[EtoseLvr03]

I gave a patient an IM injection of 100 mg Thorazine in the LUQ today, and as soon as I withdrew the needle, she really started bleeding quite a bit, like when you remove an IV from a vein, and it pours out blood. Every other time I have given an IM injection, I haven't observed bleeding like this. I aspirated before I injected the medication to make sure I wasn't giving it in the vascular, and no blood was noted then. I did everything right during the injection, just like I was taught in nursing school. I felt really bad that she bled like that, and she didn't even complain of pain during the injection. I was scared that I had injected the medicine in a vein, so I kept a very close eye on her after the injection. She was fine, and her agitation subsided. I put a bandaid over it afterwards, and applied some light pressure, but I still felt like I did something wrong. Anyone ever had anything like this happen to them, or have you ever received a blood return while aspirating before the injection?

[meownsmile]

It depends on the patient. If the patient is on coumadin, or takes large doses of asprin, getting subq heparin, or an active alcoholic they could bleed at the injection site without having accessed a vein. It could be the needle went through a vein and bled out some after the injection even though the medication was injected into muscle.
I have seen injection sites bleed some. You monitored your patient and got the reaction from the drug you were looking for so dont let it bother you.

[CrunchRN]

Sometimes you knick a capillary on the way out. It happens so don't sweat it. Your technique sounds proper/fine.

[angie1982]

oh my goodness. That is funny that I found this post on here. The same thing happened to me this morning. I was giving Benadryl IM b/c the pt. didn't have an IV and I couldn't get one started. Anyway gave it in the arm, aspirated for blood return (none) and when I pulled the needle out after the injection the pt. bleed a little bit. Scared me a little b/c this has never happened before. I hate giving IM's anyway so this threw me for a loop. The pt. said it didn't burn or anything, he was fine. Glad to see that this is normal and that i didn't do anything wrong. I asked a fellow nurse who said it was ok too, but was still wondering a little.