Giving IM Injections

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This is a stupid question but I need to ask. When you give an IM or other injection, for that matter, if you withdraw to see if it's in a vein and you do get a blood return. You are supposed to stop and take out the syringe and waste the medication mixed with the blood? Then redraw and attempt again. Is this correct?

Thanks,

mare

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Specializes in ICU, Telemetry.

What I was told was if you see blood, stop, waste the med (get a witness if it's a narcotic, of course), DOCUMENT, then get a syringe and try again in another spot.

I asked a nurse who's been a nurse 30 years how many times it had happened to her, and she said "never." Asked someone else who'd been a nurse for just a few years, and it had happened to her once. I just don't know the frequency of hitting a vein, but it doesn't seem to be terribly common. Maybe moreso in the elderly, very thin pts?

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Specializes in Emergency.

Technically speaking, if you are giving an IM injection and visualize blood in the syringe when you draw back, you are supposed to discard everything (med, syringe, needle). If you were to use the same syringe and med, you wouldn't be able to tell if you aspirate blood on the second IM attempt.

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In 33 years of nursing I've seem blood in the syringe for an IM injection only twice. The second time it was a student injecting (red) B12. Quite a surprise, but definitely blood. Yes, discard the syringe and draw up the meds again.

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Specializes in Family Nurse Practitioner.

Does anyone recall which site was used when they hit the vein?

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Specializes in LTC.

I've only been an LPN for 3 years, but when I was in school, aspiration was becoming a thing of the past. I know that Kaiser, where I did my peds rotation, doesn't do it anymore. I don't think I've ever seen it done even by nurses with several years' experience.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

it has happened to me twice in my career. i remember one was a gluteal injection and i think the second was also gluteal. these are small capillaries that the tip of your needle ends up in. you don't want to inject because the medication could go into the blood stream which makes it iv and that's not how the medication is supposed to be given. both times i withdrew the needles and discarded the entire syringe and contents. the injection track is created and you don't want to inject medication and have it leaking back to the now opened capillary if you reposition the needle, so you need to withdraw completely out of the hole you created.

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Specializes in Pain Management, RN experience was in ER.

I aspirate on all of my injections. You can't hurt anything by aspirating and it only takes a split second to do. I figure it's better to take the extra step to ensure the correct placement of the medication than to take a gamble at it. I don't know why they would phase aspiration out?? Some people never receive a blood return, others do. We don't just stop verifying our 3 medication checks times just because we've never had a med error in the past... it just makes sense to take the extra time. *stepping off of soap box* :)

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Specializes in Critical Care.

They taught us to aspirate, and discard everything if blood (Spring 2008).

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Specializes in LTC.

I should be more clear here...yes, we were absolutely taught to aspirate; but we were told by our peds instructor that *Kaiser* was phasing it out. FWIW.

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Specializes in Psych.

I'm a nursing student in psych clinicals and experienced that today. I was giving Risperdal 50mg (so about $400 dollars), to low income medi-care clients in a clinic run by the city and county...so the nurse just told me to pull back a little and inject. Can't waste it and the client did not have another Risperdal supply for him. Also, since the Risperdal comes as a set with their own needle and syringe so didn't even have a new needle to change to. I was wondering, what other options did I have in my situation?

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Specializes in LTC, Nursing Management, WCC.
I'm a nursing student in psych clinicals and experienced that today. I was giving Risperdal 50mg (so about $400 dollars), to low income medi-care clients in a clinic run by the city and county...so the nurse just told me to pull back a little and inject. Can't waste it and the client did not have another Risperdal supply for him. Also, since the Risperdal comes as a set with their own needle and syringe so didn't even have a new needle to change to. I was wondering, what other options did I have in my situation?

Just want to let you know that this is an old thread (from August). You might need to start a new thread.

Cheers!

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