If an IM injection goes subcutaneous what can happen?

Nurses General Nursing

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Hello everyone,

Im new here :) and was hoping I can get some guidance. I'm currently writing a paper on absorption rates of different injections. I was wondering if anyone knows if the patient can get an abscess from an IM injection that may have gone subcutaneous? I'm wondering specifically about paliperidone... I understand the absorption would not be the same had it been given IM, but what about an abscess?

ultimately, can you get an abscess if the injection goes subcutaneous?

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Specializes in ICU, LTACH, Internal Medicine.

1). Unless your patient is cachectic or a bodybuilder, 90+% of "IM" injection go SQ.

2). Abscess can happen with both SQ and IM injections. Also, nothing gives 100% guarantee that they don't happen.

3). Accounting for how frequently abscesses actually happen (except for unprofessional practices, they are in fact quite rare), you might as well relax about the issue.

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Thank you so much... we had a nurse who said her patient was 157 lbs and she explained " the needle wouldn't go in... it's like it hit a wall" there was no blood on aspiration and no medication came out...she went in but not all the in... just soemthing that's always been on my mind

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Specializes in Emergency, Telemetry, Transplant.
Thank you so much... we had a nurse who said her patient was 157 lbs and she explained " the needle wouldn't go in... it's like it hit a wall" there was no blood on aspiration and no medication came out...she went in but not all the in... just soemthing that's always been on my mind

What do you mean by "in but not all the in?" Was she hitting bone? Horrible feeling when you are giving the injection to hit the bone, pt doesn't flinch though....

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Specializes in Certified Vampire and Part-time Nursing Student.

This is purely anecdotal but I've had something similar happen to me, I also have to IM inject myself. It might be due to a few things: anxiety related to injecting, I've done it for years now and I still struggle to put enough "power" behind the needle to implant it in one strike just because of nerves. Also I do have spots that are super hard/ also impossible for me to inject past the subq into the muscle layer, not really sure why I'm not injecting into the bone obviously. My working theory on this is that I've injected in that spot for long enough the fascia surrounding the muscle became more thickened and scarred than normal, which became a lot harder to penetrate if you're a little baby like me and won't put much oompf behind the syringe when it comes to injecting yourself lol. I'm not really sure if this is even medically accurate but until I know better, it's what I believe for now. :confused:

Just editing to say I misread op's second post; I thought the pt was self injecting, not the nurse unable to inject all the way.

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