The ventrogluteal site (VGS) is an area on the side of the hip used for deep intramuscular (IM) injections. Healthcare professionals recognize it as the preferred site for administering many medications and vaccines, especially when a larger volume of fluid needs to be delivered. Selecting this site helps ensure the medication is absorbed efficiently into the muscle’s rich vascular system, rather than being deposited into the subcutaneous fat layer.
Identifying the Ventrogluteal Landmarks
Locating the ventrogluteal site accurately relies on identifying three specific bony prominences on the hip. The first landmark is the greater trochanter, the prominent bony knob on the upper outer thigh, where the palm of the hand is placed. The hand used to find the site should be the one opposite the hip being injected (e.g., the right hand for the left hip).
The index finger is then placed on the anterior superior iliac spine (ASIS), the bony projection at the front of the hip bone. The middle finger is spread away from the index finger toward the iliac crest, the upper curved edge of the hip bone. This positioning forms a V-shape, and the injection is administered into the center of this triangle. The thumb should be pointed toward the patient’s groin or abdomen during this process.
Why This Site is Preferred for Injections
The ventrogluteal site is favored primarily due to its superior safety profile compared to other common locations, such as the dorsogluteal site in the buttocks. This area is situated over the thick gluteus medius and gluteus minimus muscles, which are robust and well-developed in most individuals. The depth and density of this muscle mass allow for reliable absorption of the injected medication.
The ventrogluteal site is free from major nerves and blood vessels, minimizing the risk of accidental injury. In contrast, the traditional dorsogluteal site carries a significant risk of damaging the underlying sciatic nerve, which can lead to pain or paralysis. Furthermore, the VGS typically has a thinner and more consistent layer of subcutaneous fat than the dorsogluteal area, which ensures the needle reaches the intended muscle tissue.
Optimal Patient Positioning
Proper patient positioning is necessary to relax the target muscle, which improves comfort and allows for accurate landmark identification. The patient can be positioned either lying on their side (lateral position) or lying on their back (supine position). The side-lying position is often considered the easiest way to access the site.
When the patient is lying on their side, they should flex the knee and hip of the upper leg. This helps relax the gluteal muscles over the injection site. For the supine position, the patient should also be encouraged to flex their knees and point their toes inward to achieve muscle relaxation.
Administration Technique and Volume Limits
Once the site is located and the patient is positioned, the injection is administered by inserting the needle at a 90-degree angle to the skin. This perpendicular approach ensures the needle penetrates through the skin and subcutaneous tissue to reach the deep gluteal muscle. Injecting the medication with a quick, dart-like motion can help minimize patient discomfort.
A technique known as the Z-track method is often used with ventrogluteal injections. The skin is pulled laterally before injection and released afterward, creating a zigzag path in the tissue layers. This maneuver helps seal the medication within the muscle and prevents it from leaking into the subcutaneous tissue. The maximum volume for a single injection in an average adult is typically up to 3 milliliters (mL), though up to 5 mL is possible in adults with greater muscle mass.