I've read a couple of different opinions on aspirating when giving IM injections. In school we were not taught to aspirate. (The only time we were taught to aspirate was when checking placement/contents of g tube.) Now I work in an office and yesterday an MA was with me when I administered a flu shot and freaked because I didn't aspirate. The MA's I work with say that's completely wrong...you always aspirate.
Is this something new (NOT aspirating?)
Here's a link from immunize.org stating that it isn't necessary.
If you have blood return...start all over with new needle.
Maisy;)
So would you redraw the whole injection if you have blood in the first syringe? Sorry if thats a stupid question... It makes sense to get a new needle and start again though.
Specializes in Gyn Onc, OB, L&D, HH/Hospice/Palliative.
So would you redraw the whole injection if you have blood in the first syringe? Sorry if thats a stupid question... It makes sense to get a new needle and start again though.
We were always taught to aspirate w/ IM injections. Even though the chance of accidentally giving the med IV is small, I still want to take proper precautions.
Lidocaine is used as an antiarrhythmic to terminate V Tach or V Fib, but can also cause cardiac arrest. You definitely don't want that going into a vessel unintentionally.
I interpreted the CDC link to mean that, even if you hit a vessel and get blood return, because of that angle of the needle, it's unlikely that you are going to inject into the vessel. I can see both sides. I was always taught to aspirate, but have seen most nurses in my area not aspirate.
I would think that it would be very unlikely that you are giving it only directly into a large vessel. More likely that you are getting blood return because you have hit a vessel on the way down and have a little blood in the needle, or you have damaged a blood vessel at the end of your needle, with a little pooling of blood, and you are aspirating the pooling.
In the first case, you wouldn't be injecting into the vessel at all; in the second, the amount of fluid you were injecting might actually put pressure on the vessel and stop the bleeding, rather than being injected into the vessel.
It definitely takes me longer when I aspirate. I guess I don't have to give that many IMs, but stabilizing the needle to aspirate, aspirating, and then injecting takes me longer than injecting and giving. Also, I've seen a lot of nurses, when giving IM meds, move the needle around in the skin when they are manipulating to aspirate and then inject. It seems like it might be more likely to cause more damage if you move the needle much while aspirating than if you just inject.
I've seen nurses injecting lidocaine SC get a blood return on aspiration. I'd rather err on the side of caution and be 100% certain that I'm not injecting into a vessel of a person with known CAD who had just undergone a stenting procedure!
i'd rather err on the side of caution and be 100% certain that i'm not injecting into a vessel of a person with known cad who had just undergone a stenting procedure!
Fresh out of nursing school and we were taught not to aspirate for IM injections.
Interesting. I'm still in nursing school and we are taught to aspirate IM injections, however we are also taught that research shows it may not really be necessary on many IM's however it is an extra safety measure so we should do it just in case.
Specializes in med/surg/tele/neuro/rehab/corrections.
Lidocaine is used as an antiarrhythmic to terminate V Tach or V Fib, but can also cause cardiac arrest. You definitely don't want that going into a vessel unintentionally.
Thank you for this excellent point. (And on your other post as well) I will never forget it. :)
Wolfe24
85 Posts
So would you redraw the whole injection if you have blood in the first syringe? Sorry if thats a stupid question... It makes sense to get a new needle and start again though.