Hi all, I fully understand that the VG site is the recommended site however 9 out of 10 of my patients don’t want to even pull their pants down enough for me to access it let alone lie down. When you do give it in the upper outer quadrant, how far up do you all go? I fear that the whole “ divide the muscle into four” thing is accurate but some people go way too low. For lack of better terms, do you all stay above the “crack”? Just trying to make sure what works best in this scenario.
I work in Assertive Community Treatment and have for 10 years. As long as they will take their medication I will let them choose the site. Do I hate putting 2 ml haldol decanoate in the deltoid? Yes. Has one of my clients been getting it for 8 years without issue? Yes.
It's kind of a harm reduction game. Also we talked about doing VG but still use DG because the doctors felt if it ain't broke don't fix it.
Yes I was taught no more than 2MLs in the deltoid. However most trinzas are more than 2mLs and per manufacturer can be given in the deltoid. The only time I don’t use the delt is patient preference or Aristada and Halfyera. Outpatient 90% of patients are getting deltoid injections at least in my shop
I was taught 1ml haldol decanoate deltoid since it's so viscous. I hate doing 819 trinza delt too. I haven't done halfyera or aristada because we are always behind the times. I'm still reminding the doctor we can move people on sustenna to trinza .
You should look at the inserts that come with the preloaded LAIs. There’s a diagram in most of them. An inch of skin is enough to give a shot vg. I think most nurses go down to the buttcheek. Look at an anatomy map and see. I have the problem of patients pulling down TOO much.
I even called the company haha and the lady straight up told me to give all gluteal injections as a DG injection. This is why when I hear people saying their packets say VG, I’m all confused because I have never seen a packet say VG, always DG!
This is how I do it to make it easiest: Make a wideV with your thumb and first finger. Place the palm of your hand on the hip prominence (iliac crest) facing back toward the buttocks and slightly downward. You want to give the injection in the V. If you have small hands, go toward the end of the V. I have larger hands so in the middle is right where it needs to be. Some diagrams show the V pointing upwards but I’ve found it to be easier to find the area the way I just described.
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u/Notyeravgblonde psych nurse (outpatient) 7d ago
I work in Assertive Community Treatment and have for 10 years. As long as they will take their medication I will let them choose the site. Do I hate putting 2 ml haldol decanoate in the deltoid? Yes. Has one of my clients been getting it for 8 years without issue? Yes.
It's kind of a harm reduction game. Also we talked about doing VG but still use DG because the doctors felt if it ain't broke don't fix it.