Thank you all in advance. Sally is 6 months old and needs several IM immunizatio

Question

Thank you all in advance.

Sally is 6 months old and needs several IM immunizations as prescribed by the Centers for Disease Control.

In what position should Sally be placed? What muscle group should the allied health professional choose for giving this medication? What length needle should be chosen? Should medications be mixed if the health care provider does not order mixing? Why or why not? How would the allied health professional choose the size of the syringe? Since these medications are to be given intramuscularly, what angle should be used for the needle insertion?

Explanation / Answer

In the given case, the sally is of 6 months old, thus she has to be tightly hold on the lap during vaccination.

Several vaccines are administered for the welfare of the new born. Except BCG vaccine most of the vaccines are administered by intramuscular and subcutaneous route. The adjuvant containing vaccines like DT, PCV, Hib, HepA, HepB and HPV are injected into the muscle except anthrax vaccine.

The longer needles that are used for intramuscular injections are associated with less redness or swelling when compared to shorter needles. The intramuscular injections are administered at an angle of 900 to the skin. The location of injection depends on the age of the individual. The intramuscular injections are injected to anterolateral aspect of thigh or deltoid muscle of upper arm.

In the given case, the age of the sally is 6 months, thus the intramuscular injections are preferably injected to anterolateral aspect of thigh. The 1-inch, 22--25 gauge needles is required for intramuscular vaccination in infants (1 month to 12 months old) to the thigh region.

The sub-cutaneous injections are administered at an angle of 450 into the thigh of infants. For sub-cutaneous injections 5/8-inch, 23--25 gauge needles is used.

In case of infants, if multiple vaccines are administered at a single visit, then thigh is preferred over limb because of greater muscle mass and the injections should be sufficiently separated.

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