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!

[NurseAlyssa87]

According to the CDC ...

Quote

Aspiration is the process of pulling back on the plunger of the syringe prior to injection to ensure that the medication is not injected into a blood vessel. Although this practice is advocated by some experts, the procedure is not required because no large blood vessels exist at the recommended injection sites.

This information and more regarding medication administration guidelines can be found here: vaccines: recs/vac-admin/main page click "vaccine administration guidelines" it says its 15 pages next to it and its a pdf file.

[adnrnstudent, ASN, RN]

This is all very interesting. I'm a 1st year ADN and we're taught to on IM.

[Otessa, BSN, RN]

HeartsOpenWide said:

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.

Hopefully they didn't inject in your joint area-that happened to someone I know.

[littlemammanurse, BSN, RN]

I was taught to aspirate so I always do.

[TheSquire, DNP, APRN, NP]

The feedback I'd gotten from my program was that IM drug injections should be aspirated, but IM vaccinations have no need to be aspirated.

[indigonurse]

The standard of care for IM injections is to always aspirate for blood before injecting. Otherwise the medicine will not go into the are where it was ordered. If it is in a blood vessel it can cause quite a bit of trauma, pain and injury.

[dudette10, MSN, RN]

nursealyssa87 said:

"Aspiration is the process of pulling back on the plunger of the syringe prior to injection to ensure that the medication is not injected into a blood vessel. although this practice is advocated by some experts, the procedure is not required because no large blood vessels exist at the Recommended injection sites."

I'm glad the cdc is getting on board. when i did research on this practice a few months ago, the who said it's no longer required, but the cdc never came out and said it explicitly.

if you are careful about the location and assessment of your injection site and your "stick" technique, it shouldn't be a problem.

This is for vaccines only. what are the guidelines for non-vaccine drugs?

[nurse2033, MSN, RN]

Good example of how practice changes. Go with the evidence based medicine.

[nep1980]

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!

If you read the sheet that comes with the flu vaccine it says not to aspirate, I know that is what we are taught in school, but according to the CDC and the vaccine manufactures its not what they want us doing. So do what you prefer. They are many things that are taught in school and many things that are done differently, its up to you to decide what you feel is necessary for you to do for you to feel safe!

[DC Collins, ASN]

I am with those who say that EBP and ACIP do not recommend aspiration as you described it.

However, while in school, *unless* it is a matter of pt safety, which this is not, *always* go with what the instructor who will be grading you says.

DC ?

[diane227, LPN, RN]

With the current standards addressing the areas appropriate for an IM injection, I am told by nursing instructors that I have worked with that you no longer need to do this. However, being old school, it is a habit.

[OMOLURU COURAGE I]

I know it is always safer to aspirate before giving any IM to note whether you have hit a blood vessel so as to avoid gangrene resulting from wrong route of administration.