Sciatic nerve injury from an intramuscular (IM) injection into the buttock is potentially devastating. In severe cases, the hamstrings and all the muscles below the knee are paralysed resulting in a flail numb foot. This avoidable complication has been known about since the 1920s and highlighted in the nursing research literature (1 - 3) Nerve injury is a common complication following intramuscular injection and the sciatic nerve is the most frequently affected nerve, especially in children, the elderly and underweight patients. The neurological presentation may range from minor transient pain to severe sensory disturbance and motor loss with poor recovery The course of the sciatic nerve in the gluteal region places it at risk for injury from IM injections. Proper technique minimizes the risk of injury. Intramuscular (IM) injection is an important..
The effects of injection related sciatic nerve injury are variable ranging from transient sensory distur-bance to permanent paralysis and numbness (18). Affected children may be unable to walk or crawl; a signiﬁcant proportion present with foot drop (9,10,13). The common ﬁbular component of the 1574 Sciatic nerve injury from intramuscular injection Intramuscular (IM) injection is an important means of administering medication. Sound knowledge of the anatomy of the area to be injected is essential. This article describes a case of sciatic nerve injury after gluteal IM injections. Related literature is reviewed with the goal of improving practice. Case Repor Background: Accidental intraneural injection induced nerve injury is an iatrogenic tragedy and intramuscular injection (IM) is the most common injury mechanism affecting the sciatic nerve. The most frequent presentation of sciatic nerve injury includes radicular pain and paresthesia with almost immediate onset of variable motor and sensory deficit A literature review in the same study identified 17 reports of 1506 patients—most of which were children—with sciatic nerve injury from intramuscular injections. 5. A 2006 case study presented a 25-year-old-male who developed a painful, swollen left leg after several left gluteal intramuscular injections (for indications and drugs unknown) Injection palsy can begin suddenly or hours following damage to the Sciatic Nerve. A misplaced intramuscular injection at the gluteal region is the most common cause of injury and it is attributed to either frequent injections or poor techniques as a result of inadequately trained staff or unqualified staff
Injury to the sciatic nerve is a serious complication of intramuscular injection. The first sign of this complication is extreme pain. The choice of site of an injection must be based on good clinical judgment, using the best evidence available and individualized assessment of the patient. In a similar fact pattern in Hemmen v injections which were once used in the treatment of sciatica. Biggam2 and Seshachalam3 have found nerve damage due to quinine injection, and Gammel4 reported a case ofperoneal nerve palsy after bismuth injection in the treatment of syphilis. Recently Elkington5 reported 2 cases of sciatic and one of radial nerve paralysis developing within a. The doctors at different hospitals opined that it was sciatic nerve injury due to intramuscular injection. The complainant, to prove whether the treating doctor administrated the injection at all, submitted the evidence of an auto driver who took the patient from the treating Hospital to the Pediatrician Objective: To study the type of injected agents, clinical features and outcome of conservative treatment of patients with sciatic nerve injury following gluteal intramuscular injection.Methods: A prospective study of patients with sciatic nerve injury following gluteal intramuscular injection from private neurological clinic and neurophysiology unit in Ibn Sena Teaching Hospital in Mosul between January 2008 and July 2010.Results: The total number of the patients was 36 injections.CONCLUSIONSSciatic nerve injury from an i.m. injection in the upper outer quadrant of the buttock is an avoidable but persistent global problem, affecting patients in both wealthy and poorer healthcare systems. The consequences of this injury are potentially devastating. Safer alternative sites for i.m. injection exist. These should be promoted more widely by medical and nursing organisations
, especially in children, the elderly and underweight patients Direct injury to peripheral nerve trunks by deep intramuscular injection of drugs has been reported by many observers. Oppenheim 1 in his Textbook of Nervous Diseases states that paralysis of the sciatic has been produced by the subcutaneous injections of ether, sublimate and antipyrine, and by the alcohol injections which were once used in the treatment of sciatica Sciatic nerve injury in children after gluteal intramuscular injection: Case reports on medical malpractice. Zhuo P(1)(2), Gao D(2), Xia Q(2), Ran D(2), Xia W(1)(2). Author information: (1)1 Department of Forensic Medicine, Wenzhou Medical University, P.R. China
