How can I make Rocephin I'm hurt less???

MPKH, BSN, RN · Jan 15, 2012

Filter needles aren't meant for injections; they are only used for withdrawing the medication from the vial/ampule to the syringe. After withdrawing the appropriate amount of meducation, replace the filter needle with a "normal" needle before injection. The needle gauge I usually use for IM is 22-23, 1-1.5", depending on the patient and site. For patients without too much muscle mass, a SC needle can be used instead of an IM needle.When you are injecting the medication, inject slowly. Many medications are irritants to the muscle and it will hurt. Take your time and inject at a reasonable rate. Don't just push it in all at once. The site you pick will mostly depend on the volume of medication, type of medication, and the patient's muscle mass at the IM sites. I usually give injections at the ventrogluteal site as most people will have good muscle mass there but use your judgment for each patient.Hope this helps!

CapeCodMermaid, RN · Jan 16, 2012

IM anything in an elder hurts. Get the doc to change to IV.

speedyG · Jan 16, 2012

Im rocephin hurts period. Some people will try to split the dose and give two shots. Either way- that sucker hurts.

caroladybelle, BSN, RN · Jan 16, 2012

Some drugs will hurt when given IM no matter what. Rocephin tends to be one of those.

I assume that you meant that you drew up the drug with the filter needle, and then switched to a fresh regular (nonfilter) needle before injecting. If so, it is doubtful that needle is the issue.

But in the case of Rocephin, it is the med itself that is painful. Beyond using lidocaine, not much can be done. And some (me) find that lidocaine often is as painful or more so than the drug.Just try to pick the best site and do it as best you can.I do question, why not IV.

SuesquatchRN, BSN, RN · Jan 16, 2012

A lot of LTCs still aren't doing IVs. And if she has any degree of dementia the attendant disinhibition will cause her to howl like a hurt child.

turnforthenurse, MSN, NP · Jan 16, 2012

Rocephin IM I think will always hurt, even with Lidocaine, and especially in an elderly woman. When I occasionally work the ER, I've given IM Rocephin in the dorsal gluteal site - hurts a little less, I think. Just make sure you give it in the outermost upper quadrant to avoid hitting the sciatic nerve. Also, inject this one slowly and not all at once.

AZMOMO2 · Jan 17, 2012

capecodmermaid said:
I'm anything in an elder hurts. get the doc to change to iv.

The I'm route in ltc is the most appropriate and the doctor would be very unlikely to approve iv route as iv access unlikely to have been established, and is unlikely to be in the best interest of the resident, plus rocephin doses are generally ordered as 1 time only prior to getting residents started on oral abts anyway.

OP:

Should I have used the gluteal muscle instead? Yes is it better to go fast or slow? Slow what's the smallest gauge and length needle you all would recommended for someone with little to no body fat? I have given this injection with a tb syringe because my LOL weighed about 75 pounds and had no body fat just skin folds. it was recommended by pharmacy.

nurse_tnb · Jan 17, 2012

Thank you for all the helpful answers and reassurance...and yes i meant i drew the med up with the filter needle. I did not inject the med using the filter needle. Lol!!!

CapeCodMermaid, RN · Jan 17, 2012

azmomo2 said:
The I'm route in ltc is the most appropriate and the doctor would be very unlikely to approve iv route as iv access unlikely to have been established, and is unlikely to be in the best interest of the resident, plus rocephin doses are generally ordered as 1 time only prior to getting residents started on oral abts anyway.
OP:
Should I have used the gluteal muscle instead? Yes is it better to go fast or slow? Slow what's the smallest gauge and length needle you all would recommended for someone with little to no body fat? I have given this injection with a tb syringe because my LOL weighed about 75 pounds and had no body fat just skin folds. it was recommended by pharmacy.

Not always true. We have people on rocephin for days. Easier and less painful to start an iv.

JessaL · Feb 10, 2012

Is it correct to dilute a 1g vial of Rocephin with 2.1mL of Lidocaine? The reconstitution instructions on the insert says that 2.1mL will yield 350mg/mL of Rocephin. This math does not seem to add up. I need to give the whole 1gm so I realize that no matter how much liquid is used, as long as I use all of it it will equal 1g dose. But is 2.1mL going to be too concentrated & irritate the tissue??

ktwlpn, LPN · Feb 14, 2012

" lot of LTCs still aren't doing IVs. And if she has any degree of dementia the attendant disinhibition will cause her to howl like a hurt child." No IV's at my facility but it's in the pipeline for this year. I have found that giving Rocephin IM early in the am while the resident is still in bed and asleep to be very effective. 2 of us go in,one staff member gently rolls the resident onto their side while quietly telling them what we are doing while the other preps the site and admins the med Push it in slowly,that makes a difference.It's over before they know it. This technique works great for the annual flu vax rodeo.I have been screamed at and smacked in the face and for prepping an arm with an alcohol wipe-the resident acted like the Wicked Witch after receiving a full bucket of water and I hadn't even uncapped the syringe yet.