Why do some pt's bleed at IM injection site?

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    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?
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    That's happened to me a few times and the answer I got was the needle probably went thru a vein to the other side and out the far wall of the vein and embedded in muscle tissue so when you aspirated there was no blood, but after the injection and withdrew the needle back through the vein the blood following the path of the needle on the way out of the vein and the path produced by the needle through the IM site. Similar to the way blood travels the path of the needle during blood draws only without the needle for the path. -john

    Quote from 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?
    mitral likes this.
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    I was just going to post the same thing SMJ67 did... remeber that there are all those superficial blood vessels and capillaries near the surface of your skin... you probably just went through one of those and made it bleed. If you aspirated and no blood returned, thats what I would bet you did...


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