Why butt injection?

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Le Thi Minh Huong - Emergency Medicine Doctor - Department of Resuscitation - Emergency - Vinmec Nha Trang International General Hospital. The doctor has more than 06 years of experience in examining and treating internal diseases, emergency and emergency resuscitation.
As we all know, there are many different types of drugs, some are used orally, some are used for injection or infusion.... Injectable drugs are divided into intravenous injection, intramuscular injection, and intramuscular injection. subcutaneous injection, intradermal injection,... Buttock is a commonly chosen site when using intramuscular drugs.

1. Why butt injection?

First of all, we need to understand that injection is the use of a syringe and needle to inject drugs in the form of an oil-soluble, water-soluble solution or suspension into the body through a vein, muscle, subcutaneous, or intradermal route. or into the serosa cavity, spinal canal, ... The introduction of drugs into the body through injection usually works faster than taking drugs.
Intramuscular injection is injecting medicine into the patient's muscle, the drug will work faster than subcutaneous injection. Because the muscles are heavily perfused and are constantly contracting, drug absorption in the muscles is faster than in the connective tissue under the skin. At the same time, the pain sensation in the muscle is not as sensitive as the subcutaneous tissue, so strong stimulants such as Streptomycin, Penicillin, Emetin, Quinin, or blood serum can also be injected intramuscularly.
Intramuscular injection can be given in the arm, thigh or buttocks. So why do we often see butt injections more often? That's because the gluteal muscle is a large muscle with a large amount of muscle mass, and it is also a safe place because there are few nerves and large blood vessels passing through. Therefore, doctors and nurses often choose butt injection for drugs that are indicated for intramuscular injection.

2. Indications and contraindications for buttock injection

2.1. Indications for buttock injection Buttock injection as well as intramuscular injection in general can inject many different isotonic solutions such as:
Long-soluble oil, easy to cause pain. Ether, Quinine. Colloidal solutions, mercury salts, silver salts, antibiotics, hormones,... are slow to dissolve and cause pain, so they must be injected intramuscularly. Theoretically, all drugs that can be injected into the connective tissue under the skin can be injected intramuscularly with the exception of caffeine. There are some drugs that should not or should not be injected intravenously, but if you want to have a faster effect than subcutaneous injection, you should inject it intramuscularly. Drugs that are easily irritating when injected under the skin and absorbed slowly can be injected intramuscularly. In case of cracked skin, subcutaneous injection is not indicated.

2.2. Contraindicated for buttock injection Intramuscular injection in general and buttock injection in particular are contraindicated with drugs that cause tissue necrosis such as Calcium chloride, Ouabain,...

3. Buttock injection technique

3.1. Locating the buttock injection site The buttock region has large blood vessels and a large sciatic nerve running through it. Therefore, it is necessary to accurately determine the injection site to avoid injection into the sciatic nerve. However, do not worry, because the buttocks area is very large, determining the injection site is also very easy.
The buttock area is limited by 4 lines, which are:
Above: defined by the line connecting the two iliac crests. Below: is the buttock crease. Inside: is the buttock groove. Outer: is the outer edge of the buttocks. There are 2 ways to determine the buttock injection site:
Method 1: Divide one buttock into 4 equal parts, the injection site is in the upper 1/4. If injected into the lower outer part will inject into the hip joint. If injected into the internal parts will enter the sciatic nerve and blood vessels. Method 2: Draw a straight line from the anterior superior iliac spine to the coccyx, divide this segment into 3 equal parts, the injection site is the upper third of this line. The reason is that this area has a thick layer of muscle, no large sciatic nerve and large blood vessels. The patient's position when injecting the buttocks is one of the following two positions:
The patient lies on his stomach. Sit in a chair with your face facing the back of the chair and your arms around the back of the chair to reveal the remaining buttock out as the injection site.

3.2. Practice butt injection technique Buttock injection technique has two following ways:
One-stage buttock injection:
Expose the buttock area and then determine the injection site in one of the two ways above. Disinfect the injection site with iodine alcohol, then with alcohol 700. The nurse disinfects hands with alcohol 700. Left hand: use thumb and index finger to stretch the skin at the injection site. Right hand: holding the syringe that has taken the drug and has the needle, the little finger supports the needle; thumb, middle finger, ring finger on the syringe body; Forefinger supporting the syringe, stabbing at right angles to the injection site, quickly pressing the needle deeply, but not submerged, about 0.5 - 1cm from the tip. In case the needle touches the bone, it will need to be pulled out a little. Then let go of the left hand from the surface of the skin, turn the plunger slightly to see if there is any blood coming out. If there is no blood, slowly inject the drug. During the injection process, it is necessary to monitor the patient's facial expression. When all the drug in the syringe has been filled, the left hand rests on the buttocks to tighten the skin as before, the right hand gently withdraws the needle quickly vertically. Disinfect the injection site with alcohol cotton.

Two-stroke buttock injection:
Expose the buttocks, then determine the injection site in one of the two ways above. Disinfect the injection site with iodide alcohol, then with alcohol 700. The nurse disinfects hands with alcohol 700. Then 1:
Left hand uses thumb and index finger to stretch the skin at the injection site. Use your thumb and index finger to hold the needle firmly in your right hand, at this time the needle has not been inserted into the syringe. The other three fingers of the right hand were folded and patted the patient's buttocks a few times to distract attention, then quickly inserted the needle at a 90° angle to the intended injection site. Similar to the above, also do not plug in close to the needle bar. Then 2:
After the needle has been inserted into the buttock, then proceed to install the syringe with the drug and have expelled all the air into the needle. Test to see if there is any blood. If there is no blood, administer the drug slowly and monitor the patient. If there is blood on the aspiration test, the needle needs to be removed and injected into another site. When the drug is completely injected, the nurse uses the thumb and index finger of the left hand to stretch the skin, and the right hand to quickly withdraw the needle in the vertical direction. Disinfect the injection site with alcohol swabs.

4. Complications when injecting buttocks

When injected intramuscularly buttock can encounter some of the following complications:
Accidental needle twist, broken needle Needle puncture into the sciatic nerve. Causing occlusion. Infectious abscess, sterile abscess. Causes array of items... Anaphylaxis: this is the most dangerous complication. Buttock injection is a commonly used type of intramuscular injection, because the injection site is a large gluteal muscle, easy to identify. However, if you are subjective, or do not know how to determine the location and technique of injection, it can still lead to dangerous complications for the patient.

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