IM Injections

[sports2245]

Is bruising common at the IM site? We were practicing injections & I have a bruise at the site of the injection, although when aspirated, no blood appeared. I guess I have never paid attention to any bruising when I received injections before, but now that I am giving them, I would like to know if it is common/normal or not.

I would also like to get opinions on whether it is better to pinch the skin or stretch the skin for injections. Is one way better than the other?

[Eirene, ASN, RN]

i think bruising all depends on the person and the im med. when hubby and i were doing in-vitro, the im progesterone (it was very thick) tore me up with bruises and bumps.

they're teaching us to do the z-track method for im injections now. here is the synopsis of the method from the encyclopedia of nursing & allied health:

to give a z-track injection, use the non-dominant hand to move and hold the skin and subcutaneous tissue about 1-1.5 in (2.5-3.75 cm) laterally from the injection site. alert patients when the medication is about to be injected. ask them to breathe through their mouth and to try to relax the muscle to avoid muscle resistance. continue holding the displaced skin and tissue until after the needle is removed. dart the syringe rapidly into the site at a 90° angle. aspirate on the syringe to be sure that a blood vessel has not been penetrated. inject the medication slowly into the muscle. be sure that the syringe is completely empty, including the air, before withdrawing the syringe. withdraw the syringe and immediately release the skin and subcutaneous tissue.

[southernbelle08]

I also think brusing depends on the person and med.

We are taught to use Z-track on some medications, but not all. Also pinching and/or stretching is another thing that depends on the patient for us. Sometimes I pinch the skin for a "non Z-track" injection, but usually I do not.

[StudentNurseAbby]

Personally, I bruise when given IM injections. I've only give SC injections, like Lovenox, which bruised my patient. I think, like someone said, it depends on the person and med.

[amyk_ncsu]

We were taught the Z-track method for IM and the pinching for SQ injections. Not sure about the bruising with IM's, though I doubt its abnormal.