I Hit A Bone!!

[breakin_moon]

Oh, wow... I hit a bone! I was injecting an older, thin lady with 0.5mL pneumococcal vaccine IM in deltoid. I used a #23, 1 inch. needle. After seeing the client, my instructor told me to insert 1/2 of the needle. It went in her skin like butter - all the way. I heard a pop sound. My instructor stated "you didn't go in half the way." I have administered numerous IM injections, mostly in the deltoid and ventrogluteal sites without any complications. I thought I was doing a great job - until this! I'm thinking I should have gotten a shorter needle, or chosen a different site. I don't know if I can just stick the needle in 50% of the way.

Any comments are appreciated.

[MidnightTang]

I'm a student too, so I couldn't tell you for sure, but it seems to me your instructor should have told you to pick a different site. Telling you to "go in half way" seems so imprecise I can't imagine it being standard practice. Doesn't sound like you had enough muscle to inject into anyway.

[breakin_moon]

I know! We never covered any of this "just go in so much" stuff in any of my classes. Very imprecise - Thank You.

[jill48, ASN, RN]

I bet you freaked out!!! I know I would have. You should have got a shorter needle, and pinching the skin and pulling it up helps to because it increases the distance. But in my 11 years as a nurse I have never heard of inserting a needle halfway. Your instructor is wrong. You poor thing. What did the patient do? Did you know right away what had happened?

[breakin_moon]

Yes, I knew. I could feel it stop, then a pop sound. The lady was so sweet; she said she was fine. Also, I did pinch the skin.

[jill48, ASN, RN]

I'm sorry, I didn't mean to imply that you didn't pinch the skin, I was just saying that that should help increase the distance. So if you did pinch the skin, the needle was certainly too long. I'm on chat right now if you'd like to talk about this.

[breakin_moon]

No need to apologize; I didn't state that in my original message. What size needle length would be best under these circumstances?

[TazziRN, RN]

Another alternative would be to inject at an angle, rather than straight in. And don't freak out, I've hit bone many a time.

[Hellllllo Nurse, BSN, RN]

I've hit a bone a couple of times. When this happens, look at the bevel after you pull the needle out to make sure the bevel tip did not break off in the pt.

[DeLana_RN, BSN, RN]

......

[Lacie, BSN, RN]

Dont feel bad as it happens to more of us than you think. My instructor way back in the day for me lol, also told me to give an injection via the deltoid on a little lady that I swear couldnt of wieghed more than 60 pounds. She had terminal CA and I even questioned the instructor as to why I couldnt give it either in her thigh as surprisingly it was her meatest portion of her body. The instructor said absolutely not and I was required to give it in the deltoid.......oops is that bone I just felt??? eek. I felt miserable and just out of reflex pulled the needle out immediately when I felt the bone and didnt give the medication. Guess what she had me get a new needle and give in the thigh muscle!! So this poor woman had to be hit twice unnecessarily. Sometimes even students gut feelings are the right ones. That was over 20 years ago for me and I have never forgotten it nor the instructor sad to say.

[P_RN, ADN, RN]

I have hit bone several times, even using a tiny tb or insulin needle. Some times it just happens. Do check the tip and also observe the site for any leakage.