The sciatic nerve is a very deep structure and injury from im injection would be difficult unless the patient is very thin. The location if im injection in the gluteus is often in the upper outer region well away from the nerve Intramuscular Injections Intramuscular injections into the buttocks have been a common site of sciatic nerve injury since being documented in the 1920s (Mishra, 2010). These injuries may range from a transient sensory change to a permanent paralysis and paresthesia
Earlier this month, a court in Syracuse, New York awarded Tina Holstein $1,690,000 as compensation for a permanent sciatic nerve injury. Ms. Holstein was vomiting after she delivered at baby at Community General Hospital, and a nurse gave her an intramuscular injection of anti-nausea medicine The sciatic nerve is prone to injury following drug injection, and the proportion of sciatic nerve damage resulting from intramuscular injections is reported to be high (86% of all cases)  Many procedures, including intravenous line placement, joint aspiration, nerve block, phlebotomy and intramuscular (IM) injections place patients at risk of the injection injury. Common nerves reported undergoing nerve injection injury (NII) includes sciatic, radial, axillary, ulnar, median, tibial and peroneal nerves Two children presented with foot drop indicative of sciatic nerve injury following gluteal intramuscular injections. The appraisal of whether there was medical negligence, the causal relationship between the patients' nerve injuries and medical standard of care, and the causative potency were entrusted to us by the court
patients with nerve injuries after intramuscular injections. Among them, 3 (1%) patients had axillary nerve injury; it is the third most common lesion following sciatic and radial nerve injuries. Davidson et al.  reported a case of axillary nerve injury after a deltoid intramuscular injection of antiemetics Peripheral nerve injection injury: an experimental study. Gentili F, Hudson A, Kline DG, Hunter D. In an attempt to answer questions regarding nerve injection injuries, we injected 11 agents in current use and commonly administered by intramuscular injection into the sciatic nerves of adult Wistar rats Intramuscular injection-related sciatic nerve injury has been the most common cause of traumatic peripheral nerve injury in children, especially in low resource settings, with a lack of adequately trained health care workers.19, 20, 21 In such cases, NS can be confused with the injection palsy. In the present report, we have described a case of. Of 190 patients with gluteal sciatic nerve injuries in one retrospective study, the injuries were caused by injection in 164 patients (86.32%). Fifteen were treated by conservative means, and the. Background/Aims: An intramuscular (IM) injection into the buttock risks damaging the sciatic nerve. Safe injection practices need to be understood by doctors and nurses alike. The aims of this study were to determine if sciatic nerve injury because of IM injection is a continuing problem and to establish the availability of published guidelines on IM injection techniques
Sciatic nerve injection injury is a preventable event. Total avoidance of intramuscular injection is recommended if other administration routes can be used. If the injection has to be administered into the gluteal muscle, the ventrogluteal region (gluteal triangle) has a more favourable safety profile than the dorsogluteal region (the upper. Background/aims: An intramuscular (i.m.) injection into the buttock risks damaging the sciatic nerve. Safe injection practices need to be understood by doctors and nurses alike. The aims of this study were to determine if sciatic nerve injury because of i.m. injection is a continuing problem and to establish the availability of published guidelines on i.m. injection techniques
Sciatic nerve pain, referred to as sciatica, radiates along the path of the nerve on one side of the body. Sciatica can occur when the nerve is pinched, most commonly by a herniated disk or bone overgrowth. Injury to the sciatic nerve is a serious complication of intramuscular injection. The first sign of this complication is extreme pain Aim: Sciatic nerve injury is the most frequent and serious complication of intramuscular gluteal injection. This study aims to highlight the incidence and causes of this continuing problem and to discuss the relevant literature. < p < MATERIAL and METHODS: A total of 217 subjects who were diagnosed with sciatic nerve injury in our neurophysiology laboratory between 2003 and 2013 were examined
