Did I hit the sciatic nerve?

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Hello fellow nursing students and nurses/health care professionals. I have a question. I have been fixated on this all day since. I am wondering and am scared that I might have hit the sciatic nerve in a patient.

My question is: What are some immediate signs and indicators based on the patients reaction that you have hit the sciatic nerve?

In other words: suppose you do hit the SN, would the pt visibly complain or moan in pain? IS the sciatic nerve an extremely sensitive reactor THE INSTANT it is hit? Or are the effects more slowly and progressive in the following days?

The scenario: The pt stated that the injection itself did not hurt, only after stated that it "kinda hurts" AFTER. Let me state that she was not "visibly in pain" but said it rather matter of fact kind of way. She seemed pretty relaxed about it. But again I cannot dismiss the possibility of hitting the SN

Fellow nurses and the like, what say you? (for those who have actually hit the nerve, please, input on your pt's reaction)

Thanks in advance

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?? You know IM injections usually are sore afterward, right? Any other symptoms?

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Specializes in Critical care.

As already posted above, IM injections will have lingering soreness.

Actually contacting the nerve (it's the diameter of a finger) causes immediate, radiating, burning, "electric shock" pain. An injection directly proximal to the nerve can compress/irritate it, causing similar but usually less severe symptoms that resolve soon enough.

This is a great question for your instructor(s).

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Specializes in Mental Health, Gerontology, Palliative.

The doctor hit a nerve once when I was having a steroid injection. It felt like someone had poured boiling water down the nerve.

Nerve pain is fairly unforgettable

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No im just starting my journey in the field (as a MA) so i cant determine whats a "normal patient reaction" to "x or y or z

No other symptoms i noted the pt walked normal no limping or moaning or facial expressions that hinted severe pain.

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Thank you. Ive tried explaining this to my instructor but she said in a rather vague certain tone "You will know when you hit the nerve, you will know". *while she looked off in the distance with her eyes in reminisce of some sort of memory* Such words of wisdom there, but i needed some more anatomical preciseness such as your reply. So thank you

She trained us to use the "C" cup method where you start off by touching the hip bone, then flipping your hand to form a C cup and that C cup space is your area.

Hmm. Lots more reading to do on that method

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Whoa, how does THE, (like THE) doctor do that? like was he having a bad day..?

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Specializes in Pediatrics, Emergency, Trauma.

Think about where the sciatic nerve is located.

Where are you being taught to do injections?

Based on my schooling, injections are best in the ventrogluteal area, not the dorsal gluteal area due to location of the sciatic nerve; I was a LPN and used the dorsal gluteal in the past, but never hit the sciatic nerve; when I went through my BSN program, I learned that that area was avoided and IMs were no longer administered in that area and have since changed my practice.

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Specializes in Neuro, Telemetry.
LadyFree28 said:
Think about where the sciatic nerve is located.

Where are you being taught to do injections?

Based on my schooling, injections are best in the ventrogluteal area, not the dorsal gluteal area due to location of the sciatic nerve; I was a LPN and used the dorsal gluteal in the past, but never hit the sciatic nerve; when I went through my BSN program, I learned that that area was avoided and IMs were no longer administered in that area and have since changed my practice.

I I learned the same thing in my RN program. We were actually "jokingly" told that the only reason to use the dorsal gluteal area is in a double amputee with no ventrogluteal area to stick lol.

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I've had one almost hit the sciatic. I wasn't in immediate pain so I'm assuming it was close and caused compression.

To me the injection felt normal, then as soon as I walked out of the room I felt a huge cramp like feeling in my glut and it shot down my leg. Then it felt numb-ish (like my leg was asleep). I had pins and needles from my low back down to my ankle along with the cramp feeling for a solid week.

When I asked about it the MA told me if I was now having back and leg pain I needed to sign in to see the doctor again for a second visit. How's that for some customer service!

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Oh and if you are giving a large quantity injection (2ml+) that sucker is going to hurt, especially so if its a painful med like toradol or rocephin.

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Femine91 said:
Whoa, how does THE, (like THE) doctor do that? like was he having a bad day..?

Um...I'm assuming you're referring to the post where another poster said a physician hit their sciatic nerve with an IM injection.

My answer is that nobody is perfect. Everyone is capable of making mistakes. Physicians included. Your level of education or experience do not protect you from being human. I've made mistakes both as a new grad and more recently. It's inevitable, a side effect of being human. You just hope your mistakes are small, and infrequent. You also have to look at a situation, look at what might have went wrong and how to prevent the same outcome from happening again. Sure a bad day might be part of it. It could be bad technique, or it could have just been an honest mistake.

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