Im injection screw-up

[bertha1]

Today I screwed up on a Hep B injection. I thought I had it in the muscle but felt resistance as I got about less than 1/4 of the vaccine in. I pushed the needle in further and felt a breakthrough, like now I'm finally in muscle. I was able to finish, and when I pulled the needle out along with a drop of blood I saw a drop of what I think is the vaccine on the injection hole. I'm concerned b/c I know this vac is for IM not SubQ or dermal. I'm worried this'll give the person an abscess or something b/c it wasn't done properly. Any advice or similar experiences?

[unicoRNurse]

Bertha1 - I'm fine, thanks. My reaction started that night and got progressively worse for several days, lasting a few weeks total.

I'm glad you found some reassuring info. How is your colleague doing?

[rn/writer, RN]

next time you give an IM try aspirating first. We were taught this in school but I'm surprised to see that a lot of nurses don't do it, but that will let you know for sure if you're in the muscle BEFORE you give the injection. If you get blood back, go deeper.

This is what we were taught for years and years. Now, the CDC has new recommendations:

Because there are no large blood vessels in the recommended sites [vastus lateralis or deltoid muscles], aspiration before injection of vaccines (i.e., pulling back on the syringe plunger after needle insertion but before injection) is not necessary. A study published in Archives of Disease in Childhood in 2007 found that when a vaccine was administered and the needle was withdrawn rapidly without aspiration there was less evidence of pain than when the vaccine was injected and withdrawn slowly with aspiration. Also, some safety-engineered syringes do not allow for aspiration.

Me and my co-workers were told to change to the new technique within the last year.

[Anna Flaxis, BSN, RN]

Also, if you are aspirating and you get blood return, the correct answer is NOT to push deeper. The correct answer is to remove the needle from the site, put a new needle on the syringe, and try again in another spot.

[bertha1]

Update, coworker is fine. No complaints that I know of. She's using both arms just fine...sigh.

I heard the same about aspirating, no longer recommended. In school when I was about to inject saline into a classmate's delt, I got blood return upon aspiration. Needless to say I didn't inject. So if there are no major veins in the delt, where'd all that blood come from? Query? If you aspirate and don't get blood return but upon injecting you somehow make it into a nearby vein won't you be injecting air into bloodstream?