Nerve injury occurred after intramuscular injection (1 cat, 1 dog). Immediate surgical treatment was removal of intramedullary nails, extruded cement, or entrapping suture. Delayed nerve transplantation was performed in 2 dogs. Within 1 year, 13 patients recovered completely, clinical improvement occurred in 7, and there was no improvement in 7 Sciatic Nerve Injury. Sciatic nerve injury in the newborn has been observed principally after misplaced injection of drugs into the buttocks but also after prolonged paralysis (induced by pancuronium) with pressure necrosis of the skin overlying the buttock 247,255,256 and after injection of hypertonic glucose or certain other agents into the. Nerve injuries from injections are fairly common occurrence in medical practice, although their exact incidence remains unknown. Many procedures, including intravenous line placement, joint aspiration, nerve block, phlebotomy and intramuscular (IM) injections place patients at risk of the injection injury Inflammation/immune response at the site of nerve lesion is known to be an essential trigger of the pathological changes that have a critical impact on nerve repair and regeneration. In this study, we observed the effects of various doses of dexamethasone on the functional recovery after sciatic nerve crush injury in a rat model 1. Med Sci Law. 2019 Jul;59(3):139-142. doi: 10.1177/0025802419851980. Epub 2019 Jun 9. Sciatic nerve injury in children after gluteal intramuscular injection: Case reports on medical malpractice
Injections. Intramuscular injections in the caudal thigh carry a significant risk of damaging the sciatic nerve. For this reason, other injection sites are preferable. Intrafascicular injection can result in severe nerve damage with permanent disability, particularly with certain preparations, for example, penicillin/streptomycin and anthelmintics It is essential to know what part of the body the IM injection should be administered. Jul 27, 2010 · Sciatic nerve injury from an intramuscular (IM) injection into the buttock is potentially devastating. Sep 21, 2011 · You can practice either subcutaneous injection into fat, or deeper intramuscular injection A more accessible alternative to continuous catheter techniques is the use of local anesthetic adjuncts to prolong the duration of single-injection PNBs. In a mouse model of sciatic nerve block with bupivacaine, the addition of perineural (but not intramuscular) dexamethasone prevented the appearance of a rebound hyperalgesic response to. Exosomes secreted by adipose-derived stem cells (ADSC-exo) reportedly improve nerve regeneration after peripheral nerve injury. Herein, we investigated whether pretreatment of ADSCs with FK506, an immunosuppressive drug that enhances nerve regeneration, could secret exosomes (ADSC-F-exo) that further augment nerve regeneration. Designed exosomes were topically applied to injured nerve in a. Conclusion: The sciatic neuropathy is a common health problem in children after injection so, intramuscular injecton is better avoided in children. Bilateral involvement in eight cases hints that there are some more mechanisms involved in neuropathy other than local injury. Keyword: Sciatic Neuropathy, Intramuscular Injection, Electrophysiologica
Conclusion: Sciatic nerve injury due to intramuscular injection is a signifi cant health problem. Although most of the lesions were moderate, recovery was inadequate. Electrophysiological examinations give significant clues about the prognosis and treatment Iatrogenic injuries due to intramuscular (IM) injection, although less frequently reported than before, are still common. The sciatic nerve is the most commonly injured nerve because of an IM injection owing to its large size and the buttock being a common injection site Sciatic nerve injury from intramuscular injection: a persistent and global problem Sciatic nerve injury from intramuscular injection: a persistent and global problem Mishra, P.; Stringer, M. D. 2010-10-01 00:00:00 Review Criteria We obtained information from the following sources: (i) the Accident Compensation Corporation of New Zealand; (ii) nursing organisations; (iii) a systematic review of. Introduction The World Health Organization has estimated that of the 12 billion injections administered globally every year, 50% of them are unsafely administered and 75% are unnecessarily administered.1 Nerve injec tion injury (NII) is a common complication following intramuscular injection and the sciatic nerve is the most frequently affected.
By injecting intramuscular mitochondria into the gastrocnemius muscles of rodents after a sciatic crush injury, they are able to demonstrate improved markers of both muscle and nerve health over time in the treatment group, with significant improvements demonstrated in the reduction of apoptotic markers, the preservation of normal muscle. For IM injections, the nurse selects a site that is free of pain, infection, necrosis, bruising, and abrasions. The location of underlying bones, nerves, and blood vessels and the volume of medication to be administered are also considered. Because of the sciatic nerve location, the dorsogluteal muscle is not recommended as an injection site When injecting into the buttock muscle you must be particularly careful the needle does not touch the sciatic nerve. Injecting the nerve causes severe radiating pain to the lower limbs (similar to an electric shock) and can damage the nerve permanently. In a worse case scenario, sciatic nerve damage can lead to lower limb paralysis. [10 intramuscular drug injection in rats made subject to sciatic nerve injury. Materials and Methods Sixteen female Spraque-Dawley rats weighing 250-300 g were used in the study. The rats were randomly divided into two groups of 8, an experimental group comprising rats that were made subject to a sciatic nerve injury and a control group with no.
