I Hit A Bone!! - page 3

Oh, wow... I hit a bone! I was injecting an older, thin lady with 0.5mL pneumococcal vaccine IM in deltoid. I used a #23, 1 inch. needle. After seeing the client, my instructor told me to insert 1/2... Read More

  1. by   Antikigirl
    If a needle breaks, it must be removed...typically local surgery to the site using a local analgesic...someone is going to have to cut in and find it and remove it (MD time!).

    Don't know the whole insurance thing about that...I mean, how it is paid for by the nurse or nurses employer for this...but I was just told never to break it off inside a pt (like that helps...LOL!).

    I mean think of the ramifications...metal inside not self, and heck...what if they go into an MRI? WOW! EEK!

    Yep...has to be removed by an MD.
  2. by   Fiona59
    I would have used a shorter needle of the same guage. (5/8 seems to work fine with most little old ladies)
  3. by   jill48
    Quote from zenman
    What is your rationale for thinking that the instructor was wrong?
    That's easy. First of all it should have been given in an area with more muscle. Second, she should have used a shorter needle. And third, who teaches a new nurse to insert a needle halfway when the proper way is to jab it in like a dart. Duh.:trout:
    Last edit by jill48 on Nov 22, '06
  4. by   perfectbluebuildings
    Quote from TriageRN_34
    If a needle breaks, it must be removed...typically local surgery to the site using a local analgesic...someone is going to have to cut in and find it and remove it (MD time!).

    Don't know the whole insurance thing about that...I mean, how it is paid for by the nurse or nurses employer for this...but I was just told never to break it off inside a pt (like that helps...LOL!).

    I mean think of the ramifications...metal inside not self, and heck...what if they go into an MRI? WOW! EEK!

    Yep...has to be removed by an MD.
    I know it's a little off topic but this made me think of it- someone who told me in nursing school, her instructor was helping take out an IV and the cathelon broke off into the patient!! I'm not sure how they managed that one.
  5. by   Antikigirl
    YIKES! I know we always have to list "cath in tact" on iv d/c but I always wondered how one would break...maybe an autoimmune thing that makes it weak and break? OH lordie that would be very bad!!!!!!!!! Scary!

    Or perhaps when putting it in the needle punctured the cath and during withdrawl that part loosens and breaks? EEK!

    Or of course manufacturer error....

    Just scary..thank goodness I have never seen that one! You hope that a valve keeps that from the cirulation long enough to retrieve it! EEEEEKKKKKKK!
  6. by   cookie102
    in home health we do alot of injections, B12, flu etc, i use a needle that is 23 G with 5/8" works beautiful for deltoid injections even in those tiny old ladies
  7. by   West_Coast_Ken
    Quote from jill48
    And third, who teaches a new nurse to insert a needle halfway when the proper way is to jab it in like a dart. Duh.:trout:
    Thank you!!! "Make sure you dart it." Been told that several times (IM, flu vaccine that is).

    How could anyone experienced or not only dart "half way"? That's nuts!

    My first IM was in our class lab and the "pt" was a healthy fellow student with excellent musculature and I hit her bone, too. It freaked me out as I never thought about going too far. No one but me knew as I didn't hit it too hard. I looked at the tip when I removed the needle casue I wondered if it "fish hooked" and it didn't. The needle was intact.

    No one ever told us what to do if we hit a bone. Now I know. Check the tip and if it is in the pt, call the doc. Thanks again, Allnurses team!~
  8. by   jill48
    [quote=West_Coast_Ken;1936625]Thank you!!! "Make sure you dart it." Been told that several times (IM, flu vaccine that is).

    How could anyone experienced or not only dart "half way"? That's nuts!

    Your welcome.:chuckle
  9. by   SOREFEETEMPTYSTOMACH
    Never Fear , My Dear. In 30 Yrs. Believe Me I Hit Bone Often. You Will Encounter Many Other Things Before You're Through Working. At Least You Care. I Know Some Who Would Not.
    Just Keep Plugging Away. I'm Sure Your Instructors Could Share Horror Stories With You.
  10. by   MidnightTang
    I can't imagine quickly holding onto the hub and trying to aspirate with the needle only halfway in.
  11. by   loquacity
    as an instructor she should know (as i do as a fellow student) that even if she is able to quickly dart it in to only halfway, that a student realtivley new to injections probably doesnt have the dexterity, motr control, muscle memory to do such a deed, and if she wanted you to practice on a arm going only half in, you should practice on a beefy arm...not the skin and bones arm.
    ~Loquacity
  12. by   TazziRN
    Quote from jill48
    And third, who teaches a new nurse to insert a needle halfway when the proper way is to jab it in like a dart. Duh.:trout:
    *raising hand*

    Me. I was taught the darting method too, and those are the times I hit bones the most. Since then I've darted just hard enough to get past the dermal layer, from just above the skin, then pushed in gently. Haven't hit one since and pts have told me my injections are less painful than others because other nurses make them feel like dart boards. We have nursing students during the school year and when I observe them giving IMs I tell them, "I know you have to do it this way because of school, but this is how I do it."
  13. by   yadda_yadda_yadda
    :icon_hug:

    Been there..done that, too.--and you can't help but feel terrible, but we don't have 'x-ray eyes'. If the needle was intact, just take a deep breath & move forward.

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