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)
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.
Yes. I'm in nursing school right now and have been told to avoid that area entirely.
Exactly, Furbabymom. And humans can have some less than perfect anatomy. Femine91, sciatic pain is exquisite. It would be unmistakable if you had hit it.
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.
Before doing procedures like injections on patients, it is very important to know what the "normal patient reaction" SHOULD be, so that you can know if their response deviates from it. As you learn new skills in your program, I encourage you to keep in mind that it is always important to know the reasons for what you are doing, and the expected response from your actions.
Whoa, how does THE, (like THE) doctor do that? like was he having a bad day..?
It very much sounds like an epidural steroid injection. The sciatic n. arises from the L4 and L5 nerve roots so it wouldn't be uncommon at all to elicit parasthesias along the sciatic distribution. It's not a mistake or complication, it's just falls within the category of possible expected and known events with that procedure.
it occurs in a completely different place as what the OP describes, but to even come near the sciatic with an attempted gluteal IM injection, you need to be way far medial to commonly accepted landmarks and have a very long needle or a very small patient.
Purple_roses
1,763 Posts
Yes. I'm in nursing school right now and have been told to avoid that area entirely.