Good injection technique can mean the difference between less pain and injury. Angela Cocoman and John Murray explain . The administration of intramuscular injections is a common nursing intervention in clinical practice. 1 This article aims to, raise awareness in relation to the injection sites used for intramuscular injection and, to highlight best practice in relation to IM injection. Small SP (2004) Preventing sciatic nerve injury from intramuscular injections: literature review. Journal of Advanced Nursing; 47: 3, 287-296. Walsh L, Brophy K (2011) Staff nurses' sites of choice for administering intramuscular injection to adult patients in the acute care setting. Journal of Advanced Nursing; 67: 5, 1034-1040 Intraneural-extrafascicular injection of saline (n = 5) was used as a control. After emergence from anaesthesia, neurological examinations were conducted over two weeks. After harvesting the sciatic nerves, no changes in nerve fibre density or myelin width indicative of nerve injury were observed in any of the groups due to injection of drugs into subcutaneous tissue instead of muscle tissue, adverse drug reactions due to intravenous injection of drugs instead of IM injection, sciatic neuropa-thy due to incorrect injection site detection or different an-atomic structure of sciatic nerves, and nerve-bone injuries due to incorrect injection site detection deficits immediately after receiving injection however they were referred late after injury. The commonest nerve involved was sciatic nerve due to gluteal injection. Within sciatic nerve, common peroneal division was more often involved. The MRC grading of key muscles and sensory zones of the involved nerve is summarized in Table 3. All patient
Applied anatomy sciatic nerve injury. After completion of this session, students should be able to discuss, identify, and describe: The anatomical factors predisposing to nerve injuries. The anatomy of deformity, weakness and sensory loss following the nerve injury. The applied anatomy of clinical examination for specific nerves Iatrogenic sciatic nerve injuries can result in severe nerve damage with subsequent motor and sensory loss, or when loss is less severe, there may be pain. Practice of proper injection techniques, understanding of the anatomy, and use of intraoperative monitoring may help to prevent these complications They were recorded 3 and 1, after performing SCS trial respectively. There were many clinical studies, reviews and case reports about sciatic nerve injury due to intramuscular injection. Most of them are about the management, surgical and conservative therapies, results of sciatic injection injury In the sciatic nerve injury, all the muscles below the knee are paralyzed and the weight of foot causes it to assume the plantar-flexed position (foot drop). According to MRC, the gradation of weakness that can be seen with foot drop are as follow: 0= Complete paralysis. 1= flicker of contraction. 2= Contraction against gravity eliminated alone
Injury to the sciatic nerve following intramuscular injections is the most common trauma. In this case, an intense foreign-body reaction occurs around the nerve, after which the nerve is compressed by a dense scar tissue that surrounds it. Approximately 20% of all sciatic nerve lesions occur during total endoprostheses of the hip. Apart from. Effects of dexamethasone on the sciatic function index (SFI) 7, 14, 21, and 28 days after surgery. Rats were administered local intramuscular injections with 0.5, 1, or 2 mg/kg dexamethasone, or saline once daily after surgery. The values are represented as means ± SD for 6 rats per group Cindyjp, sounds like the person who administered your Faslodex shots hit the sciatic nerve! It's an inter-muscular Injection that should always avoid the sciatic nerve! A few times I had a hematoma in the injection site, usually the infusion nurses are very cautious because they need to avoid hitting that nerve and causing a painfu Cardenas-Mejia A, Martinez JR, Leon D, et al. Bilateral sciatic nerve axonotmesis after gluteal lipoaugmentation. Ann Plast Surg. 2009;63(4):366-8. CAS Article Google Scholar 16. Ramtahal J, Ramlakhan S, Singh K. Sciatic nerve injury following intramuscular injection: a case report and review of the literature
