Published Sep 26, 2010
Toad38350
1 Post
Today I gave a pneumovax injection in a patient's right arm with no issues. Then as i was giving her the flu vaccine in her left arm she said OUCH very loudly and then proceeded to ask if I had done it correctly or if it would even work now. I think she may have clenched the muscle as I was about to inject the vaccine. I usually push these pretty slowly and amuser I was in the deltoid muscle. Any other suggestions for better technique or other tricks to make people a little happier.
MissCharlieRN
64 Posts
I usually get the flu shot every year without issue. This year the shot that was given had the H1N1 vaccine with it, and it hurt like heck (I almost cried [i know, I'm a wimp]). It hurt for 3 days after the shot, too.
Everyone I know that received the shot said it hurt a whole lot, too.
So maybe it was just the vaccine itself and not so much the technique.
PediLove2147, BSN, RN
649 Posts
I have to agree with MissCharlieRN. I got the flu shot recently and was in pain for a few days afterwards.
DuluthMike
164 Posts
Can you give it wrong? Sure.. if you give it SQ to the face or something
The pain of the initial shot is going to be dependent on what random nerves you hit on injection and the tolerance of the recipient. Some will hurt a little, some a lot, some a medium amount. The pain afterword is going to pretty much be the same for everyone as the inflammatory process takes over in a larger, in relative terms to the initial injection insult, area. This larger inflammation is going to trigger pain in everyone.
Faeriewand, ASN, RN
1,800 Posts
I agree with the other posters. All the nurses at my hospital just attended a nursing fair at our hospital and each nurse who got the flu shot said it hurt like heck this year and for a week afterward. My arm had a huge red spot on it as well.
evolvingrn, BSN, RN
1,035 Posts
my arm hurts still ... 3 days later. the nurse giving it said alot of people had commented on how much it hurt this year
cocoashade
3 Posts
"I usually push these pretty slowly and amuser I was in the deltoid muscle."
rom what I was taught, when you're giving an intramuscular injection you do it quickly.
I don't know why they hurt though. ugh.
HeartsOpenWide, RN
1 Article; 2,889 Posts
"I usually push these pretty slowly and amuser I was in the deltoid muscle."rom what I was taught, when you're giving an intramuscular injection you do it quickly. I don't know why they hurt though. ugh.
I think she meant she pushes the plungers slowly, which you are suppose to do. Darting motion with the needles, slowly push the plunger/medication.
Reno1978, BSN, RN
1,133 Posts
I received my flu shot the other day and it didn't hurt afterwards more than any other IM injection I've ever received in my arm.
CareteamRN70
155 Posts
Experience I had on the receiving end was back in school when we were doing IM injections on each other with normal saline. I had taken 2 shots and had sat for my third (only guy in class and not afraid of needles).
I felt so bad for the student who injected me last because her technique was flawless, felt little to no discomfort, but when she was pulling the needle out I think she "touched" a nerve. My deltoid actually "rolled" on its own accord and I felt like a jolt of electricity had run down my arm to my wrist. The needle actually bent into an arc because my muscle rolled so quickly and violently.
Never had that happen before or since. I admit I winced and let out a gasp which just tore the other student up. I explained to the instructor what I think happened and she concurred so the other student still got her check off on IM's.
NurseLoveJoy88, ASN, RN
3,959 Posts
I had a lady scream like hell when I gave it. She jerked her arm when the needle was in the muscle. Afterwards she said " Oh my goodness it felt like that thing went in my muscle". I replied " This is an IM injection"
I've given plenty and only had one scream like that. I feel as though my technique is good. Grasp flesh over deltoid muscle, use a quick darting motion, inject slowly, and pull out quickly. ( Wow almost sounds like a quickie ).
sibilo
11 Posts
hey toad, nice post. if your needle was not too long, jam it in fast, not giving your patient time to move or tense up, make sure the elbow is against the abdomen, pull and push. if you get blood when u aspirate, toss it and start over, hardly ever happens, i have seen many nurses push it anyway, but i dont. thick meds or neulasta and a bunch of other meds hurt like hell, push slow. dont be afraid to push it in the butt if they are real skinny or even the quad. i have hit bone in the deltoid a lot of times, prolly doesnt hurt nothing but its not good practice. you should see what people do to partially ocluded central lines, makes this problem look like childs play. anyway i hope that helps. right needle, hit it fast, elbow against abdomen, pull and push. same for kids. good needle selection is important, i like 23g or 24g sometimes if i can get it for deltoid IM, if your patient has thromoctopenia a 22g can make for good bleeding (not cool). dont forget, right patient, right time, right order, right date, right med, right route, right documentation, right allergy check, right everything. i remember i gave an IM inj to deltoid and this PA saw me, I had blood return, so i tossed it and started over, he freaked out, what an idiot, he doesnt even know how to give a shot and is a PA. hello? i dont want my Tdap IV dude! thanks. Pat.