The problem of using deltoid muscle for intramuscular injection

Although the deltoid muscle has often been used as a site of intramuscular injection (ImI), the risk of axillary nerve injury caused by the needle is overlooked. The present study examined the potential risk of needle insertion in the deltoid muscle during the dissection of 14 shoulders from cadavers. A needle was pierced into the deltoid muscle from the overlying skin at the middle of the horizontal line, as described in the standard nursing textbooks. The axillary nerve is located beneath the deltoid muscle, with its branches extending through the quadrangular space as far as the anterior part of the deltoid muscle. It was found that the needle passed very close to the axillary nerve trunk in all cases. This finding suggests that the deltoid muscle is not appropriate for ImI, even if the anterior part is selected as the injection site. This study warns nurse practitioners know of the potential nerve injury as the result of ImI in the deltoid muscle