularda 18- 41 mm, fazla kilolularda 25-50 mm, obezlerde 17-82 mm arasıuzunlukta bulundu. Ayrıca iğne penetrasyon derinliğinin BKİ sınıflamasına göre kadın ve erkeklerde istatistiksel olarak farklı olduğu belirlendi (p<0,001) ve cinsiyete göre de istatistiksel olarak farklıydı (p<0,001)
Sonuç: Özellikle kilolu ve obez kadınlarda daha uzun iğneler tercih edilmelidir ve BKI dikkate alınarak kadınlardaki iğne penetrasyon derinliği erkeklerden fazla olmalıdır. Ayrıca iğne penetrasyon derinliği aralığının geniş olduğu görülmektedir ve bu nedenle IM enjeksiyon uygulamasında, bireye özgü değerlendir me yapılmalı, yağ dokusunun kalınlığı ve kasların durumu bölge palpe edilerek tanılanmalıdır.
Anahtar Kelimeler
Beden kitle indeksi cinsiyet kas içi enjeksiyon ventrogluteal bölge iğne penetrasyonu
Proje Numarası
315S160
Kaynakça
- Kaya N, Turan N, Palloş AÖ. Should not the dorsogluteal site be used for intramuscular injection? Florence Nightingale J Nurs 2012;20(2):146-53. google scholar
- Berman A, Snyder S, Frandsen G. Kozier and Erbs’s Fundamentals of Nursing. Tenth Edition, New Jersey: Pearson Education Inch, pp.797-803, 2016. google scholar
- Kaya N, Salmaslıoğlu A, Terzi B, Turan N, Acunaş B. The reliability of site determination methods in ventrogluteal area injection: A cross-sectional study. Int J Nurs Stud 2015;52:355-60. google scholar
- Kaya N, Turan N, Aydın GÖ. Intramuscular injection to ventrogluteal site: A systematic review. Int J Caring Sci 2016;9(3):1168-76. google scholar
- Tanioka T, Takase K, Yasuhara, Y, Zhao Y, Noda C, Hisashige S. Efficacy and safety in intramuscular injection techniques using ultrasonographic data. Health 2018;10(3):334-50. google scholar
- Larkin TA, Ashcroft E, Elgellaie, A. Hickey BA. Ventrogluteal versus dorsogluteal site selection: A cross-sectional study of muscle and subcutaneous fat thicknesses and an algorithm incorporating demographic and anthropometric data to predict injection outcome. Int J Nurs Stud 2017;71:1-7. google scholar
- Larkin TA, Ashcroft E, Hickey BA, Elgellaie A. Influence of gender, BMI, and body shape on theoretical injection outcome at the ventrogluteal and dorsogluteal sites. J Clin Nurs 2018;27(1-2):e242-50. google scholar
- Lippert WC, Wall EJ. Optimal intramuscular needlepenetration depth. Pediatr 2008;122(3):e556-63. google scholar
- Potter AP, Perry AG, Stockert P.A. Fundamentals of Nursing. 9th Edition, USA: Elsevier, 2017, pp.647-54 google scholar
- White S, Goodwin J, Behan L. Nurses’ use of appropriate needle sizes when administering intramuscular injections. J Contin Educ Nurs 2018;49(11):519-25. google scholar
- Gillespie M, Toner A. The safe administration of long-acting depot antipsychotics. Br J Nurs 2013;22(8):466-9. google scholar
- Coskun H, Kilic C, Senture C. The evaluation of dorsogluteal and ventrogluteal injection sites: A cadaver study. J Clin Nurs 2016;25(7-8):1112-9. google scholar
- Kaya N, Palloş A. Parenteral drug applications. In Atabek Aştı, T., Karadağ, A. (Eds.), Nursing Principles, Istanbul: Academy Press and Publishing. 2019 pp.761-809. google scholar
- Holliday RM, Gupta V, Vibhute PG. Body mass index: a reliable predictor of subcutaneous fat thickness and needle length for ventral gluteal intramuscular injections. Am J Ther 2019;26(1):e72-8. google scholar
- Ashad F, Rea P. Examining the related anatomical structures of the dorsogluteal and ventrogluteal sites for safe administration of intramuscular injections in practice. Joint Meeting of the British Association of Clinical Anatomists and the European Association of Clinical Anatomists; 2017 July 04-07; Coventry, UK, google scholar
