Preventing sciatic nerve injury from intramuscular injections: literature review.

Abstract

Injury to the sciatic nerve (SN) is a serious complication of intramuscular injection. The purpose of this paper was to identify factors associated with such iatrogenic injury in adults and measures that nurses may take to prevent it. A review of the English language literature was undertaken to identify applicable research studies and determine the information that currently is being disseminated on relevant injection procedure. Legal databases were also searched for pertinent court decisions. The evidence is that injury to the SN is associated with use of the dorsogluteal (DG) site for injection. The choice of site for injection must be based on good clinical judgment, using the best evidence available and individualized assessment of the client. There is wide agreement in the literature that the ventrogluteal site is preferable. If the DG site is chosen, the nurse must have a full appreciation of the anatomy of the site and proximate anatomic structures, be able to accurately identify anatomic landmarks and site boundaries, and administer the injection with meticulous technique. Not only may SN injury resulting from erroneous injection cause client discomfort, morbidity and lasting disability, but it also provides the basis for nursing negligence suits. The research base for intramuscular injection is limited. Studies on various aspects of the procedure need to be carried out to provide support for clinical guidelines.