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Impaired coagulation mechanisms
Occlusive peripheral vascular disease
Edema
Shock
After thrombolytic therapy
During myocardial infarction

Sites for IM injection

Figure 16.5 sites of IM injection

A. Dorsogluteal: Place hand on the iliac crest and locate the postero superior iliac spine. Draw
an imaginary line between the trochanter and the iliac spine; the injection site is the outer
quadrant.
The site can be located by two methods
An anatomic landmark is used to locate the dorsogluteal site. The posterior superior iliac
spine and the greater trochanter are palpated.
An imaginary line is drawn between the posterior superior iliac spine and the greater
trochanter.
The injection site is lateral and slightly superior to the midpoint of this line.
Divide the buttock into four quadrants using the crest of the ileum and gluteal fold as the
superior and inferior boundaries, respectively, between which an imaginary vertical line
is drawn.
An imaginary horizontal line is drawn from the medial fold to the lateral aspect of the
buttock.
The injection is given in the upper outer quadrant. If the site is identified correctly, the
nurse will avoid damage to the sciatic nerve.
The dorsogluteal site is not to be used for children under 3 years of age because their
gluteal muscles are too small.

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