- Turan N, Aydın GÖ, Kaya N. Current approaches to subcutaneous injection. HSP 2019;6(2):406-11. google scholar
- Meneses AS. A proposal for a geometrical delimitation model for ventro-gluteal injection. Rev Bras Enferm 2007;60(5):552-8. google scholar
- Ozen O, Gunaydin M, Tosun A, Coskun ZU, Aytekin K, Takir S. Assessment rate of true dorsogluteal intramuscular drug injection using ultrasonography. Pak J Med Sci 2019;35(4):1132-7. google scholar
- Diggle L, Deeks J. Effect of needle length on the incidence of local reactions to routine immunisation in infants aged 4 months: Randomised controlled trial. BMJ 2003;21(7266):931-3. google scholar
- Nisbet A. Intramuscular gluteal injections in the increasingly obese population: Retrospective study. BMJ 2006;332(7542):637-8. google scholar
- Jain SM, Pandey K, Rao PK. Evaluation of skin and subcutaneous tissue thickness at insulin injection sites in Indian, insulin naïve, type-2 diabetic adult population. Indian J Endocrinol Metab 2013;17(5):864-70. google scholar
- Turan N, Aydın GÖ, Kaya N. Selection of a site for administration of the intramuscular injection to adult patients by nurses: A cross-sectional study. KOU Sag Bil Journal 2019;5(3):134-40. google scholar
- Strohfus P, Palma S, Wallace T. Dorsogluteal intramuscular injection depth needed to reach muscle tissue according to body mass index and gender: A systematic review. J Clin Nurs 2022;31(19-20):2943-58. google scholar
NEEDLE PENETRATION DEPTH ACCORDING TO GENDER AND BODY MASS INDEX IN VENTROGLUTEAL INTRAMUSCULAR INJECTIONS IN ADULTS
Öz
Objective: This study aimed to investigate the needle penetration depth in ventrogluteal intramuscular injections in adults, taking into account gender and body mass index (BMI).
Material and Method: This study was designed as correlational research with a sample of 232 patients. The ventrogluteal intramuscular injection area was identified using V and G methodsand these points were examined under ultrasonography; the subcutaneous tissue, M. gluteus medius, and M. gluteus minimus thicknesses were defined by considering the gender and BMI. Data analysis was performed using arithmetic mean, standard deviation, frequency, percentage, Independent Samples t Test, and ANOVA.
Result: Needle penetration depth is between 20-48 mm in thin women, 18-53 mm in normal weight women, 29-62 mm in overweight women, and 26-88 mm in obese women; 23-37 mm in thin men, 18-41 mm in normal weight men, 25-50 mm in overweight men, and 17-82 mm in obese men. In addition, it was determined that needle penetration depth was statistically different according to the BMI category for bot women and men (p<0.001) and also statistically different according to gender (p<0.001).
Conclusion: Particularly in overweight and obese women, longer needles should be used. In addition, considering BMI, the needle penetration depth in women should be greater than in men. It was found that the range of needle penetration depths is wide and should therefore be assessed individually during IM injection; adipose tissue thickness and muscle condition should be assessed by palpating the area.
Anahtar Kelimeler
Body mass index gender intramuscular injection ventrogluteal area needle penetration depth
Destekleyen Kurum
Scientific and Technological Research Council of Turkey (TUBITAK)
Proje Numarası
315S160
Teşekkür
We are greatly thankful to the Scientific and Technological Research Council of Turkey (TUBITAK) for its invaluable contributions to the study (Project No: 315S160).
