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Changing needles prior IM injection

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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:

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

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

Specializes in surgical, neuro, education. Has 22 years experience.

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) :p

Both reasons here too.

txspadequeenRN, BSN, RN

Specializes in ICU, PICC Nurse, Nursing Supervisor. Has 20 years experience.

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

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

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.

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

MrsWampthang, BSN, RN

Specializes in Emergency room, med/surg, UR/CSR.

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

Pam

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

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

Has 20 years experience.

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.

Gampopa

Specializes in Adult M/S. Has 10 years experience.

We also were taught to replace the needle after drawing up the injectable. But we were also taught to never recap the needle so how do you remove the 1st needle to place it in the sharps?

No problem with recapping a new needle, it hasn't come into contact with anyone. Where you should be concerned is when the needle has been used on the patient. These should be placed directly in the sharps containers at your patient's bedside.

txspadequeenRN, BSN, RN

Specializes in ICU, PICC Nurse, Nursing Supervisor. Has 20 years experience.

I have worked in facilities that have been fined for having capped needles in the sharps box. So I always uncap anything prior to putting in sharps. Seems like a big risk of getting stuck to me....

No problem with recapping a new needle, it hasn't come into contact with anyone. Where you should be concerned is when the needle has been used on the patient. These should be placed directly in the sharps containers at your patient's bedside.

I'm adding my 2 cents...I ALWAYS change the needle before giving injections...and I asked about the capped needles in the sharps containers...I was told that since they are not attached to a syringe we wouldnt get fined for those.

Along this same subject...I have a question....(I graduated LPN school 12-2002) I was taught to give IM injections in the ventro gluteal, not dorso gluteal....recently (I work in a physicans office) my provider happened to see me give an injection and afterwards told me that he does not want me to give that way any more because it is DANGEROUS! :imbar

In school we were given several reasons...including ventro gluteal being safer and less painful to use that site....I have searched every reference I can find...and have come up empty handed!

Can anyone help with sites that compare the 2 sites and if there is actually a preferred site?

Thanks

I always change my needles.

Burnt Out, ASN, RN

Specializes in Med-surg; OB/Well baby; pulmonology; RTS. Has 19 years experience.

I draw up my IM meds with an 18 guage needle so I always change my needle! I've never had complaints about my IMs...

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