Changing needles prior IM injection

Gampopa · May 28, 2004

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?

suzanne4, RN · May 29, 2004

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 · May 29, 2004

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.

SoonToBeNurse · May 29, 2004

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

Darlene K. · May 29, 2004

I always change my needles.

Burnt Out, ASN, RN · May 29, 2004

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...

gypsyatheart · May 29, 2004

Just another voice to chime in here...yes,yes, yes, you always change the needle after drawing up your med for the reasons already presented. Not to sound harsh but that is Nursing 101....any instructor not teaching that....well, I would have my doubts about them....

Nurse-o-Matic · Jun 2, 2004

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.

Thanks for the tip. I will try this next time! Patients appreciate it when you offer a way to lessen the ouch! :crying2:

critcarenurse16 · Jun 2, 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)

Your are absolutely right. I'd like to add that some medication when infiltrated can cause discoloration. The one that comes to mind first is B12 inj. (its red).

karenG · Jun 2, 2004

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

we were taught upper outer quadrant of the buttock... draw a cross on the buttock and head for the upper outer quadrant. this is to miss the sciatic nerve. also yes, change needles for all the reasons stated before. Its good practice. smiling said bend the knee... I'd add get the patient standing (I work in general practice) and ask them to bend the knee and wriggle their toes as I give the injection. You cannot tense the muscle and this reduces the pain....even with iron injections (which I detest giving!)

Karen

chris_at_lucas_RN, RN · Jun 2, 2004

if you always change the needle after drawing up the med you can never forget to change out a filter needle......

glass bits in a muscle would really smart, wouldn't they????

btw, my reason for changing out needles before reading this post was the dulling of the point issue. thanks for giving me two more (including the one i just came up with!)

chris

adidas99 · Jun 5, 2004

I usually draw up my medication from a vial with a blunt needle or filter(if needed). I alawys thought just certain meds could be damaging to SC tissue..but not all...so I just change my needle with every IM med just because i'd rather not take the chance of damaging tissue. Guess i'm dumb(heck i am blonde) but i never really thought about the needle getting dulled after 1 poke into a rubber topped vial....hmm...never recall that from nursing school...but guess it isn't a big deal for me to think about it since i just always draw up with a blunt tip needle, then switch it over to the correct needle size. hmm...