Subcutaneous tissue of obese children may be too thick for injection solutions to reach intramuscular tissue

Background: It is very important to measure the subcutaneous tissue thickness of the obese children and choose the appropriate needle length to reach the muscle layer. Objective: The aim of this study is to measure the subcutaneous tissue thickness of the obese children at the major injection sites (deltoid, vastus lateralis and gluteal area) with ultrasound (US) and to determine the most appropriate needle length for intramuscular injections. Study Design: A total 74 healthy overweight (n=14) and obese children (n=60) from Gulhane Military Medical Academy participated in this study between April to November 2009. Thickness of subcutaneous tissue was measured by radiologist with ultrasound probe on major injection sites for children. Results: A statistically significant positive correlation was found between weight groups and subcutaneous tissue thicknesses in the all injection sites; the higher the weight group (BMI >= 95), the thicker the subcutaneous tissue. Although a statistically significant positive correlation was found between age groups and subcutaneous tissue thicknesses, there was no correlation between sex and subcutaneous tissue thickness. Conclusion: To reach the muscle (perpendicular) a nurse should asses both the age and injection site together while choosing the appropriate needle length in overweight and obese children.