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Ventro/Dorso Injection Sites, Are the Manufactures of LAIs Behind in Best Practices??

By Dean Visk posted 08-14-2016 01:53 PM

  

I'm creating this thread to reach out in discussion with my fellow behavioral health health nurses and leaders in behavioral health nursing. The evidence continues to favor the ventrogluteal injection site over the dorsogluteal for administration of IM injection medication. The issue in this is that despite texts such as Lippincott no longer acknowledging the dorsogluteal site, most of the manufacturers of the LAI's that we give on a daily basis have not caught up with this practice in their product labeling and continue to suggest the dorsogluteal site as the location for IM administration. I'm very interested in what others thoughts are on this? Is behavioral health behind on keeping up with the literature? I am interested to hear your thoughts. I have reached out to all the manufacturers of the behavioral health LAIs and they all have responded. Only one recognizes the evidence and lists the ventrogluteal site as best practice with their medication. The others have responded positively and I have a meeting set up with one of the manufacturers scientific specialists regarding this topic.  Please share your valuable thoughts and insights.  Thank you. 

 

 


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Susan Kawczynski
09-09-2016 04:38 PM

the only negative for me is that clients have to expose themselves somewhat more... most people don't mind showing their "back" as much as when they have to lower their pants, etc, near their "front".  Anyone agree?

Dean Visk
08-21-2016 12:18 PM

Thank you Wailua for your comment and vast experience. It's great to hear that colleagues like you reinforce the best practice of the use of the ventragluteal site for the LAIs given in the gluteal region. I have brought to the manufacturer's attention the diagrams used in their product labeling and they seem to be appreciative and responsive. 

Thank you

Wailua Brandman
08-16-2016 03:56 AM

Aloha Dean, you bring up an important point.  As an individual member, I'd like to add that I never give dorsogluteal injections, and have always preferred the ventrogluteal injection site in my 44 year career.  I was taught the VG site in basic nursing education in 1970.  I was under the impression that the recommended site of the manufacturer's came from their studies in which it is unclear which site was used, as it only mentions "gluteal" injection as the recommendation.  This leaves it up to the provider which gluteal muscle to select.  When I do promotional programs for an LAI pharmaceutical company, I always mention the VG site while stating that the insert only specifies "gluteal."  There are far less nerve endings in that site, and the muscle is big enough to hold at least 2 cc's.  Patients complain less of pain at the site as well.  No sciatic risk, either.  I feel it is by far a superior injection site.  Mahalo for raising this question.   Warmest Aloha,  Wailua