aspiration before IM injections; are you SURE?

[agingnursie]

My question is this: I see that aspiration of vaccine injections is no longer required, as there are "no major blood vessels where injections are given".

My experience, however, is that, in the course of giving hundreds of deltoid injections of tetorifice/diphtheria vaccine, always aspirating as I was taught in the stone age, I once aspirated blood freely.

This leads me to believe that THAT vaccine would have gone into a vein or artery. Which leads me to question the wisdom of giving up aspiration.

Would someone with more recent training address this, please? I understand the current recommendation, but question it. Thanks!

[NurseGirl525, ASN, RN]

We are still being taught in nursing school to aspirate but I also read that article. Going to ask my instructors next week about this.

[heron, ASN, RN]

Same thing happened to me, twice.

Once when giving colloidal gold (suspended in sesame oil), once with Procaine penicillin.

I'll keep aspirating, thanks.

[BiotoBSNtoFNP]

I was taught in nursing school not to aspirate for IM immunizations.

[Tenebrae, BSN, RN]

I finished in 2012. We were taught to draw back a little to ensure we hadn't inadvertently stuck our needle in a vein.

[klone, MSN, RN]

Proper aspiration is rarely done - in order for it to be effective, it needs to be done over 10 seconds.

Per all the research I've done, and per our facility's nursing education department, the only site that requires aspiration is dorsoglute. I try to avoid that site unless the patient insists (my go-to site is ventroglute but for some reason, that freaks people out).

[laKrugRN]

I'll admit, we didn't aspirate in training. I see some nurses at my job aspirate, and others don't.

[NurseGirl525, ASN, RN]

When we did our IM injection check offs aspirating was a critical point. Which means if we didn't do it, we failed our first check off. This was in the last 2 months. I am going to print off the article I read, I think it was Mighty Nurses that shared it on FB, and show it to my instructors tomorrow and see what they think about it.

[Farawyn]

I don't aspirate. My HOB is always up 30 degrees or higher.

(sowwey. I had to.)

[mariebailey, MSN, RN]

I once aspirated blood freely.

This leads me to believe that THAT vaccine would have gone into a vein or artery. Which leads me to question the wisdom of giving up aspiration.

The current practice NOT to aspirate is based on evidence that, while you may hit a vessel at those sites occasionally, you would not cannulate the vessel &, therefore, give a med intravenously as a consequence. The vessel would simply rupture.

[mariebailey, MSN, RN]

I included a link to an article entitled, "To aspirate or not: An integrative review of the evidence" https://www.nursingcenter.com/_PDF_.aspx?an=00152193-201203000-00008 & a quote from CDC immunization experts.

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[TD]Do you need to aspirate before giving a vaccination?[/TD]

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[TD]No. ACIP does not recommend aspiration when administering vaccines because no data exist to justify the need for this practice. There are data that show that aspiration is more painful for the vaccine recipient. IM injections are not given in areas where large vessels are present. Given the size of the needle and the angle at which you inject the vaccine, it is difficult to cannulate a vessel without rupturing it and even more difficult to actually deliver the vaccine intravenously. We are aware of no reports of a vaccine being administered intravenously and causing harm in the absence of aspiration. Ask the Experts: Administering Vaccines[/TD]

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[agingnursie]

Thanks, all; it's pretty clear that what's taught in nursing school varies.

See later post by MarieBailey, 11/23/14. Thanks, Marie!!! First answer I've seen that makes sense.