injections - page 2
About sub cutaneous injections: After pinching the skin at the appropriate site,inserting the needle,do you then release the skin and inject? How many continue to pinch the skin while injecting? or... Read More
Sep 2, '02Occupation: ADON-LTC Specialty: 19 year(s) of experience in LTC, ER, ICU, ; Joined: Feb '01; Posts: 5,856; Likes: 36originally posted by psychomachia
lpn,future, rn asks: if the order calls for an injection to be given sq , and depending on the size of the patient/neddle, if you didn't pinch and hold, would not you be giving an im instead?
me: depends on the size of the needle and thickness of the skin/subcutaneous fat. most sq needles - 25g 1/2" are probably not going to make it to the muscle unless the pt has little fat.
so why pinch? i do it to see if there is enough fat to give a sq injection. if i can pinch up enough fat so that i know the needle won't be injecting into muscle, then i feel better about the injection location/route.
thanks for your reply.
Sep 2, '02Joined: Jun '01; Posts: 430Thank you jenac,you were taught with sub cu's to pinch realse inject.Thats what I read and it was different than I was taught,maybe its the better way now.
psycho,not pinching for a sub. c shot? I couldnt do that. Have to pinch. Never heard of not pinching for sub c.
Sep 2, '02Joined: Jun '01; Posts: 430For those who dont map the Ims,I really wish I could do that.
At work theres this nurse that gives the dorsal gluteal without mapping,she looks and pokes. This method works great if you have a alzheimer patient that is uncooperative ,wont lie down for a shot and is agitated.Just give the shot while their standing up,look and poke.
But Im to paranoid to do that. It was drilled into me in school about sciatica damage with improper Im administration in the doral gluteal area and Ive read about law suits against nurses who gave IM shot incorrectly ,caused sciatica damage and got sued
If a pt. is uncooperative I cant give the shot,cause they wont lie down so I can map the shot. I tell the dr. I cant give it and he looks at me in dis-belief and another nurse does it.This makes me feel like crap.
Sep 2, '02Occupation: cynic Joined: Aug '02; Posts: 284; Likes: 49ohbet: not pinching for a sub. c shot? I couldnt do that. Have to pinch.
Me: Ok, why are you pinching the skin to begin with? I don't want to answer for you, but I do it to make sure there is enough subcutaneous tissue (aka fat) to inject into. When I see someone with big fat arms...well, I know I don't need to pinch any skin to verify there is something to inject into. So why bother pinching it if you know it's going into the subcutaneous tissue? Just go ahead and inject. If I have a little ol' lady w/o any subcutaneous fat (aka skin & bones), then I'll pinch the skin up to see if there is enough there so I don't end up giving an IM injection.
Sep 2, '02Joined: Sep '01; Posts: 16,606; Likes: 680Depending on the patient...infant, toddler, child, teen, adult....and size of each...pinching before SQ injections is standard. The angle at which the SQ injection is given will also depend on the patient's age and size (ie..child over adult). For SQ injections, I always use a 25 g/ 1/2 inch needle.
I always always always map the site before giving IM injections....and always use 'z-track' when injecting iron medication into the site.
I 'individualize' injections for each patient's body build, etc.