SKIPD, Okay, one issue at a time here. First of all, when you said you got your annual flu shot and pneumonia vac.....I hope you are not getting that pneumonia vac every year unless they have changed how it's administered. I was always under the impression that it was good for ten years. I might be wrong on that I will look into it.
Then you said you got a shot in your bum after a Dx of strep. Yes, that would be correct. I would venture to guess that you either got Bicillin or Rochepin. Both of these medications are antibiotics and are pretty painful no matter where you get them. The preferred site for both of those is in your backside because the muscle is bigger and is more accommodating, which usually means the pain will be or should be considerably less in that site. Personally speaking I never give IM injections in the arm to my patients. I do not give them a choice, except which side of their tush they want it on.
You were talking about some people getting a flu shot in their tush and having adverse reactions, not from the medication itself but because of where the shot was administered. First of all, it was absolutely not the medication itself. If someone is going to have a reaction to the medication, it wouldn't matter where it was given. Now I am not a doctor but the few side effects that you mentioned sound to me like the administrator might have hit a nerve. Well, unfortunately that happens sometimes, rarely, but it does. When we inject someones backside we hit the right upper outside quad so we avoid hitting the sciatic nerve that runs down the entire back of the leg and into the foot. However, you do once in a great while find someone who's anatomy isn't normal. There are people who have their heart on the right side of their bodies instead of the left. It's rare, but it can happen.
I have said this probably a thousand times on here, but it's okay, I would rather explain it a thousand more and educate people instead of having them just believing everything they hear. Please read this carefully. Almost every single kind of injection that needs to be delivered via IM can go into the backside. There are a few examples of this that won't apply, but they are very few, and they are always specialty meds that have to be given in a certain location like trigger point injections would be a good example of this.
I will admit that the instructions inside the flu vac box do say that they are to be given in the deltoid muscle in the arm. The ONLY reason for this is because people are getting fatter and fatter. A vaccination has to get fully into muscle tissue in order to be most effective. Because people are getting fatter and fatter a one inch needle and half the time for women a 1 and a half inch needle is NOT long enough to sink the bevel of the needle completely into muscle tissue. Vaccinations are either not effective at all, or are not effective enough when they are injected into adipose tissue. Again, there are some vaccinations that are sub-q and they don't apply. But any vaccination that is to be given IM can be given into ANY muscle including the back of the calf. I wouldn't recommend it at all, but it's a muscle.
If you are a thin person a 1.5 inch needle will be long enough to be completely sunk into a muscle. If you are really thin, there is nothing that says the administrator has to sink the needle all the way into the hub. They need to use their nursing judgement there. For women who are even slightly over weight, or who carry extra weight in their tush, a 2 inch needle is the shortest that can be used.
There are tons and tons of studies that have been done on this topic. The research was overwhelming actually. When I start at a new facility or what not I almost always sit down and talk to both the administrator and the DON and I present them with this information. There are some medications that will necrose adipose tissue, and they have to absolutely be injected into muscle. Phenergan is a good example of that. So I convince them to start ordering more 1.5 inch needles, as well as 2 inch needles, and to cut way back on their 1 inch needles. They have listened and agreed every single time. They have because again, I presented them with the information and studies from leaders in the medical field that prove this to be true.
So, my advice to you is this, keep your mouth shut and take it where they offer it to you which will be in your arm, or, insist that they administer it in your backside. If they argue then you educate them with what I just told you. Or you print it out and take it with you. Or you do what I do, I carry around or have some in the van or where ever I can get to them a 2 inch needle for them to use. I have done this before at Dr.Johns office. His assistant started coming at my arm with an ATB no less. I pulled John back in my room and I told him what I just told you. He completely agreed and I didn't get that shot in my arm that day either.
Mashie