Aspirating for blood when giving injections to infants?....Have the rules changed?

Nurses Medications

Published

Nurses Month 2024 | Discounts & Freebies AORN Celebrates Nurses Month

My grandson got his second set of immunizations today. I was done with work and knew where they were so I stopped in. I got there just in time to see him get the immunizations. He got 4 in 4 different syringes which I realize is normal now-a-days. I don't ever like to make it known that I'm a nurse. It makes some people uncomfortable and I don't ever want to come across as a know-it-all so I just stay quiet on the subject. This young woman, probably early 20's came in with the syringes. The needles looked to be 23G 5/8". She stuck him twice in the front of each thigh. She was not far enough over to the lateral aspect and also did not aspirate for blood. It happened so fast but I watched her with all four injections. She promptly left the room. I was kinda stunned. My daughter was like "Mama" is something wrong? I told her I didn't think the immunizations were given properly. This young woman was very fast, I'll give her that, she was polite, she had no identification on. I'm thinking that I should go back there and discuss it with her or the office manager or the nurse, if they have one. I'm not looking to get her in trouble but gees that's my grandson and all those children are somebody else's. I've only gotten blood back once in 30 years while aspirating giving an IM injection. But hey it happens. What do you think I should do? Check it out? or Do Nothing?

By the way, my unit is children's psych and when we give IM's we often, well, almost NEVER aspirate on the kids, even if they are as big as me (which seems to be alot of them!) The reason is because by the time it is time to give the kid an IM, 5 or so people are holding him/her down and he/she is screaming like a banshee and fighting us tooth and nail. We usually have to crawl in between an open space among various arms and legs, and inject before the needle breaks off in the pt on account of all that struggling. I know this is a totally different situation, but i thought I would mention it. .

Up Vote Up Vote ×

Per the CDC: It is not recomended to aspirate when giving vaccines to children.

Up Vote Up Vote ×
Specializes in PACU.

I've been a MA for a little over two years. I was taught to aspirate during school but when I actually started working [in pediatric medical office] I was told not to aspirate. I am quite comfortable giving injections to children. I get compliments from parents and complaints from others when I give injections. I always let parents know what vaccine I am injecting before I inject. Sometimes they bleed sometimes they don't. Sometimes they cry sometimes they don't. Sometimes there is swelling at the injection site and sometimes the kids do develop a low grade fever. One time after my coworker gave a varicella vaccine, a rash developed. I understand parents/grandparents/ect. care givers get worried and scared. If your really worried, call and talk to the MD.

Up Vote Up Vote ×
Specializes in PACU.

And where I work we use 25G needles...I don't have any identification on when I'm working as well and you bring up a valid point. I will discuss this w/ my manager as well as the MDs.

I know we don't aspirate because there is only so much time we have when giving injections to children.

Up Vote Up Vote ×
Specializes in OB/GYN/Neonatal/Office/Geriatric.

Okay I used to work pediatric office many moons ago and we aspirated. We did a one-handed aspiration with the thumb pulling the plunger up. Very quick and efficient and didn't bother the child. I just can't imagine giving an IM injection where there is a blood supply without aspirating first. Especially vaccines. I guess I must have been too cautious. How things change!!

Up Vote Up Vote ×

This is the link to the ACIP Vaccine Administration Guidelines:

http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/D/vacc_admin.pdf

The first sentence on page 10 states their position on aspiration (not needed) and the rationale.

I still feel funny not aspirating though.

Up Vote Up Vote ×
Specializes in OB/GYN/Neonatal/Office/Geriatric.

@AugustRain:

Thanks for the link. Found it very informative. I have aspirated blood twice in 12 years, both on vaccines, so I would probably stick with it. Ooops no pun intended! I did it so quick I've never had a problem with pain or bruising or anything, knock on wood.

Thanks again!

Up Vote Up Vote ×
+ Add a Comment