[Montessori Mommy]

I'm a new grad nurse in L & D. Today the nurses on the floor were discussing if we are suppose to pull back before injecting Vitamin K or not. Does anyone know where I could find information on proper Vitamin K administration? I've checked AWHONN, and literature search engines but can't find anything about this specifically.

Thanks in advance!

[Elvish]

I think current research indicates that you don't HAVE to aspirate anymore. Most people I know do it, though. Supposedly if you get your landmarks right, you're not going to hit any major nerves or vessels.

[Jordydan4]

Contemporary Maternal-Newborn Nursing Care by Ladwig, 6th edition, pg 642, states:

"Procedure for vitamin K injection. Cleanse area thoroughly with alcohol swab and allow skin to dry. Bunch the tissue of the upper outer thigh (vastus lateralis muscle) and quickly insert a 25 guage, 5/8-in needle at a 90-degree angle to the thigh. Aspirate, then slowly inject the solution to distribute the medication evenly and minimize the baby's discomfort. Remove the needle and gently massage the site with an alcohol swab."

I am also in my OB class right now, and my instructor also stated to us to aspirate first because you don't want the vit k to get into the vascular system, it's dangerous for the baby to have it absorbed quickly. IM's absorb more slowly.

Hopes this helps.

[crissrn27]

I always aspirate. I have never got a return, but a couple of folks I work with say they have. So I guess better safe than sorry.

[Thedreamer]

I always aspirate simply because it only takes a second to check but can be damaging if you do happen to give it accidently IV instead of IM without checking. Keep up the good work and keep that inquisitive mind in gear!

[Elvish]

Just for the record, I aspirate. I agree, better safe than sorry. And by now, it's a habit.

[RN4PatientCare]

By the way this question is asked, I believe you are assuming the vitamin K is administered IM. In our hospital IM vitamin K is only administred in critical care areas. On the floor our orders must be subcutaneous or PO. Therefore, we've received orders for IM and have had to contact the doctor for a route of admin change. Most go with subq.

[rninwch]

Originally Posted by RN4PatientCare

By the way this question is asked, I believe you are assuming the vitamin K is administered IM. In our hospital IM vitamin K is only administred in critical care areas. On the floor our orders must be subcutaneous or PO. Therefore, we've received orders for IM and have had to contact the doctor for a route of admin change. Most go with subq.

When caring for a neonate vitamin K is ALWAYS given IM in the vastus lateralis, and for the record I always aspirate. I actually have aspirated blood on 2 occasions and like someone already said, it only takes half a second.

[Montessori Mommy]

Thank you for all of your responses.

I was taught in school to aspirate, but one of the nurses on L & D mentioned that she read that aspirating can lead to complications. I had never heard that, and was looking for research on that topic.

Thanks again!

[dawngloves]

I've never heard that either. Ask her to put up or shut up.