Intramuscular Injection Sites: Landmarks, Technique & Volume Limits

Site selection based on age, volume, medication viscosity, and patient condition. Use 22–25G needle, 1–1.5" (adults), 5/8–1" (children).

1. Vastus Lateralis (Thigh) — Preferred for Infants/Children; All Ages

• Landmark: Middle third, anterolateral thigh (between greater trochanter & lateral femoral condyle).
• Volume: Up to 5 mL (adults); 2 mL (infants).
• Technique: Stretch skin flat; insert 90°; aspirate (optional per guideline); inject slowly.

2. Ventrogluteal (Hip) — Safest for Adults/Adolescents

• Landmark: Heel of hand on greater trochanter, index finger to ASIS, middle finger toward iliac crest → inject in V formed.
• Advantages: Thick muscle, no major nerves/vessels, less subcutaneous fat.
• Volume: Up to 4 mL.
• Angle: 90°.

3. Deltoid (Upper Arm) — Convenient for Small Volumes

• Landmark: 2–3 fingerbreadths below acromion, midline of lateral arm.
• Volume: ≤2 mL (ideally 0.5–1 mL).
• Angle: 90°.
• Caution: Radial nerve, axillary nerve; avoid if <10 kg or atrophied.

4. Dorsogluteal (Upper Outer Quadrant) — No Longer Recommended Routinely

• Risk: Superior gluteal artery, sciatic nerve.
• Use only if other sites unavailable; landmark: upper outer quadrant (lines from PSIS to greater trochanter, and midline).

Documentation

Site, side, needle size, volume, lot #, patient tolerance.