Do you aspirate before giving an IM deltoid injection? Do you aspirate before giving an IM deltoid injection? - pg.4 | allnurses

Do you aspirate before giving an IM deltoid injection? - page 4

I am hoping someone can clear up this issue for me! I am finishing up my last semester in an ADN program. Graduation is December 16th! :) In school we are taught when giving IM injections to... Read More

  1. Visit  chrisrn24 profile page
    0
    When I was orienting to my job, I was giving insulin and my preceptor said "you don't aspirate for SubQ?" I said "we only learned to aspirate for IM." She just said "ok." So yeah, she might aspirate for SubQ but I don't.
  2. Visit  Ayvah profile page
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    Quote from RN_BSN09
    I've never heard of aspirating for anything other than IM. When you administer SubQ you are admin into the fatty tissue... no veins or arteries are in subcutaneous tissue like they are in the muscular tissue, so if there is bleeding it's from damaging capillaries...

    Here's an example of a sub-q injection that you must aspirate on, per manufacturer's protocol (step 10)

    CIMZIA® (certolizumab pegol) Injections at Home | Instructions on Self-administration

    "Step 10
    Release the skin pinch, keeping the syringe in position. Pull back slowly on the plunger. If blood enters the syringe, this means you have entered a blood vessel. Do not inject CIMZIA. Pull the needle out and throw away the prefilled syringe and needle in a puncture-proof container. Repeat the steps to prepare for an injection using a new prefilled syringe. Do not use the same prefilled syringe. "

    Everyone's anatomy is different, don't assume you won't enter a blood vessel simply because its sub-q - or please show evidence to the contrary.
  3. Visit  Ayvah profile page
    0
    Quote from chrisrn24
    When I was orienting to my job, I was giving insulin and my preceptor said "you don't aspirate for SubQ?" I said "we only learned to aspirate for IM." She just said "ok." So yeah, she might aspirate for SubQ but I don't.
    As I mentioned earlier, general recommendation now is that you don't need to aspirate for insulin and heparin, but I've not seen any evidence that all other subcutaneous injections shouldn't be aspirated.

    edit: Here's evidence per Lippincott that other subcutaneous injections should be aspirated (pg 306):

    http://books.google.com/books?id=fhY...page&q&f=false
    Last edit by Ayvah on Mar 19, '13
  4. Visit  SleeepyRN profile page
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    Shaking my head. I am so confused now lol. I guess I'll just go by P&P. However, I'll make sure when going by policy for anything, that the P&Ps are kept up to date by EBP.
  5. Visit  Steve123 profile page
    0
    I don't think your preceptor aspirates for SQ injections. I think she just wanted to give you a hard time.
  6. Visit  whattodo4 profile page
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    watching IM shots in the hospital whilst in clinical- I have never seen aspiration, yet when we do labs at school we have to aspirate. Thus for the school I will aspirate but in practice I wont, espically since people have linked that it is no longer legally required. I assume the schools are still doing it the old way and will eventually move to no aspiration
  7. Visit  PS0812 profile page
    0
    Giving an IM in the backside.......yes, you aspirate first. Per the Academy of Medical Surgical Nurses' site: "According to the CDC, aspiration is not indicated for IM injections of vaccines and immunizations, nor is it required for subcutaneous injections of immunizations, heparin, and insulin. However, it may be indicated for IM injections of medications such as PCN. The CDC recommends following facility policy in regards to this practice. Perry & Potter (Fundamental of Nursing textbook) describes aspirating when using Z track method of injections; yet for routine injections in the deltoid or vastus lateralis muscles, aspiration is not necessary as the sites do not contain large blood vessels.

    Most nurses are concerned about the practice of aspiration as they often ask about the appropriate technique and are quite fearful. Because there are no large blood vessels in the recommended sites, aspiration before injection of vaccines (i.e., pulling back on the syringe plunger after needle insertion but before injection) is not necessary. Also, some safety-engineered syringes do not allow for aspiration. Old habits die hard.....I'm an aspirator.
  8. Visit  la_chica_suerte85 profile page
    0
    Quote from Ayvah
    Here's an example of a sub-q injection that you must aspirate on, per manufacturer's protocol (step 10)

    CIMZIA® (certolizumab pegol) Injections at Home | Instructions on Self-administration

    "Step 10
    Release the skin pinch, keeping the syringe in position. Pull back slowly on the plunger. If blood enters the syringe, this means you have entered a blood vessel. Do not inject CIMZIA. Pull the needle out and throw away the prefilled syringe and needle in a puncture-proof container. Repeat the steps to prepare for an injection using a new prefilled syringe. Do not use the same prefilled syringe. "

    Everyone's anatomy is different, don't assume you won't enter a blood vessel simply because its sub-q - or please show evidence to the contrary.
    It's interesting that it says this but in the injection video there is no instruction to aspirate.
  9. Visit  punkdmm profile page
    0
    http://www.nnpnetwork.org/Uploads/EB...%20iowa%20.pdf
    The saga continues...I was taught only to aspirate for IM, but it never made any sense to me. Seemed like I would be damaging tissue or vessels by doing this. We are now debating this at the facility I work at...so I found this EBP above and will go with it.
  10. Visit  IPuccino profile page
    0
    I just finished reading an article on "Aspirate or Not to Aspirate". The article is written by several medical professionals that suggest that there is no evidence to suggest that is necessary for SQ or IM. I am including the article in this email.

    http://aspirafile:///C:/Users/Irene/...%20Not.pdftion

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