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IM injections

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In my school, we were taught to aspirate on all IM injections for blood return. Many people that I have assisted in giving multiple injections ( Well Child visits, refugees, etc ), do not aspirate. Most of the parents that bring their children in for Well Child visits are already behind 4 to 5 immunizations, and for the most part, don't want their child to be getting all those shots. So, many times it comes down to easing their fears and "hurrying up with the injections."

My clinical supervisor said that she has never aspirated on any IM injection and that we didn't have to either.

My question is to those of you out there reading this, in the real world, what do you practice? Do you make sure to aspirate, or just inject?

I would appreciate your thoughts!

:uhoh3:

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

Moved to the General Nursing Discussion forum for more replies.

What does the policy of that clinic state? That's what matters.

kmarie724

Specializes in LTC. Has 5 years experience.

I was taught to aspirate and do it out of habit, but I have heard that there is new research that says it isn't necessary. But I haven't read any of these studies and as far as I know, my facility's policy is still to aspirate for IM injections.

whodatnurse

Specializes in Psych.

IM injections are not intended to be given IV. If you hit a blood vessel with that needle, that is essentially what you are doing if you proceed with the injection.

I always aspirate when giving an IM injection.

joanna73, BSN, RN

Specializes in geriatrics.

I always aspirate to check for any blood return. However, I have been told by several nurses that it is very rare you would hit a vein, so there is no need to aspirate. I guess opinions are mixed.

voneek

Specializes in school nursing, home health,geriactrics. Has 6 years experience.

i always also aspirate but there are a lot of different opinions when it comes to IM injections, also the same when i do flu clinics some people say not needed to aspirate.

There is new research suggesting the old practice of aspiration is no longer warranted.

whereslilly

Specializes in Long term care, Rehab/Addiction/Recovery. Has 30 years experience.

There is new data showing that pulling back for the purpose of aspiration is unnecessary. In a perfect world, with a perfectly compliant patient,HA! Aspirating would be a good idea. I can tell you this, in my career I have given thousands of IM injections to babies, adolescents, adults, and geriatrics. The idea is to get in there, distract..and inject fast and smooth! Especially when you are giving multiple injections. Its a skill you acquire. I always get a clean shot, no blood return. Know your age group, the anatomy, use an appropriate sized needle with good technique-no problems!:smokin:

Bottom line, there is a standard of care that we are expected to perform. This is there to protect the public's safety as well as the nurses license. If a patient were to be injured by an injection and it was discovered that the nurse did not follow the accepted standard of care they could be disciplined for something like gross negligence and things along those lines. The fact the family members and the kids want to get this over with as soon as possible is no excuse for putting a patient in jeopardy. This is where pt. teaching comes into play. If you teach the parents why you do what you do then they will be more accepting of the way we need to do the procedure. I would rather **** a parent off, listen to a child cry then knowingly do something to a child that I know has the potential to cause them harm.

Lisa, MA

Specializes in Medical Assistant, Peds. Has 23 years experience.

20 some odd years ago I was taught to ALWAYS aspirate for blood. I don't know that I could even attempt to retrain myself to do otherwise. In my opinion, regardless of the "data"...its just good practice.

OCNRN63, RN

Specializes in Oncology; medical specialty website.

We should be following evidence based practice, not personal opinions.

Lisa, MA

Specializes in Medical Assistant, Peds. Has 23 years experience.

So then does the "evidence" support any ideology that aspirating causes any harm? No? Then I think I'll continue on as is.

OCNRN63, RN

Specializes in Oncology; medical specialty website.

I said that as a general concept, not necessarily speaking to only one specific issue. I hope that clarifies things.

nursel56

Specializes in Peds/outpatient FP,derm,allergy/private duty. Has 45 years experience.

So then does the "evidence" support any ideology that aspirating causes any harm? No? Then I think I'll continue on as is.

Me too. It's interesting to me that people will vigorously defend the use of a filter needle though the chance of harm to a patient if a filter needle is not used is entirely theoretical, but don't aspirate on an IM because they've never aspirated blood themselves.

DesertRN2, MSN, APRN

Specializes in Corrections, Education, Med/Surg, AGNP-HIV. Has 25 years experience.

Actually it does, which is why continued education is important. Doing something because you have always done it that way is substandard care. Nursing evolves and so should your practice.

I was taught to aspirate all IM injections except the deltoid. Apparently, EBP has found that the incidence of hitting a blood vessel in the deltoid is slim to none and aspirating thus causes too much discomfort for no beneficial reason. However, the vastus lateralis and dorsal gluteal still require aspiration.

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&ved=0CCsQFjAB&url=http%3A%2F%2Fwww.nnpnetwork.org%2FUploads%2FEBP%2520aspiration%2520poster%25209%252025%252012%2520for%2520iowa%2520.pdf&ei=EO_zUvy3DaqqyAH50YDwDQ&usg=AFQjCNEj2FvrdH9p6Di6wR6bNsVWyKiLoQ&bvm=bv.60799247,d.eW0