IM Injection, Hitting Bone?

I was giving my mother an IM injection for the Flu Vaccine at the hospital, I did the injection and felt that I hit a bone or something. I did aspirate and received no blood return and went ahead and inject the medication. The injection was a little high up, not where I received mine.

Is hitting the bone bad or something... will it cause any negative effects. I asked her if there was pain afterwards and she said not really?

Specializes in ER, progressive care.

It happened to me once. I was still a student and was volunteering at a flu shot clinic. It was a little elderly lady and as soon as I put that baby in I hit the bone - I was terrified, but the lady didn't even flinch! I had a horrific look on my face and as soon as the lady looked at me I wiped that look off of my face, smiled at her and asked, "doing okay? we're almost done." I pulled back a bit, aspirated and injected the medication.

learning from that experience, I would either go for a smaller needle for children/elderly or do not inject as deep.

Specializes in Med/Surg, Academics.

Did it once, and the lady didn't even flinch. But I'll never forget the sensation. I went a little high on the deltoid when it happened, so now I am careful to hit the meat of the muscle. Smack dab in the middle.

Specializes in SNU/SNF/MedSurg, SPCU Ortho/Neuro/Spine.

The same time the meat pulling helps you tighten and bulge the muscle, it helps deviate the pain from the prick, since you are causing enough nervous sensation from your grip... Haven't been a nurse for too long, but have given at least a few hundred IM to geriatrics, from vaccines, Ativan, Phenergan, Rocephin, B12...and a hand full to babies

I've hit bone a few times too, never had a patient react.

If there is limited underlying adipose tissue pull up a pinch..flu vaccines are usually given sub q

Hitting the bone can cause some site pain.

Specializes in Med/Surg.
CHATSDALE said:
if there is limited underlying adipose tissue pull up a pinch..flu vaccines are usually given sub q

hitting the bone can cause some site pain

Flu vaccines aren't given subq....or am I missing something? I've never known of a vaccine that wasn't IM.

I've never given a flu shot subQ, am I missing something?

Thanks folks for the reply...

The problem was that I did not pull back when I hit the bone...all I did was aspirate and then inject the medication. My mother didn't twitch or anything...

I'm scared it might have a negative effect on her... :(

CHATSDALE said:
if there is limited underlying adipose tissue pull up a pinch..flu vaccines are usually given sub q

hitting the bone can cause some site pain

cherrybreeze said:
Flu vaccines aren't given subq....or am I missing something? I've never known of a vaccine that wasn't IM.

I believe what CHATSDALE is referring to is that if you have a very low body fat client, they also tend to be low muscle. You see this type a lot in the elderly (deltiod) or in low birthweight infants (Vastus Lateralis). The technique is to grab some muscle and draw it together, and up just a little, so that the tip of your needle is dwelling inside a "pocket of muscle" that you aggregated, rather than hitting bone.

Specializes in Gyn Onc, OB, L&D, HH/Hospice/Palliative.
etep1209 said:
Thanks folks for the reply...

The problem was that I did not pull back when I hit the bone...all I did was aspirate and then inject the medication. My mother didn't twitch or anything...

I'm scared it might have a negative effect on her... :(

Don't worry, I'm sure she'll be just fine! ;)

Specializes in Med/Surg.
woknblues said:
I believe what CHATSDALE is referring to is that if you have a very low body fat client, they also tend to be low muscle. You see this type a lot in the elderly (deltiod) or in low birthweight infants (Vastus Lateralis). The technique is to grab some muscle and draw it together, and up just a little, so that the tip of your needle is dwelling inside a "pocket of muscle" that you aggregated, rather than hitting bone.

I understand that. What CHATSDALE said was that flu vaccines are given subq, and they are not. This doesn't explain that statement.

cherrybreeze said:
I understand that. What CHATSDALE said was that flu vaccines are given subq, and they are not. This doesn't explain that statement.

Hmm. Good point.

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