Chart — Pharmacology
Injection Sites Reference Chart
Correct injection site selection and technique prevents nerve injury, inadequate drug delivery, and tissue damage. This chart covers IM and subcutaneous injection sites with landmarks, needle selection, and safety notes for clinical practice.
Educational use only. Injection technique should be learned and validated through supervised clinical practice. This reference is for general educational purposes. Always follow your facility's injection technique guidelines and manufacturer instructions. Data sourced from CDC/WHO injection safety guidelines. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Intramuscular (IM) Injection Sites
| Site | Landmark | Max Volume | Needle Length | Notes |
|---|---|---|---|---|
| Ventrogluteal | Place heel of hand on greater trochanter; point index finger toward ASIS; spread middle finger toward iliac crest — inject in the “V” | 3–5 mL | 1–1.5 inch (25–38 mm) | Preferred site for most adults — no major nerves or vessels nearby; accessible in both supine and lateral positions |
| Deltoid | 2–3 finger-widths below acromion process; triangle-shaped area on lateral upper arm | 1–2 mL | 1 inch (25 mm) standard adults; 1.5 inch for obese patients | Used for vaccines and small volumes; radial nerve injury risk if too low or too posterior; not for repeated injections |
| Vastus Lateralis | Middle third of outer thigh, between greater trochanter and lateral femoral condyle | 1–5 mL | 1–1.5 inch | Preferred for infants and toddlers; acceptable in adults with limited deltoid/ventrogluteal access; patient can self-inject here |
| Dorsogluteal | Upper outer quadrant of buttock | 2–5 mL | 1.5–3 inch (depending on adipose tissue) | Largely avoided — high risk of sciatic nerve injury; ventrogluteal is preferred for gluteal injections |
Subcutaneous (SQ) Injection Sites
| Site | Location | Max Volume | Notes |
|---|---|---|---|
| Abdomen | 2 inches from the umbilicus (avoid umbilicus itself) | 1–2 mL | Fastest absorption rate; preferred for insulin and LMWH; large surface area for rotation |
| Outer Upper Arm | Posterolateral surface, middle third of upper arm | 1 mL | Patient may require assistance; commonly used for vaccines and insulin |
| Anterior Thigh | Outer anterior surface of thigh (middle third) | 1–2 mL | Easy self-injection site; good rotation option for insulin users |
| Upper Outer Buttock | Above and lateral to the gluteal crease | 1–2 mL | Less commonly used; may require assistance; less variable absorption than abdomen |
Needle Selection Guide
| Route | Needle Length | Gauge | Angle |
|---|---|---|---|
| IM — average adult | 1–1.5 inch (25–38 mm) | 21–23 G | 90° |
| IM — obese patient | 1.5–2 inch (38–50 mm) | 21–23 G | 90° |
| SQ — standard | 5/8 inch (16 mm) or 1/2 inch (12 mm) | 25–27 G | 45° (or 90° with short needle if adequate tissue) |
| SQ — insulin pen | 4–8 mm | 29–32 G | 90° |
| Intradermal (ID) | 3/8–5/8 inch (10–16 mm) | 25–27 G | 5–15° (bevel up, into dermis) |
General Safety Notes
- Aspirate or not? Current CDC and WHO guidelines no longer recommend aspiration for IM vaccine injections. For medications (e.g., IM antibiotics, hormones), facility policy may vary — follow your institution's guidance.
- Z-track method — used for IM injections of irritating medications (e.g., iron dextran, hydroxyzine). Pull skin 1–1.5 inches laterally before injection; release after withdrawing needle to seal the track.
- Rotate sites — document injection location and rotate systematically to prevent lipodystrophy (SQ) and fibrosis (IM).
- Assess site before injection — avoid areas with bruising, induration, lipohypertrophy, scars, or active inflammation.
- Safe sharps disposal — never recap needles with two hands; use a one-handed scoop technique if recapping is necessary; discard in an approved sharps container immediately after use.
- Pinch up for SQ — in thin patients, gently pinch skin to elevate SQ tissue and avoid inadvertent IM injection.
Related References
Standards & sources
Fact-checked Jun 20, 2026This page is written to align with CDC / WHO Injection Safety Guidelines. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →