Changing needles prior IM injection

lilbiskit78 · May 25, 2004

Okay now, I am only a lowly student, so this answer may be incomplete, or heck, just wrong all together! I am just going to tell you what we were taught (proud that I remember this!!). We were taught to change the needle after drawing up the meds & put a new one on before injection...some meds (ie Phenergan) are very irritating to the tissues, and drops of it may be left on the outside or bevel of the needle used to draw it up. If you use it to inject, those drops can get in the subQ tissue as you are passing through and cause irritation & burning (as if IM is not bad enough). Now this answer may not be a real world answer, it is just what we are being taught in school. If anyone has more input, I would like to know...I am always up to learning new things. Tried my best!

Lil

JohnnyGage · May 25, 2004

Okay now, I am only a lowly student, so this answer may be incomplete, or heck, just wrong all together! I am just going to tell you what we were taught (proud that I remember this!!). We were taught to change the needle after drawing up the meds & put a new one on before injection...some meds (ie Phenergan) are very irritating to the tissues, and drops of it may be left on the outside or bevel of the needle used to draw it up. If you use it to inject, those drops can get in the subQ tissue as you are passing through and cause irritation & burning (as if IM is not bad enough). Now this answer may not be a real world answer, it is just what we are being taught in school. If anyone has more input, I would like to know...I am always up to learning new things. Tried my best!
Lil

I never give IMs any more, but when I did, I always changed needles. Mostly for the fact that going through the rubber on a vial will slightly dull the needle and I always wanted to give my patient the sharpest needle possible... less pain that way. I figure, why not? In the grand scheme of things needles aren't very expensive. I guess my question is why wouldn't you change them out?

zumalong · May 25, 2004

Both those answers are the reason's behind changing the needle before giving IM. The needle can become dull after puncturing the vial, the medicine on the needle itself can be irritating to subq tissues (which is one reason why you give med IM in first place). I also used to find more 1" syringes in our med cart and mostly used 11/2" needles for Im. We used to give many many IM's for pain control-now it seems most everything is IV. Don't forget Z track method--this does seem to make difference for injection pain (I used to use it for most of my IM's)

SCRN1 · May 25, 2004

Both reasons here too.

txspadequeenRN, BSN, RN · May 25, 2004

I always change the needle after drawing it up, the needle canl dull after going through the vial .:)

What is your current practice in reference to changing the needle prior IM injection after withdrawing the medication from a vial? If you change the needle after withdrawing medication prior use on patient, why? Do you have a reference to back that up?
Thank you:rotfl:

Marie_LPN, RN, LPN, RN · May 25, 2004

It's our policy to change the needle because it can be dulled when going through the vial. I personally would want the needle changed, getting a shot on the butt area hurts enough as it is.

Dixiecup · May 25, 2004

I was not taught in nursing school to change the needle and I never do. Everyone says I give great shots!

MrsWampthang, BSN, RN · May 25, 2004

Same here. I was taught in nursing school for both the reasons stated previously.

Pam

Rhoresmith · May 25, 2004

Those are the reasons I was taught this last semester in school and also if you are using a glass ampule to use a filtered needle to draw the med and then to change the needle. Funny thing they told us that about changing needle because of dulling etc then they never had us do it because said increased risk for needle sticks Go figure, I did change the needles if there was medication running down needle so cause that burns like crazy teachers were not thrilled I did that but I figured that is part of me advocating for that patient Rhonda

SCRN1 · May 25, 2004

Those are the reasons I was taught this last semester in school and also if you are using a glass ampule to use a filtered needle to draw the med and then to change the needle. Funny thing they told us that about changing needle because of dulling etc then they never had us do it because said increased risk for needle sticks Go figure, I did change the needles if there was medication running down needle so cause that burns like crazy teachers were not thrilled I did that but I figured that is part of me advocating for that patient Rhonda

Yep, I always use a filter needle when drawing from ampules. I wouldn't want glass in my veins, so I don't risk it with someone else either.

I'd rather poke myself in changing needles (that hadn't been inserting into someone else) than to cause my patients a more painful shot from a dull needle or unnecessary irritation by a needle that has irritating meds on it that I may not see.

SmilingBluEyes · May 25, 2004

ALWAYS CHANGE THE NEEDLE before giving injections for reasons above. Those who don't are being lazy and obviously have not had to be on the other side of the bedrail very often. Injections HURT people, and we owe it to our patients to give them in the most competent, aseptic and kind way possible. It is worth the extra minute to do this right. Having been on the receiving end of so many injections, blood draws and IV sticks lately, I am real sympathetic these days. I hope I stay that way.

Oh before I forget, one tip to take the sting out of IM injections to the gluteus; have the person bend the knee and bring leg a bit forward--- on the side you plan to inject FIRST, either in bed or standing. It lessens their ability to tense the muscle, making the injection MUCH less painful. It really works! I can attest to that one, and I always do this before receiving an injection in my butt.