IM inj hitting humerus

Esme12, ASN, BSN, RN · Jul 4, 2014

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..

hybr1d · Jul 4, 2014

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.

Been there,done that, ASN, RN · Jul 4, 2014

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

Where did you receive your education?

hybr1d · Jul 4, 2014

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.

klone, MSN, RN · Jul 4, 2014

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.

klone, MSN, RN · Jul 4, 2014

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

allnurses Guide · Jul 4, 2014

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!

SoldierNurse22, BSN, RN · Jul 5, 2014

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.

RNsRWe, ASN, RN · Jul 5, 2014

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?

TheGooch · Jul 5, 2014

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.

Junebug903, LPN · Jul 5, 2014

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