I/M Injections

Published

Hello,

I have a question. I'm in school currently learning about injections. I have started to give vaccinations such as flu shots and tdap. Each time I give an injection right after the patient is okay, I confirm that they are fine throughout the entire injection and after. A few days after they end up having either a red, hot patch at the injection site, or will have a bump from where the injection was given. Is there something that I'm doing wrong? I am aspirating and not seeing any blood. Does if have to do with the way I am pinching the skin at the top of the deltoid? Any feedback helps. It is really starting to get me discouraged.

Thanks,

Up Vote Up Vote ×
Specializes in Psych, Corrections, Med-Surg, Ambulatory.

1. First change your user name. It is illegal to identify yourself as an RN until you actually are one.

2. What does your instructor say about your injection technique? You should not be giving injections without supervision until you have demonstrated proficiency.

Up Vote Up Vote ×

If your are talking to them through out the actual injection; then the injection is taking too long. It's a hit target and go. You will learn to be faster. I mean, the way you said it, sounds like you're talking about the weather while aspirating. Concentrate...

Up Vote Up Vote ×

You don't need to aspirate for vaccines given in the deltoid.

Up Vote Up Vote ×
Specializes in PICU, Pediatrics, Trauma.
You don't need to aspirate for vaccines given in the deltoid.

Not sure about this...Ive hit veins before in the deltoid...not often at all, but still possible.

Up Vote Up Vote ×
Not sure about this...Ive hit veins before in the deltoid...not often at all, but still possible.

Check the CDC guidelines. Aspiration in the context of deltoid injections is not EBP.

Up Vote Up Vote ×
Specializes in PICU, Pediatrics, Trauma.

It is common for injection sites to have some redness...some vaccines do cause inflammation. The "bump", can be caused by the same.

Now having said that, I can't really speak to your technique without seeing you give an injection. Is there anyone who can watch you who has experience and give you feedback?

Up Vote Up Vote ×
Specializes in PICU, Pediatrics, Trauma.
Check the CDC guidelines. Aspiration in the context of deltoid injections is not EBP.

Okay. I'm old. Thanks for the update. We were taught to always aspirate while giving IM injections. There was no mention of them being specific to a site regarding aspiration.

Up Vote Up Vote ×
Specializes in Nurse Leader specializing in Labor & Delivery.

The only site in which you need to aspirate is the dorsogluteal.

Up Vote Up Vote ×
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Moved to the Nursing & Patient Medications forum.

Up Vote Up Vote ×
Specializes in Neuro/Trauma Critical Care.
Check the CDC guidelines. Aspiration in the context of deltoid injections is not EBP.

Yes! I'm in nursing school right now and am giving flu vaccines next week. We were told specifically NOT to aspirate.

Up Vote Up Vote ×

To aspirate or not to aspirate has generated a lot of controversy over the years. I believe every country has their own guidelines as to whether you do so or not. As a Ghanaian nurse, i aspirate as long as it is an IM injection and not SC, irrespective of the site, be it ventrogluteal, dorsogluteal, deltoid or vastus lateralis. I am of the view that as long as there is a chance of hitting a vessel, no mattter how remote that chance might be, precautionary measures should be taken to avoid giving an IM injection intravenously. Then again, the australian, american or canadian nurse would think this too radical and thats fine too.

Up Vote Up Vote ×
+ Join the Discussion