Did I do the I'm injection correctly?

commonsense · Apr 21, 2011

TayBabyNurse said:
Hi,
I'm a second semester RN student and I'm currently doing my OB rotation. I gave a Depo-Provera injection to a woman. I've never given an I'm before and I have several concerns about how I did it.
1) My professor was with me every step of the way, but I dont think that the needle was long enough. The needle may have been inch, which I guess is supposed to suffcient for an I'm injection but I gave her the Depo in her hip area, and she had quite a bit of SC fat there. I was very nervous.
2) After I withdrew the needle, one small drop of the med leaked back out of of her skin. Is this a confiramtion that the medication did not get to the muscle?
Please Help!

I'm a third semester RN student so I know how hard it can be to do things in front of your instructor, I think they take a class on how to freak students out. Did you spread the skin taught to move most of the SQ fat out of the way?

aussienurse1 · Apr 21, 2011

I read a study recently that said that only 8% of IM injections given to women actually reach the muscle due to the level of SC tissue/fat....

Best practice is IMI are to be given in the Ventrogluteal, or the deltoid if appropriate for the medication....

Some leaking back happens quite often, Especially in psych meds which can be quite oily and hard to push.

Have you learnt the Z-track technique? It's always a goodie for stopping the leak.

Good luck! It's wonderful that you are actually thinking about the route of administration and the effectiveness of your technique!

Black Jade, BSN, RN · Apr 21, 2011

I used to always give Depo Provera in the deltoid muscle. Rarely I would give it in the gluteus muscle, but if I did, I would give it Z-track. On ocassions I would have some medication leaking out, but the patient never complained or had an adverse reaction. Most importantly, they didn't become pregnant!

Five&Two Will Do · Apr 21, 2011

Depending on the volume of the injection, it is much easier to ensure delivery into the muscle in the deltoid. I always use 1.5in needle for IM

P_RN, ADN, RN · Apr 21, 2011

If you patient possessed more than an inch of adipose at that site I doubt you got it intramuscular. My instructors always said if you can pinch more than an inch get a longer needle.

My spouse takes a depot injection every two weeks and I use a 1 1/2" and z track it. Haven't had any leak and haven't had any bleed. Adipose bleeds.

siomai_siopao73 · Apr 21, 2011

Yes the Z-track method works best and, I also palpate first for muscular bulkness on the preferred site before delivering IM injections. I had learned a lot with IM injections after my first experience giving MgSO4 deep IM alternately on the buttocks with a needle similar to the size of a spinal needle.

morte, LPN, LVN · Apr 21, 2011

i would personally doubt that a 1" needle was sufficient for a young healthy female......

jennlpn1975 · Apr 21, 2011

I give my sister her depo shot every three months and she always brings the needle and it's a 1" needle. My sister is a big girl. I always get a drop that leaks out. We have been doing this for four years and she has never gotten pregnant.

morte, LPN, LVN · Apr 21, 2011

jennlpn1975 said:
I give my sister her depo shot every three months and she always brings the needle and it's a 1" needle. My sister is a big girl. I always get a drop that leaks out. We have been doing this for four years and she has never gotten pregnant.

The proof is in the pudding.....if it ain't broke, don't fix it, LOL

leslie :-D · Apr 21, 2011

P_RN said:
My spouse takes a depot injection every two weeks and I use a 1 1/2" and z track it. Haven't had any leak and haven't had any bleed. Adipose bleeds.

as does muscle, yes?

(bolding, mine)

leslie

MzTayTay · Apr 22, 2011

Thanks guys. I really was nervous that I dont think I spread the skin taut. They didnt really teach us the Z track technique, but Im going to ask one of the instructors to show me how.