used for infants less than 7 months old and people who are unable to walk or who have loss of muscular tone. The site is located by dividing the front thigh into thirds vertically and horizontally to form nine squares; the injection is administered in the outer middle square. This site is also the usual site of administration for epinephrine autoinjectors, which are used in the outer thigh, corresponding to the location of the vastus lateralis muscle. The dorsogluteal site of the buttock site is not routinely used due to its location near major blood vessels and nerves, as well as having inconsistent depth of adipose tissue. Many injections in this site do not penetrate deep enough under the skin to be correctly administered in the muscle. While current evidence-based practice recommends against using this site, many healthcare providers still use this site, often due to a lack of knowledge about alternative sites for injection. This site is located by dividing the buttock into four using a cross shape, and administering the injection in the upper outer quadrant. This is the only intramuscular injection site for which aspiration is recommended of the syringe before injection, due to higher likelihood of accidental intravenous administration in this area. However, aspiration is not recommended by the Centers for Disease Control and Prevention, which considers it outdated for any intramuscular injection. Special populations Some populations require a different injection site, needle length, or technique. In very young or weak elderly patients, a normal-length needle may be too long to inject properly. In these patients, a shorter needle is indicated to avoid injecting too deeply. It is also recommended to consider using the anterolateral thigh as an injection site in infants under one year old. To help infants and children cooperate with injection administration, the Advisory Committee on Immunization Practices in the United States recommends using distractions, giving something sweet, and rocking the baby side to side. In people who are overweight, a 1.5-inch needle may be used to ensure the injection is given below the subcutaneous layer of skin, while a -inch needle may be used for people who weigh under . In any case, the skin does not need to be pinched up before injecting when the appropriate length needle is used. History Injections into muscular tissue may have taken place as early as the year 500 AD. Beginning in the late 1800s,