It is becoming increasingly important for clinicians to identify a safer intramuscular (IM) injection site in the deltoid muscle because of possible complications following the vaccine administration of IM injections. We herein examined 4 original IM sites located on the perpendicular line through the mid-acromion to establish a safer IM injection site. Thirty healthy volunteers participated in this study and the distances from our 4 IM sites to some anatomical landmarks on their left arms were measured. Ultrasonography (US) was also performed to measure the thickness of the deltoid muscle and identify the posterior circumflex humeral artery (PCHA) along the course of the axillary nerve. Subcutaneous thickness was measured using 2 methods: measuring the skin thickness with caliper after pinching the skin, and with US. The results obtained revealed that the intersection between the anteroposterior axillary line (the line between the upper end of the anterior axillary line and the upper end of the posterior axillary line) and the perpendicular line from the mid-acromion was the most appropriate site for IM injections because it was distant from the axillary nerve, PCHA, and subdeltoid/subacromial brusa. At this site, depth of needle insertions was 5 mm greater than the subcutaneous thickness at a 90° angle, which was sufficient to penetrate subcutaneous tissue in both sexes. Subcutaneous thickness can be assessed with almost the same accuracy by US or measuring with calipers after pinching the skin. The results of the present study support the improved vaccine practice for safer IM injections.

译文

:由于在注射IM疫苗后可能引起并发症,因此在三角肌中确定更安全的肌内(IM)注射部位对临床医生而言变得越来越重要。我们在本文中检查了位于中-突垂直线上的4个原始IM部位,以建立更安全的IM注射部位。 30名健康志愿者参加了这项研究,并测量了我们4个IM部位到他们左臂上一些解剖标志的距离。还进行了超声检查,以测量三角肌的厚度并确定沿腋神经运动的肱回旋肱骨头(PCHA)。使用两种方法测量皮下厚度:捏紧皮肤后用卡尺和US来测量皮肤厚度。获得的结果表明,前后腋线(腋前线上端与后腋线上端之间的线)和距肩峰中段的垂直线之间的交点是最适合IM的部位注射,因为它远离腋神经,PCHA和三角肌/肩峰下硬脑膜。在这个部位,针插入深度比90°角处的皮下厚度大5毫米,足以穿透男女的皮下组织。皮下厚度可以通过超声或夹住皮肤后用卡尺以几乎相同的精度进行评估。本研究的结果支持针对更安全的IM注射的改良疫苗实践。

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