I recently started working in a pediatric office where today I gave a rocephin injection IM. We don't normally aspirate with vaccines but with rocephin we do. Since I don't aspirate much, because we do vaccines more, I'm a little concerned about an incident today. When giving a rocephin today to a 9 month old I aspirated, no blood return but what looked like an air bubble formed. I proceeded to inject the medication and then went on the rest of my day not thinking much about it til now. Was that incorrect to inject the air bubble? Will it harm the patient? Still learning :)! Thank you!
TriciaJ, RN 4,295 Posts Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 42 years experience. May 1, 2014 I always aspirate a glute shot, but not deltoid. Of course, I don't have to inject babies which suits me fine. But I've never heard of aspirating an air bubble. I don't think small amounts of air IM do any harm. Hopefully you get some posts from someone who's up on the latest and greatest.
newgrad1988 23 Posts May 1, 2014 Thank you for your response! It was given in the thigh, not arm. Just thought I'd clarify...
newgrad1988 23 Posts May 1, 2014 I was able to talk to someone I work with and they said yes that's just fine as long as there is no blood. :)
Asystole RN, BSN, RN 2,313 Posts Specializes in Vascular Access, Infusion Therapy. May 1, 2014 The air bubble was most likely not air but rather vacuum. This is much easier to do with smaller gauge syringes. As an experiment, close the cap tight on a syringe and pull back on the plunger, then let go.
psu_213, BSN, RN 3,878 Posts Specializes in Emergency, Telemetry, Transplant. Has 14 years experience. May 1, 2014 If you don't pull back blood, something has to "fill" the extra volume you have now created in the syringe (either that or the syringe has to collapse on itself). The irony to it, it that the space is "filled" with nothing--i.e. a vacuum, as Asystole stated. And, even so, it is OK to inject air--remember the airlock technique for IM injections.
bloodorange 136 Posts May 1, 2014 As an unlucky one-time recipient of a Rocephin IM injection, I hope it had lidocaine in it.
KelRN215, BSN, RN 1 Article; 7,349 Posts Specializes in Pedi. Has 16 years experience. May 2, 2014 I always aspirate a glute shot, but not deltoid. Of course, I don't have to inject babies which suits me fine. But I've never heard of aspirating an air bubble. I don't think small amounts of air IM do any harm. Hopefully you get some posts from someone who's up on the latest and greatest.For an infant, an IM would not be given in the deltoid. IM injections in infants/toddlers are given in the vastus lateralis.
