Delivered by intramuscular (IM)
injections, Long Acting Injections (LAI), offering comparatively long term
medicinal effects from several weeks to several months, are gaining much
attention. However, there are dangers such as vascular damage, muscle
contracture, nerve injury due to IM injection, and injections site reactions
such as redness and swelling, which may occur. Moreover, in administration of
injectable medications, physicians and nurses are unable to confirm visually
whether or not the tip of the injection needle has reached the muscle.
Therefore, physicians and nurses need to select an appropriate injection needle
penetration depth in conjunction with patient physique, injection site and
anatomical understanding of nerves and blood vessels.
Accurate anatomical
knowledge is necessary in order to administer IM injections. It is possible to
gain an adequate understanding of injection site anatomical structures by using
ultrasound diagnostic devices. In particular, ultrasonography offers real-time
diagnostic data allowing for observation of injection site, subcutaneous
tissues, fat layers, muscle membrane, muscles and bones. The aim of this
article was to indicate a safe and effective IM injection technique based on
evidenced data derived from ultrasonographic data. Data were obtained from 136
patients undergoing treatment with LAI and 83 healthy subjects by ultrasonography
at four psychiatric hospitals and one psychiatric clinic in Japan.
The findings showed
that when administering IM injections to the buttocks area, a suitable
injection needle between 23G 25 mm to 21G or 22G 38 mm must be chosen depending
on physique and drug characteristics. Needles determined as safe and effective
through ultrasonographic evidence are needed such as in the case of a deltoid
injection site, in which a 23G 25 mm injection needle is used in the absence of
notable obesity. Not only the needle type is essential, but also the IM
procedure itself. It is important to stretch the skin, inserting the needle at
90 degree angle to ensure depth of needle insertion to the muscle.
In conclusion, until
new confirmed evidence becomes available, it is necessary to increase the
understanding of injection site selection methods, needle insertion depth,
needle angle, and established IM injection techniques. And the application of
ultrasound devices in the development of next-generation techniques for IM
injection is promising. Importantly, these techniques provide critical
information from a risk management perspective.
Article by Tetsuya
Tanioka, et al, from Japan.
Full access: http://mrw.so/2hjmCh
Image by PetConnection.com, from Flickr-cc.
评论
发表评论