IM injection too high up?

Nurses Safety

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I've been a nurse for four years now and work as a school nurse. I do not give injections routinely there but have still done plenty of them that I felt comfortable enough to agree to help out a coworker. They got the depo provero shot from the pharmacy and and I agreed to administer it their daughter to save a trip into town to the doctor's office. It was a standard 1 1/2 inch needle and I used my landmarks like I always do. As soon as I aspirated there was blood return so I withdrew and since that was the only one they had we disposed of it and they had to go get another one. I have never hit a vein before and they said they gave it to her lower down when she went back to her doctor to get another shot. I know she is fine but I'm wondering if I just screwed up or if her size had anything to do with it? She is a very tiny girl (Maybe 5'6", 110 lbs) and I attempted it in the dorsogluteal site. Is it possible that I did measure the landmarks correctly, just given her size I should have gone just a tad lower? I do my aunt's monthly b12 shots in the same place and have done another coworkers depo shot there as well but this was my first time dealing with someone who had low muscle mass.

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Specializes in Pediatrics, Emergency, Trauma.

I usually use the ventral gluteal site...less chance of hitting a vein.

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I don't think you did anything wrong, and you were correct in stopping when you saw blood return. Sometimes you miss, and it's okay.

We give Depo on discharge a lot, and when someone is very thin or small I do not insert the needle all the way. I'm not sure if that prevents from hitting a vein but I feel like it helps because it goes far in to hit a muscle but not so deep to miss it.

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Specializes in Med/Surg,Cardiac.

I always feel for the muscle in addition to using landmarks and go into a meaty portion.I'm glad you aspirated and realized there was blood. I don't think you did anything wrong. It happens

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Thank you all. You've made me feel better. I've never messed up on one before. Thank you for the tips as well to use in the future.:)

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