med error..

[nursiemellie]

on the medex it said to administer pneumovax 0.5cc IM to deltoid. Not specifying WHICH deltoid it is. So I just gave it to one of the deltoids. My mom works at this SNF as a LPN too. I told her I gave pneumovax and when she asked where i put it, i told her "LA deltoid" and she told me that pneumovax always goes in the RA deltoid. Like I said, no specification on the medex as to WHICH deltoid it was supposed to be given, which I told her. I'm a new nurse at this SNF and no one had told me that pneumovax is always given to the RA deltoid. I'm wondering if this is a major error? I'm freaking out and I don't want to lose my license or get sued for something like this, I dont feel like it's a "big" deal since it still went into the deltoid. I would just like to know your opinions on my situation?

[SAHMU4IA]

.....AND FURTHER MORE.... the Dr's order should simply say "drug", 0.5 ml, one time only, IM. As long as it's IM,it's the nurse's and/or pt's choice as to which area.(butt or delt).

[sharona97, BSN, RN]

.....AND FURTHER MORE.... the Dr's order should simply say "drug", 0.5 ml, one time only, IM. As long as it's IM,it's the nurse's and/or pt's choice as to which area.(butt or delt).

Not all drugs can be given in Deltoid. If the insert reuirese a gluteal injection, I'll ask which side would you prefer. Quantity of drug also may dictate if the deltoid is inappropriate to use.

[SAHMU4IA]

but is that to be written in the Order? I thought it was our biz to know WHICH site.. Maybe it's just my Doc's thank dont specify.

[cholli]

Most dialysis grafts I've worked with have been in the forearm, no where near the deltoid.

I hope I am misreading your quote- even though the dialysis shunt is in the foream, we still treat it like a lifeline and NEVER do any injections, b/p etc on that arm.

I'm sure you know that- just clarifying.

[sharona97, BSN, RN]

but is that to be written in the Order? I thought it was our biz to know WHICH site.. Maybe it's just my Doc's thank dont specify.

I believe 2cc is the max to gve in the deltoid for adults if the insert recommends deltoid. It's an individual thing, for instance I'd never give penicillian in the deltoid. Only the gluteal( or vastus laterus if I had too.

The usual amount is 0.5 - 2ml in adults. In children 0.5 to0.1ml at the IM site. In adults, divided doses are rec for amounts>3ml.

Anybody? Please correct me if I'm wrong..

[SAHMU4IA]

I hope I am misreading your quote- even though the dialysis shunt is in the foream, we still treat it like a lifeline and NEVER do any injections, b/p etc on that arm.

I'm sure you know that- just clarifying.

I never do ANYTHING on an arm with a fistula.

[pedsnursebs]

Bless your heart! I understand your worries about this situation, but trust me...you're OK! As a pediatric nurse, I have given babies & small children many, many vaccinations. When I was being trained, I was told that certain vaccines are "always" administered to a specific side. (ex: Pediarix "always" goes into RT vastus lateralis) Then I found out it is just so sites can be monitored for reactions. As long as you document correctly what site you administer what med/vac to, you should be ok. After all, our muscles are the same bilaterally! Right deltoid is just as good as left deltoid! I think your mom is just going by habitual administraion techniques. Don't worry! You will run into many situations like this from more "experienced" nurses. Just take it in stride & be the best nurse you can be!

Of course...I mean this in case of NO contraindication to administering to a certain side such as fistula placement, etc... I deal with babies/children after all!