Abstract
Gluteal intramuscular injection requires accurate needle insertion into the specific muscle area for accurate, safe, and efficacious delivery of medication for long-acting anti-psychiatric drugs. With ultrasonography, accurate evaluation of the "Distance from the Epidermis to the Under-Fascia (DEUF)" can be determined. However, a nurse in the clinical settings, ultrasonographic measurements during intramuscular injection is impractical and difficult. The purpose of this study was to estimate the thickness of subcutaneous fat by using a near-infrared ray measuring device.This study was approved by the Ethics Committee of Tokushima University Hospital. There were 39 subjects (21 men and 18 women) aged 20 to 60 years (Mean ± SD: 44.97 ± 15.20 years old). Bilateral DEUF at Ventrogluteal and Dorsogluteal sites (AVIUS: Hitachi-Aloka Medical Co.) were evaluated on B-mode scan as the gold standard. At the same sites, the thickness of the subcutaneous fatty tissue was measured using the PoccoStick (HORIC: smallsize instrument measuring the thickness of the subcutaneous fat with a near-infrared ray device). The right Ventrogluteal site thickness of the fatty tissue was significantly overestimated by PoccoStick (15.18 ± 8.77 mm) measurements, as compared to the ultrasonography (12.42 ± 5.26 mm) (p<0.01) results. The left-side Ventrogluteal site and both the right and left Dorsogluteal sites measurements did not show significant differences. This illustrated and supported the credible use of inexpensive devices such as the PoccoStick in estimating the DEUF. The development of a more highly accurate small-sized instrument is recommended.
Highlights
IntroductionIntroduction efficacy of using ultrasonography as an objective and accurate way to Intramuscular injection is an essential nursing technological skills with a high risk of arteriovenous injury or nerve injury [1,2,3]
Intramuscular injections require a deeper insertion into the target muscle, as compared to intracutaneous injections or subcutaneous injections, because the muscular layer is located under subcutaneous fatty tissues
The body-mass index (BMI) of the subjects ranged from 21.92 ± 2.99 kg/m2, while their percent of body fat were 22.97 ± 7.28 % on the left leg and 22.59 ± 7.14 % on the right leg
Summary
Introduction efficacy of using ultrasonography as an objective and accurate way to Intramuscular injection is an essential nursing technological skills with a high risk of arteriovenous injury or nerve injury [1,2,3]. Intramuscular injections require a deeper insertion into the target muscle, as compared to intracutaneous injections or subcutaneous injections, because the muscular layer is located under subcutaneous fatty tissues. In cases in which medications are injected into the subcutaneous tissue, manifested side effects, induration, skin redness, and abscesses may arise [4]. The delivery of medicine into the intramuscular layers leads to an improved therapeutic efficacy, it is important to establish a practical and economical method to assess hypodermal tissues at the intramuscular injection sites
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