IM--to draw back or not?

Nurses Medications

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Specializes in Med-Surg, ED.

I was in a bit of a panic last week when I gave an IM and totally forgot to draw back to aspirate for blood. I talked with one of my friends (an NP) who told me that it was okay, that the latest guidelines say that one does not have to aspirate when giving an IM. I haven't been able to get in touch with her since to get an idea where these new guidelines might be.

Does anyone know? I really want to see it in writing before I go about giving IM's all wrong.

Thanks!

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I was always taught to aspirate to ensure that you haven't entered a vein are giving the med IV.

Having said that, I honestly think that most nurses have made the same mistake.

Don't beat yourself up over it.

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this article is from medscape, and r/t im vaccinations in the pediatric population.

still, much relevance.

http://www.medscape.com/viewarticle/56196

leslie

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Specializes in Med-Surg, ED.
this article is from medscape, and r/t im vaccinations in the pediatric population.

still, much relevance.

www.medscape.com/viewarticle/56196

leslie

Thanks Leslie, but the link doesn't work!

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Specializes in Rehab, Med Surg, Home Care.

I run into this every fall when I do flu clinics. CDC guidelines now say aspiration is not necessary (sorry, no link). Apparently, it's not that you will never draw blood but that it really isn't harmful if there is a small amt of capillary blood and you still inject. However, seems there are still so many RN's in general practice that go ballistic at the thought of not aspirating that I uaually ask which practice they follow at each clinic. When in Rome...

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Thanks Leslie, but the link doesn't work!

oops.

let's hope this link works:

"CDC posts online Summary of Major Changes in the "General Recommendations on Immunization"

http://www.immunize.org/genr.d/issue297.htm

scroll down to "Aspiration Before Injection"

leslie

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Specializes in LTC, Nursing Management, WCC.
I run into this every fall when I do flu clinics. CDC guidelines now say aspiration is not necessary (sorry, no link). Apparently, it's not that you will never draw blood but that it really isn't harmful if there is a small amt of capillary blood and you still inject. However, seems there are still so many RN's in general practice that go ballistic at the thought of not aspirating that I uaually ask which practice they follow at each clinic. When in Rome...

CDC states this in regards to immunizations or for all IMs?

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Specializes in TraumaER ,NICUx2days, HEMEONC CathLab IV.
I was in a bit of a panic last week when I gave an IM and totally forgot to draw back to aspirate for blood. I talked with one of my friends (an NP) who told me that it was okay, that the latest guidelines say that one does not have to aspirate when giving an IM. I haven't been able to get in touch with her since to get an idea where these new guidelines might be.

Does anyone know? I really want to see it in writing before I go about giving IM's all wrong.

Thanks!

Been a ER nurse, Office nurse, blaa blaa blaa nurse for 30 yrs, only drew blood x2 while giving an IM injection, but I sure would not have wanted to give Vistaril 100mg,IV, on the first one,(yes we gave vistaril 100 im all day long, and on the 2nd, Morphine 10 mg and Phenergan 25mg. yes we mixed phenergan and Morphine all day long.....

SOOOOOO. make it a practice to aspirate back, be safe, IMHO, just because some one comes out with a guide line, look at it, pick the safest route.

My guide line is. Would I do this to my mother/father. I haven't gotten in trouble for being too safe.

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Not a nurse yet, soon to graduate though. And we were taught by our lab instructors and it was in a very current issue of our Nursing Fundamentals book to always apirate with IM injections.

Like the other poster said, until there is a specific guideline that says I don't have to, I'll continue to apirate with any IM I give. It only takes seconds to do it and I am much more comfortable giving that med when I know its not in a vessel.

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Specializes in Community Health, Med-Surg, Home Health.

While in school, some of the professors stated we needed to aspirate, others said 'no'. I admit, I don't do it when it is in the deltoid.

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Specializes in Med surg, Critical Care, LTC.

I have been a nurse for 16 years, and I've always aspirated before giving an IM injection.

TWICE in my career I aspirated blood back - I remember both times,

FIRST: 100mg Demerol/25mg Vistaril - if I had not aspirated, that would have been given IV. That's a lot of Demerol for the average person in one dose IV

SECOND: I was giving 1g Rochephin mixed with lidocaine IM - again, wouldn't have been good to give that IV.

Twice in 16 years is rare, but better to be safe than sorry.

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