Best testosterone injection site, no aspiration needed, avoids all nerves

maxadvance

Active Member
Thread starter #1
So I ran across the term "Ventrogluteal IM injection site" and found an article describing it as what is currently the most medically recommended injection site. I tried it a few times now and have to agree. No blood gushing pinholes, no veins, no nerves, minimal pain.


IN: The Ventrogluteal IM injection site.


The ventorgluteal (VG) site has less subcutaneous fat and a thicker muscle mass than the dorsogluteal site with an almost certain probability of penetrating muscle with a standard needle.
The VG site is also sparse of any major innervating nerves or blood vessels whilst remaining well perfused from smaller branches.
Locating the VG site.

The ventrogluteal site is located halfway between the hip and the head of the femur. One method to locate the correct site is:
First, place the heel of your hand (use your L hand if injecting into the patients R VG and vice-versa) over the patients greater trochanter, and feel for the anterior superior iliac spine with your index finger.
The middle finger then slides across to make a peace-sign pointing up to the iliac crest.
The injection site is in the middle of this peace-sign.
Wipe site with alco-wipe in a circular motion and allow to dry.
Use your peace sign to spread skin taut.
Insert needle at 90 degree angle. Take care as you are inserting needle in proximity to your fingers.
There is no evidence for the need to aspirate the plunger when using the VG site.
Inject medication slowly (around 10 seconds per ml), remove needle quickly, and gently apply pressure to site for 10 seconds.





OUT: The Dorsogluteal IM injection site.

This site been used by nurses for years as the target of choice for IM injections.
It is found in the area of the superior lateral aspect of the gluteal muscles, commonly known as the upper outer quadrant.
It is located by dividing the buttock into four equal quadrants. This is usually done by drawing an imaginary cross (bisecting it vertically and horizontally).
Problems that have been identified with using this site include:

Presence of major nerves and blood vessels in this area, including the sciatic nerve and superior gluteal artery.
It has been taught that you will probably avoid this by further dividing the upper outer quadrant into another quadrant and giving the injection into the upper outer of the upper outer.
Despite this, there have been reports of injuries to the sciatic nerve leading to problems ranging from foot drop to paralysis of the lower limb.
Thickness of fat in this area. A number of studies have found that the depth of muscle in the dorsogluteal region is often greater then the length of a standard needle used for IM injections, resulting in a failure to achieve intramuscular deposition of the medication.
In fact, one study found the success rate of IM injections to be 32% (which fell to 8% in female patients)!
With the increasing incidence of obesity amongst our patients we are probably going to be delivering subcutaneous injections if we choose this location.
Pain receptors are located in the subcutaneous layer, not in muscle tissues and so medication delivered into this area may be more painful.
Dorsogluteal site has a decreased absorption rate increasing the possibility of a depot effect with drug build up and potential for overdose.




Still IN: the Z-track.


When delivering medications via any IM route the technique of Z-tracking should be used.
This both reduces pain, and prevents dispersion of medication into subcutaneous tissue.
Apply gentle traction on the skin to pull it away from the injection site (about 2-3 cm). Use your non-dominant hand.
Inject (slowly) with needle at 90 degrees to skin surface.
Withdraw needle quickly.
Release skin.

Summary:

Whenever possible the VG site should be the preferred location for intramuscular injections.
The Z-Track method should be used for IM medication delivery.
The patient should be positioned so the target muscle is as relaxed as possible.
 

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#5
For me personally, I don't care for either glute site. The dorso glute location is just too difficult for me to administer an injection to myself. The ventro glute location is easier to access for a self administered injection, but the area you need to "hit" with the needle is much smaller, and you need to be very accurate when pinning here.

I still prefer the vastus lateralis (outer quad) for any shallow IM injection. It's a huge muscle, with a lot of surface area available for pinning up and down the muscle. It is by far the easiest location to pin yourself, as you can prop your leg up, use two hands, and if you don't hit your exact spot, it's usually not an issue. With a 1/2"/29ga insulin pin, it just doesn't get any easier.
 

maxadvance

Active Member
Thread starter #6
I don't do upper outer quad anymore, I've hit too many nerves and veins and gushers, so I'm done with that location. Ventro glute is not that small of an area, painless and the only area where you don't need to aspirate.
 

Vin

New Member
#7
Hi Vince, what Guage do you use and is it not too painful there? Going to be my first time once I receive my prescription (hopefully this week) maybe it's just a mental hurdle for me to get over to shoot in the glut ., with the thought of my shoulder being solid and I have muscle there and could grin and bear it., lol
 

Vince

Moderator
#9
Hi Vince, what Guage do you use and is it not too painful there? Going to be my first time once I receive my prescription (hopefully this week) maybe it's just a mental hurdle for me to get over to shoot in the glut ., with the thought of my shoulder being solid and I have muscle there and could grin and bear it., lol
I use Easy Touch insulin syringe 27g 1/2", for shallow IM.
 
#12
how do you exactly determine where to inject into the VG injection site?

this description does nothing for me (english is not my first language, I'm not familiar with these medical terms and if am not mistaken this description is for nurses and impossible to do by yourself):

"First, place the heel of your hand (use your L hand if injecting into the patients R VG and vice-versa) over the patients greater trochanter, and feel for the anterior superior iliac spine with your index finger.
The middle finger then slides across to make a peace-sign pointing up to the iliac crest.
The injection site is in the middle of this peace-sign.
Wipe site with alco-wipe in a circular motion and allow to dry.
Use your peace sign to spread skin taut.
Insert needle at 90 degree angle. Take care as you are inserting needle in proximity to your fingers."
 
#13
how do you exactly determine where to inject into the VG injection site?

this description does nothing for me (english is not my first language, I'm not familiar with these medical terms and if am not mistaken this description is for nurses and impossible to do by yourself):

"First, place the heel of your hand (use your L hand if injecting into the patients R VG and vice-versa) over the patients greater trochanter, and feel for the anterior superior iliac spine with your index finger.
The middle finger then slides across to make a peace-sign pointing up to the iliac crest.
The injection site is in the middle of this peace-sign.
Wipe site with alco-wipe in a circular motion and allow to dry.
Use your peace sign to spread skin taut.
Insert needle at 90 degree angle. Take care as you are inserting needle in proximity to your fingers."
I just feel my hip bone and move down a few inches from there, that's where I inject. I do inject daily now so I like to find a few good places to inject, I believe the VG is an easy place to inject, once you get used to it.
 
#20
Thanks, really good post. I'm so comfortable injecting in my shoulders, it would almost be impossible for me to switch.
Somehow the thought of injecting in my shoulder scares me, but perhaps I should give it a try. Exactly where do you inject on the shoulder? Front? Side? High or low?
 
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