Flu shot advice

[bcm9579]

Hello nurses!

I am a first year medical student. We will be administering flu shots to each other in a clinical class later this week. I would love some advice from the pros!

Thanks a bunch

[amoLucia]

Anytime I give an injection, start an IV or access a port, I have the patient take a deep breath in and blow out. I inject while they are blowing out.

This helps ease their discomfort.

I have done this for YEARS! It causes pts to focus on breathing rather than the injection, so for that flash nano-second, I inject.

I thought I was the only one to do this! IT WORKS!

[nursej22, MSN, RN]

Before i give them the shot, I reassure them the injection will not hurt me so in case they are worrying about me, I'll be OK.

'Tis better to give than to receive.

[DowntheRiver]

Anytime I give an injection, start an IV or access a port, I have the patient take a deep breath in and blow out. I inject while they are blowing out.

This helps ease their discomfort.

This is what I have patients do as well, and patients often compliment my technique. They're so focused on taking the breath that it really does distract them for the most part, particularly with my port patients. Good advice.

[DowntheRiver]

I have done this for YEARS! It causes pts to focus on breathing rather than the injection, so for that flash nano-second, I inject.

I thought I was the only one to do this! IT WORKS!

I do this as well. It also cuts down of people who vasovagal because they tend to focus on breathing. If you hold your breath, tense up, and bear down you're going to go down, literally.

[SiwanRN]

If you are working with children, it can help to give them some choice in the matter. They are getting the vaccine regardless, but letting them decide if they want to sit on their parent's lap or up on the exam table and which shoulder you use helps ease their anxiety some, I have found. It also helps to ask them to demonstrate how they blow out birthday candles, then practice together on the count of three, then when you give the shot to count to 3 and to poke on 3 as they are blowing out the pretend candles. I have also found that pinching the deltoid just a little (not to raise the muscle, but to provide a different sensation) helps them to feel my grip more than the needle going in. Using these techniques helps decrease discomfort for the children I immunize quite a bit. They also work with needlephobic teens and adults.

[TheSquire, DNP, APRN, NP]

There is no reason to z-track.

Do you have a reference to cite?

[amoLucia]

I also ask pts to position their preferred injection arm across the chest. It seems to relax the arm's deltoid and makes the inj less painful than injecting into a 'hard' muscle.

It also changes their their attn away from the impending inj to their arm.

[Daisy Joyce]

When I do flu shot clinics, I chit-chat with the patients to distract them from the needle.

[Tenebrae, BSN, RN]

I have done this for YEARS! It causes pts to focus on breathing rather than the injection, so for that flash nano-second, I inject.

I thought I was the only one to do this! IT WORKS!

I tell mine to wiggle their toes and to keep wiggling their toes until I tell them to stop.

[Tenebrae, BSN, RN]

Before i give them the shot, I reassure them the injection will not hurt me so in case they are worrying about me, I'll be OK.

I once had a patient ask me if it was going to hurt.

I looked at them and said "it wont hurt me a bit, you on the other hand I can make no guarantees"

Made the patient laugh and relax

[Have Nurse, ADN, RN]

It's just like throwing a dart. Remember to z-track first.

No need to Z-track unless someone is getting multiple injections, such as Decadron for MS.

But yes, it is in the wrist action.

[nursej22, MSN, RN]

Do you have a reference to cite?

From the Immunization Action Coalition, "Ask the Experts", immunize.org,

Is the "Z-track" method recommended for IM injections?

ACIP does not address the use of this method for vaccination in its Best Practices Guidelines for Immunization (

ACIP Vaccine Administration Guidelines for Immunization | Recommendations | CDC

). If you choose to use this method, you should still adhere to the ACIP's recommendations regarding needle length and anatomical site.