Injection administration - A sure shot. Angela Cocoman and Carol Barron outline best practice for administering injections into the deltoid muscle. The aim of this article is to highlight to practitioners of the possibility of injury due to poor landmarking of intramuscular injections into the deltoid muscle. Approximately 12 billion injections. The dorsolateral gluteal quadrant is a common site for intramuscular injections and has been associated with sciatic nerve injury (78). Risk factors for injury to the sciatic nerve following intramuscular injection included elderly men with low body mass index (04). (3) Other iatrogenic and related causes Sciatica and Epidural Injections - Risks and Side Effects. So far in this series we've discussed what epidural injections are, what they are not, and how to determine if you are a candidate for the procedure. What we haven't discussed are the risks and potential side effects that go along with getting these injections Thus, intramuscular injection may be an alternative treatment option in nerve injury either short term for reducing denervation injury or long term for facilitating nerve regeneration. Other studies have shown that AFS cells have the potential to secrete several neurotrophic factors to assist the muscle and nerve regeneration [21; 26-31]
Before being discharged from the recovery room, a nurse gave an intramuscular injection for pain into the plaintiff's hip. The patient felt immediate severe pain of the hip and down his leg. He complained of numbness of the lower leg with-in 5-10 minutes after the injection. EEG nerve studies later confirmed permanent nerve damage Sciatic nerve injury caused by intramuscular injection in the gluteal region in the child seems as a sensory-motor palsy of the lower limb of variable degree. In preterm children or in children with severe perinatal distress, requiring intensive care, a drop foot is often missed or misdiagnosed as a malformative clubfoot or late diagnosed
Nicolau syndrome (NS) is a rare injection site reaction, following intramuscular administration of drugs, with varying degrees of tissue damage.4 It is synonymously described as embolia cutis medicamentosa and livedoid dermatitis. The typical presentation is intense pain around the injection site soon after injection, followed by erythema. Arm: Injections into the lateral surface of the deltoid muscle are associated with a significant risk of nerve and vascular injury. If this site is chosen, have the patient relax their arm. By palpation, locate the acromion process. The injection site is 3 fingerbreadths below the acromion process, in the middle of the deltoid muscle. 3
The injection might have injured the sciatic nerve The sciatic nerve injury may be due to direct injury by the needle or due to rupture of blood vessel around the nerve causing haematoma and compression of the nerve. In your case since there is bleeding after prick, there may be chance of blood vessel injury causing this problem The injection of the nerve causes severe pain that radiates to the lower extremities (similar to an electric shock) and can permanently damage the nerve. In the worst case, sciatic nerve damage can lead to paralysis of the lower extremities. When injecting, make sure no blood vessels are touched
Intramuscular injection. Peripheral nerve injury related to intramuscular injection is caused either by injection close to the nerve or by accumulation of the injected drug within the spaces where the sciatic nerve travels and which are formed between the piriformis, gemellus, quadratus and obturator muscles Injection injury account for 50% of sciatic nerve injuries in one large series reported from the USA . Sciatic nerve injury and dysfunction is not an uncommon cause of lower extremity symptoms in a musculoskeletal practice. The sciatic nerve derives its nerve fibers from the L4, L5, S1, S2, and S3 nerve roots
Recently, there are considered no advantages to using this site with greater emphasis placed on using the vetrogluteral site instead for deep IM injections due to the slower absorption rate using this muscle as well as risk to sciatic nerve injury, identified as a serious complication of iatrogenic injury fig.9.9.- The patient is asked to abduct the shoulder against u p into droplets of myelin and the cells of the sheath of Schwann are converted into phagocytes 2) Flexor digitorum supcrficialis and profundus (lateral half).- In ca e of injury to the and supra-condylar fracture of Ule femur, the sciatic nerve may be injured. The most peculiar LONG THORACIC i and peripheral nerves First Walk is on Us! GPS tracked walks Activity reports On-demand walkers. Book FREE Walk. Jump to Section. What is Sciatic Nerve Injury? Due to the nerve running over the greater sciatic notch, injuries may be common as a result of poor injecting of intramuscular injections (these are injections that are inserted into the muscle) or pelvic fractures