Mistake with IM injectiom

  1. Started a new job in the OBGYN clinic and was to give a tDAP. I pull out the med, made sure it was correct, drew it up and gave in IM in the deltoid. Except I gave it too high because it was my first injection and I was nervous (not excuses). I truly didn't know and thought I was doing it correctly. At out it in the shoulder, not on the side of it. Anyhow when I left the room, my trainer told me she noticed I gave it too high but didn't say anything because I already stuck the pt. I really wish she would've said something

    I'm naturally a nervous person and I feel like complete ****. I texted my supervisor a few hours ago just to fill her in. I'm so upset and disappointed with myself
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  2. 8 Comments

  3. by   oceangirl1234
    Mistakes happen. Yes, you should have maybe been more prepared and taken more time if needed but you didn't. If the patient was fine, then use this as a learning experience to be better next time.
  4. by   LPNewbie
    How do I know if she's fine? I keep thinking about the worst
  5. by   klone
    Quote from LPNewbie
    How do I know if she's fine?
    Read the obits and see if her name shows up?

    Seriously, though - it'll be fine. Relax, and make sure you're using your landmarks (3 finger widths below acromiom process).
  6. by   bananas1
    Hey please don't worry about this. I have just starting vaccinating too and landmarking is hard! (I vaccinate kids and they move!!) The good news is, the deltoid muscle does cover a fair bit, and if you had truly injected too high or too low, the client would have been incredibly in pain, or you would have had some blood return! Different places landmark the deltoid region differently, some use the 2-3 fingers below acromion, some use the triangle and we use the axilla line. So basically, with a relaxed arm at clients side, you go at the line of that arm crease and straight down from that acromion.

    I have hit the bone a couple of times in some really skinny pre-teens and fark *cringe, clench teeth* ... they didn't even flinch!
  7. by   klone
    Quote from bananas1
    Hey please don't worry about this. I have just starting vaccinating too and landmarking is hard! (I vaccinate kids and they move!!) The good news is, the deltoid muscle does cover a fair bit, and if you had truly injected too high or too low, the client would have been incredibly in pain, or you would have had some blood return!
    You shouldn't be aspirating with a deltoid injection.
  8. by   bananas1
    Quote from klone
    You shouldn't be aspirating with a deltoid injection.
    Dude where did I say I did that?? Of course I dont aspirate, if you've ever done venipuncture you'd know you get blood return once in the right spot. In the case of vaccinating, the wrong spot.
  9. by   klone
    Quote from bananas1
    Dude where did I say I did that?? Of course I dont aspirate, if you've ever done venipuncture you'd know you get blood return once in the right spot. In the case of vaccinating, the wrong spot.
    Um, "dude,"

    You won't have "blood return" with an IM injection unless you are aspirating.
  10. by   bananas1
    Quote from klone
    Um, "dude,"

    You won't have "blood return" with an IM injection unless you are aspirating.
    Oh cool, that's alright We were just taught a bit differently. No worries

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