IM Injection, Hitting Bone? - page 2
by etep1209 58,724 Views | 36 Comments
So I was giving my mother an IM injection for the Flu Vaccine at the hospital, I did the injection and went the whole needle inside and felt that I hit a bone or something. I did aspirate and received no blood return and went... Read More
- 0Nov 1, '08 by DolceI did it once on a skinny teenager. She didn't even flinch. I was a new grad and was absolutely horrified. I tugged a little to retrieve the needle from the bone and then aspirated and gave the injection. She was completely unfazed and didn't notice anything. I, on the other hand, have been extremely careful about giving scrawny folks injections after that. Be sure that your needle length is appropriate for the size of the person you are injecting.
- 1Nov 1, '08 by BinkieRNQuote from pagandeva2000Gauge does not equal length. I typically use a 1" needle for an IM injection in the arm. Little or elderly people a 5/8".It's happened to me on occasion. Nothing happened. What I have done since having it happen a few times is to really look at the arm and decide whether or not to administer the IM with a 25 gauge needle instead of a 22 or 23. I've had some really emaciated patients that can only handle a 25 gauge IM.
- 0Nov 1, '08 by Mo_RNIn nursing school we were instructed to use 1-1 and a half inch needles IM, depending on the patient's chubbiness. But now on the floor, some nurses actually use five-eigths needles on skinny adolescents for deltoid injections. My colleagues also insert 1 and a half inch needles only half way when administering IM. I question this.
- 1Nov 1, '08 by woknbluesQuote from CHATSDALEif there is limited underlying adipose tissue pull up a pinch..flu vaccines are usually given sub q
hitting the bone can cause some site painQuote from cherrybreezeI believe what CHATSDALE is referring to is that if you have a very low body fat client, they also tend to be low muscle. You see this type a lot in the elderly (deltiod) or in low birthweight infants (Vastus Lateralis). The technique is to grab some muscle and draw it together, and up just a little, so that the tip of your needle is dwelling inside a "pocket of muscle" that you aggregated, rather than hitting bone.Flu vaccines aren't given subq....or am I missing something? I've never known of a vaccine that wasn't IM.
- 0Nov 2, '08 by GrumpyRN63Quote from etep1209Don't worry, I'm sure she'll be just fine!Thanks folks for the reply...
The problem was that I did not pull back when I hit the bone...all I did was aspirate and then inject the medication. My mother didn't twitch or anything...
I'm scared it might have a negative effect on her...
- 0Nov 2, '08 by cherrybreezeQuote from woknbluesI understand that. What CHATSDALE said was that flu vaccines are given subq, and they are not. This doesn't explain that statement.I believe what CHATSDALE is referring to is that if you have a very low body fat client, they also tend to be low muscle. You see this type a lot in the elderly (deltiod) or in low birthweight infants (Vastus Lateralis). The technique is to grab some muscle and draw it together, and up just a little, so that the tip of your needle is dwelling inside a "pocket of muscle" that you aggregated, rather than hitting bone.