Do you aspirate before giving an IM deltoid injection?

[seasalt1023]

I am hoping someone can clear up this issue for me! I am finishing up my last semester in an ADN program. Graduation is December 16th! ? In school we are taught when giving IM injections to aspirate first to check for blood return. If it is clear you give the injection. Is this true when giving an IM injection in the deltoid? I am feeling confused about this because I did a free flu vaccination clinic and the RN (who is also the school's LPN instructor) told us that when giving an injection in the deltoid there is no need to aspirate. The other day I was giving an IM injection and my preceptor told me you always aspirate with any IM injection, but she couldn't find a hospital policy on this. So which way is the correct procedure?

I appreciate any reply on this matter!

[OutlawNurse86, BSN, RN]

I was taught to ALWAYS aspirate when you give a IM. Granted I think there is more danger in the thigh than the deltoid but...Can't ever be too safe.

[Anisettes, BSN, RN]

I ALWAYS aspirate before injecting anything IM anywhere, but then that's what I was taught back in the last ice age and habits are hard to break. When in doubt, always go with safety.

[PostOpPrincess, BSN, RN]

YES. I've hit an artery a couple of times....so YES......

[JoblessNewGradRN]

I was always taught to aspirate because if you hit a blood vessel and inject, you would be giving the medication the wrong route, not to mention affect absorption rate and potentially harm the patient.

Other IM injection stuff:

-Generally use 23 gauge (pretty much all I have used and the needle length is 1-1.5 inches)

-Deltoid gets 1ml or less (unless the person is very muscular), and if amount is more than that you have to go for bigger muscles like in the thigh or butt

-Injection should be done at a 90 degree angle

-And, you can use Z-track method to ensure the med stays put

Good luck!

[canesdukegirl, BSN, RN]

Yes, always aspirate. It is difficult to do with a wiggling youngin', but always do this.

[SonorityGenius]

No, EBP says not necessary anymore.

[Otessa, BSN, RN]

seasalt1023 said:

I am hoping someone can clear up this issue for me! I am finishing up my last semester in an ADN program. Graduation is December 16th! ? In school we are taught when giving IM injections to aspirate first to check for blood return. If it is clear you give the injection. Is this true when giving an IM injection in the deltoid? I am feeling confused about this because I did a free flu vaccination clinic and the RN (who is also the school's LPN instructor) told us that when giving an injection in the deltoid there is no need to aspirate. The other day I was giving an IM injection and my preceptor told me you always aspirate with any IM injection, but she couldn't find a hospital policy on this. So which way is the correct procedure?

I appreciate any reply on this matter!

Your instructor was correct-during instillation of an IM immunization-no aspiration is necessary. I had to look this up on the CDC website.

[Nursiebree, ASN, RN]

I was taught in school to ALWAYS aspirate . It wont hurt if you do anyway , if anything it will help . So aspirate , you wont go wrong .

[Otessa, BSN, RN]

IAC Express Issue 891: Issue number 891: October 1, 2010

From October 2010-most asked questions.

Quote

Q: Do you need to aspirate before vaccinating?

A: No. ACIP guidance does not recommend aspirating (pulling back on the syringe plunger once the needle is in the arm before injecting, to see if you get blood return) when administering vaccines. No data exist to justify the need for this practice. IM injections are not given in areas where large vessels are present. Given the size of the needle and the angle at which you inject the vaccine, it would be very difficult to administer the vaccine intravenously.

[HeartsOpenWide, RN]

I got a Tetorifice vaccine in my deltoid and the M.A. did not aspirate and my entire left side went numb for two days. Yes, aspirate.

[mmm cdiff]

I'd aspirate even seeing the EBP article.