difficulty injecting IM medication

Nurses General Nursing

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:uhoh21: I have given lots of flu shots over the years. Recently, I was giving an IM injection into the deltoid muscle (flu shot) and noticed difficulty inserting the medication once in the muscle. It was like the muscle was really tense and tight and I could not inject the medicine into it. I pulled the needle out and tried on the other side and had the same problem. Anyone know what this means? The guy was really nervous about getting a shot. Please give me some advice here.

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Specializes in DD, Geriatrics, Neuro.

Bad syringe? The only IM meds I have had that problem with are really thick, like Haldol or Prolixin. However, I have had a syringe malfunction on me (we have the self retracting kind. It prematurly retracted)

Sorry I'm not much help with that, just haven't heard of it before with the flu vac. Maybe someone else with more exp. than me has.

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I had a similar thing happen when i got my flu shot (im a nursing student). She stuck me and i could tell she was having trouble pushing the med, but she just kept at it and it shot in really fast and there was a popping noise, then my arm got tingly...im she said she must have hit a nerve? i dont know what happened but it sounds familiar!

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If the pt was nervous he was probably tensed up, which would cause this.

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If the pt was nervous he was probably tensed up, which would cause this.

That's what I was going to say. Also, what size needle did you use?

Did you use the same needle twice?

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Specializes in Anesthesia.
:uhoh21: I have given lots of flu shots over the years. Recently, I was giving an IM injection into the deltoid muscle (flu shot) and noticed difficulty inserting the medication once in the muscle. It was like the muscle was really tense and tight and I could not inject the medicine into it. I pulled the needle out and tried on the other side and had the same problem. Anyone know what this means? The guy was really nervous about getting a shot. Please give me some advice here.

It would be kinda hard to do, but by chance do you think the needle could have been crossthreaded onto the syringe.

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That's what I was going to say. Also, what size needle did you use?

Did you use the same needle twice?

It was a 23 guage 1 in. needle. Different needle 2nd time. The young man was very tense and nervous and I wondered if that was the problem. Also, he told me that he worked outed vigorously the day before and his muscles were already tense and sore from that. I did get the medicine to go in, but it was not smooth and easy like it usually is. Thanks for your reply.

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Specializes in Med/Surg, Ortho.

I was thinking the same. If the needle wasnt seated on the syringe properly you may have had resistance when you tried to inject. I have that problem sometimes when im flushing SL, if the syringe isnt seated straight on the luer lock it is real stiff and hard to flush or may not let me flush at all. You have to take it off and reseat the syringe on the lock end for it to push smoothly.

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Specializes in ER/AMS/OPD/UC.

We gave ton of shots in outpatient! I had a very experienced nurse there, and she taught me to make sure the needle size is a litle bigger than what I need, this helps with eliminating the pressure of injection the med smaller diameter, more pressure (which hurts), and another thing she taught me was to pinch, so the patient feels the pinch more so than the injection. So if I am giving a flu shout I will grab the deltiod (helping me to determine if the patient is tense) squeeze just enough the person can feel it and inject. I have had many comments from patients that they didnt feel it or it didnt hurt, even kids!

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