The Journal of emergency medicine · 2026
Muscle or Subcutaneous Fat? A Prospective Ultrasonographic Study of Dorsogluteal Injection Accuracy in the Emergency Department.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ardic Senol, Cakir Ismet, Bulut Eser, Altun Ibrahim, Peker Gokhan
Аннотация
BACKGROUND: Dorsogluteal intramuscular (i.m.) injection is commonly used in emergency departments, but successful delivery into muscle tissue may vary depending on patient anatomy.
OBJECTIVES: This study aimed to evaluate the accuracy of dorsogluteal i.m. injections performed in the emergency department using immediate postinjection ultrasonography and to identify factors associated with successful i.m. deposition.
METHODS: This prospective observational study was conducted in the dedicated injection area of a tertiary care emergency department between June 1 and June 15, 2018. Adult patients receiving dorsogluteal i.m. injections were consecutively enrolled. After exclusions, 134 patients were included in the study. The primary outcome was ultrasonographic determination of whether the injectate was deposited in the i.m. or subcutaneous (s.c.) plane. To address interobserver reliability, 20 additional consecutive patients receiving injections underwent independent ultrasonographic assessment by both radiologists, each blinded to the other radiologist's classification. Agreement was summarized using overall percentage agreement and Cohen's κ with a 95% confidence interval (CI), where estimable.
RESULTS: Of the 134 patients, 72 (53.7%) were men. Ultrasonography reported that 82 injections (61.2%) reached the i.m. plane, whereas 52 (38.8%) remained in the s.c. tissue. Successful i.m. deposition was significantly more frequent in men than in women (88.9% vs. 29.0%, p < 0.001). s.c. tissue thickness and combined skin-plus-s.c. tissue thickness reported stronger discrimination for s.c. deposition than body mass index (BMI). In the additional 20-patient dual-ultrasound reliability cohort, the radiologists agreed on the clinically dichotomized injection outcome (correct i.m. vs. incorrect s.c./s.c.-i.m. deposition) in 19 of 20 examinations (95.0%), with a Cohen's κ of 0.875 (95% CI, 0.638-1.000), indicating almost perfect agreement.
CONCLUSION: A considerable proportion of dorsogluteal injections performed in the emergency department do not reach the target muscle tissue. Direct regional s.c. tissue thickness seems to be a more clinically informative determinant of injection success than BMI alone.
OBJECTIVES: This study aimed to evaluate the accuracy of dorsogluteal i.m. injections performed in the emergency department using immediate postinjection ultrasonography and to identify factors associated with successful i.m. deposition.
METHODS: This prospective observational study was conducted in the dedicated injection area of a tertiary care emergency department between June 1 and June 15, 2018. Adult patients receiving dorsogluteal i.m. injections were consecutively enrolled. After exclusions, 134 patients were included in the study. The primary outcome was ultrasonographic determination of whether the injectate was deposited in the i.m. or subcutaneous (s.c.) plane. To address interobserver reliability, 20 additional consecutive patients receiving injections underwent independent ultrasonographic assessment by both radiologists, each blinded to the other radiologist's classification. Agreement was summarized using overall percentage agreement and Cohen's κ with a 95% confidence interval (CI), where estimable.
RESULTS: Of the 134 patients, 72 (53.7%) were men. Ultrasonography reported that 82 injections (61.2%) reached the i.m. plane, whereas 52 (38.8%) remained in the s.c. tissue. Successful i.m. deposition was significantly more frequent in men than in women (88.9% vs. 29.0%, p < 0.001). s.c. tissue thickness and combined skin-plus-s.c. tissue thickness reported stronger discrimination for s.c. deposition than body mass index (BMI). In the additional 20-patient dual-ultrasound reliability cohort, the radiologists agreed on the clinically dichotomized injection outcome (correct i.m. vs. incorrect s.c./s.c.-i.m. deposition) in 19 of 20 examinations (95.0%), with a Cohen's κ of 0.875 (95% CI, 0.638-1.000), indicating almost perfect agreement.
CONCLUSION: A considerable proportion of dorsogluteal injections performed in the emergency department do not reach the target muscle tissue. Direct regional s.c. tissue thickness seems to be a more clinically informative determinant of injection success than BMI alone.