Pediatric intramuscular injections: do you know the procedure and complications?

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J D Losek1, J Gyuro

  • 1Department of Pediatrics, Medical College of Wisconsin, Milwaukee.

Pediatric Emergency Care
|April 1, 1992
PubMed

Insights

Outpatient antibiotic injections for children are common, but improper technique, like using the wrong site or needle length, poses risks. New guidelines aim to prevent complications from pediatric intramuscular injections.

Area of Science:

  • Pediatric Emergency Medicine
  • Pharmacology
  • Clinical Practice Guidelines

Background:

  • Outpatient intramuscular antibiotic therapy offers an alternative to hospitalization for pediatric patients at risk of serious bacterial infections.
  • The utilization of this therapeutic approach is anticipated to rise, necessitating a review of current practices.

Purpose of the Study:

  • To assess the knowledge of intramuscular (IM) injection techniques among pediatric emergency physicians and residents.
  • To identify common deviations from recommended IM injection practices in pediatric patients.
  • To present evidence-based guidelines for safe pediatric IM injections.

Main Methods:

  • A survey was administered to pediatric emergency physicians and residents to evaluate their understanding of IM injection techniques.
  • Data on injection site selection, needle length, and volume per site were collected and analyzed.
  • A review of current literature and expert consensus was conducted to formulate guidelines.

Main Results:

  • The dorsogluteal site, contraindicated in children, was incorrectly used for 21% of patients.
  • 1 1/2-inch needles were preferred for 30% of children aged 0-24 months, contrary to recommendations for 1-inch needles.
  • Injection volumes exceeding 1 ml per site occurred in 47% of cases, increasing complication risks.

Conclusions:

  • Suboptimal practices in pediatric IM injections are prevalent, increasing the risk of infectious complications and neurovascular/muscle injuries.
  • Adherence to established guidelines for pediatric IM injections is crucial for patient safety.
  • The presented guidelines aim to mitigate risks associated with outpatient IM antibiotic therapy in children.

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