IM inj hitting humerus

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Hi. I'm a new nurse on my first nursing job. I was giving vaccinations today on 2 teens. One of them was really really skinny and I managed to hit bone. I've been feeling horrible all day, naive me never even thought of that happening, no one ever mentioned it during my education, not the books either. I wanted to take a smaller needle but it came prefilled with needle that wasn't removeable She was a bit nervous and flinched when I pierced the skin but didn't say anything, I know bone doesn't have pain receptors but could I have hurt her beyond pain? I pulled the needle back a tiny bit before injecting, there was basically almost no room to use. I got so horrified I forgot to aspirate too. I might just be the worst nurse ever :( Just looking for some support!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

BREATHE! You are not the worst nurse ever. In very thin patients you grab and pinch the skin to avoid hitting the bone. As long as you didn't break the needle tip you're fine. I am more concerned about a teen girl being that thin and an eating disorder..

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Thank you thank you Esme12. *breathes a bit* Yes, I should have pinched, I thought I'd manage without doing it and simply being a bit more careful with how far in I put the needle. Needle was maybe 1½ inch and I hit bone not even having half in. PT was 13 years old. Yes when you mention it, I mean some are just skinny but she was really skinny. Though she got tbe-vacc due to competing in orienteering, maybe skinny due to that, I don't know. I barely got any contact with her, very flat responses. Maybe she was just shy though.

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"No one ever mentioned it, there was nothing in the books".

Where did you receive your education?

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Northern European university. I mean logically of course I realize that it's possible just surprised that I've never heard anyone mention it. Maybe it's something you don't tell other nurses though? I ask a lot of questions and asked a whole lot about injections, like tell me everything type of questions but nope, no one mentioned it during my internships or anything.

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Specializes in Nurse Leader specializing in Labor & Delivery.

The only place you need to aspirate is dorsal gluteal. Anywhere else, not necessary to aspirate. I have to ask, though, where were you giving it if you think you hit the humerus.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Fwiw, I was giving an injection in the deltoid to a very thin woman and I hit the bone too.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

I don't believe aspirating is best practice for giving injections of vaccines anymore, either. I found this link that has so much useful information in it I'll share it here. Best wishes! http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/d/vacc_admin.pdf

edit: I see klone already mentioned it!

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As a nurse who's been hit in the humerus while receiving an injection from an inexperienced medic, trust me--your patient will be fine. S/he probably won't forget it, but s/he'll be fine.

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Northern European university. I mean logically of course I realize that it's possible just surprised that I've never heard anyone mention it. Maybe it's something you don't tell other nurses though? I ask a lot of questions and asked a whole lot about injections, like tell me everything type of questions but nope, no one mentioned it during my internships or anything.

It's something you should have learned in school, right on the same page as 'this is how you do it correctly'. The same instruction should have included 'and this is what happens when you do it incorrectly'. That's why you were asked where you got your education.....it was supposed to be part of it.

No, it's not something "you don't tell other nurses". We learned it in school, before being let near a patient....that's why you were met with surprise that you didn't know this. And it hasn't been best practice to aspirate since.....when?

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BREATHE! You are not the worst nurse ever. In very thin patients you grab and pinch the skin to avoid hitting the bone. As long as you didn't break the needle tip you're fine. I am more concerned about a teen girl being that thin and an eating disorder..

I once was that skinny but I didn't have an eating disorder. It's possible that she just can't put on weight like me. That changed later in life.

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Specializes in LTC, SNF, Rehab, Hospice.

Yes, it happens. Some elderly, etc. are so thin. No worries. Somethings you may only learn by experiencing it.

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