Upper arm:
Choose a site about 3 child's fingers above the elbow in the fleshy part of the arm and just below the muscle-line (deltoid insertion). When teaching someone how to give an injection in this site, a hint that may make injection easier, is to get them to push the fleshy part of the arm against their knee, the back of a chair, or a door stop so they can see what they are doing.
Anterior thigh
Choose a site one child's hand above the knee and one hand below the groin; draw a line up the middle of the thigh and down the middle of the lateral aspect of the thigh. The square that is defined represents the area for injection.
Buttock
Choose the upper outer quadrant of the buttock. Place your index finger on the iliac crest. Make a right angle between this finger and your thumb to approximately define the upper outer quadrant.
Anterior abdomen
Choose a site above the groin, avoiding the midline area above and a 2.5 cm area surrounding the umbilicus, but extending up to the anterior rib cage. The availability of sites on the anterior abdomen may be limited by the amount of subcutaneous fat in children and teens. It is sometimes helpful to have the child to sit and lean forward slightly to find the fatter places.
The Diabetes in Children and Adolescents Management Guidelines Manual, 2003; 2nd Edition, prepared for Nova Scotia Diabetes Centres, by The Diabetes in Children and Adolescents Subcommittee, Chaired by SR Salisbury MD,FRCPC, Medical Director, Diabetes Care Program of Nova Scotia, Halifax, NS. The project was funded by the Nova Scotia Department of Health. For copies of the Manual contact: The Diabetes Care Program of Nova Scotia, 1278 Tower Road, Bethune Building- Suite 577, Halifax, NS, B3H 2Y9; 902 473 3219; dcpns@diabetescareprogram.ns.ca; www.diabetescareprogram.ns.ca