Kaynakça
- Kaya N, Turan N, Palloş AÖ. Should not the dorsogluteal site be used for intramuscular injection? Florence Nightingale J Nurs 2012;20(2):146-53. google scholar
- Berman A, Snyder S, Frandsen G. Kozier and Erbs’s Fundamentals of Nursing. Tenth Edition, New Jersey: Pearson Education Inch, pp.797-803, 2016. google scholar
- Kaya N, Salmaslıoğlu A, Terzi B, Turan N, Acunaş B. The reliability of site determination methods in ventrogluteal area injection: A cross-sectional study. Int J Nurs Stud 2015;52:355-60. google scholar
- Kaya N, Turan N, Aydın GÖ. Intramuscular injection to ventrogluteal site: A systematic review. Int J Caring Sci 2016;9(3):1168-76. google scholar
- Tanioka T, Takase K, Yasuhara, Y, Zhao Y, Noda C, Hisashige S. Efficacy and safety in intramuscular injection techniques using ultrasonographic data. Health 2018;10(3):334-50. google scholar
- Larkin TA, Ashcroft E, Elgellaie, A. Hickey BA. Ventrogluteal versus dorsogluteal site selection: A cross-sectional study of muscle and subcutaneous fat thicknesses and an algorithm incorporating demographic and anthropometric data to predict injection outcome. Int J Nurs Stud 2017;71:1-7. google scholar
- Larkin TA, Ashcroft E, Hickey BA, Elgellaie A. Influence of gender, BMI, and body shape on theoretical injection outcome at the ventrogluteal and dorsogluteal sites. J Clin Nurs 2018;27(1-2):e242-50. google scholar
- Lippert WC, Wall EJ. Optimal intramuscular needlepenetration depth. Pediatr 2008;122(3):e556-63. google scholar
- Potter AP, Perry AG, Stockert P.A. Fundamentals of Nursing. 9th Edition, USA: Elsevier, 2017, pp.647-54 google scholar
- White S, Goodwin J, Behan L. Nurses’ use of appropriate needle sizes when administering intramuscular injections. J Contin Educ Nurs 2018;49(11):519-25. google scholar
- Gillespie M, Toner A. The safe administration of long-acting depot antipsychotics. Br J Nurs 2013;22(8):466-9. google scholar
- Coskun H, Kilic C, Senture C. The evaluation of dorsogluteal and ventrogluteal injection sites: A cadaver study. J Clin Nurs 2016;25(7-8):1112-9. google scholar
- Kaya N, Palloş A. Parenteral drug applications. In Atabek Aştı, T., Karadağ, A. (Eds.), Nursing Principles, Istanbul: Academy Press and Publishing. 2019 pp.761-809. google scholar
- Holliday RM, Gupta V, Vibhute PG. Body mass index: a reliable predictor of subcutaneous fat thickness and needle length for ventral gluteal intramuscular injections. Am J Ther 2019;26(1):e72-8. google scholar
- Ashad F, Rea P. Examining the related anatomical structures of the dorsogluteal and ventrogluteal sites for safe administration of intramuscular injections in practice. Joint Meeting of the British Association of Clinical Anatomists and the European Association of Clinical Anatomists; 2017 July 04-07; Coventry, UK, google scholar
- Turan N, Aydın GÖ, Kaya N. Current approaches to subcutaneous injection. HSP 2019;6(2):406-11. google scholar
- Meneses AS. A proposal for a geometrical delimitation model for ventro-gluteal injection. Rev Bras Enferm 2007;60(5):552-8. google scholar
- Ozen O, Gunaydin M, Tosun A, Coskun ZU, Aytekin K, Takir S. Assessment rate of true dorsogluteal intramuscular drug injection using ultrasonography. Pak J Med Sci 2019;35(4):1132-7. google scholar
- Diggle L, Deeks J. Effect of needle length on the incidence of local reactions to routine immunisation in infants aged 4 months: Randomised controlled trial. BMJ 2003;21(7266):931-3. google scholar
- Nisbet A. Intramuscular gluteal injections in the increasingly obese population: Retrospective study. BMJ 2006;332(7542):637-8. google scholar
- Jain SM, Pandey K, Rao PK. Evaluation of skin and subcutaneous tissue thickness at insulin injection sites in Indian, insulin naïve, type-2 diabetic adult population. Indian J Endocrinol Metab 2013;17(5):864-70. google scholar
- Turan N, Aydın GÖ, Kaya N. Selection of a site for administration of the intramuscular injection to adult patients by nurses: A cross-sectional study. KOU Sag Bil Journal 2019;5(3):134-40. google scholar
- Strohfus P, Palma S, Wallace T. Dorsogluteal intramuscular injection depth needed to reach muscle tissue according to body mass index and gender: A systematic review. J Clin Nurs 2022;31(19-20):2943-58. google scholar
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Hizmetleri ve Sistemleri (Diğer) |
| Bölüm | ARAŞTIRMA |
| Yazarlar | |
| Proje Numarası | 315S160 |
| Yayımlanma Tarihi | 1 Aralık 2023 |
| Gönderilme Tarihi | 16 Mart 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 86 Sayı: 4 |
Kaynak Göster
Contact information and address
Addressi: İ.Ü. İstanbul Tıp Fakültesi Dekanlığı, Turgut Özal Cad. 34093 Çapa, Fatih, İstanbul, TÜRKİYE
Email: itfdergisi@istanbul.edu.tr
Phone: +90 212 414 21 61