IM injections

[Hotnurse06]

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!

[OCNRN63, RN]

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

[Lisa, MA]

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]

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

[nursel56]

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]

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.

[ChipNurse]

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

[anon456, BSN, RN]

I always follow the policy at my institution and aspirate. We also use z-track on many of them.

[CodeteamB]

This discussion may interest you.

https://allnurses.com/general-nursing-discussion/question-about-im-850002.html

[ArtClassRN, ADN, RN]

Personally, I don't aspirate for vaccinations. I do aspirate for any other IM injection.

[BrandonLPN, LPN]

So what harm does aspirating do?

[utadahikaru]

The first rule of medicine is that some people will cut corners where ever possible, don't be one of them. That is the very reason that we end up with issues like people having the wrong limb chopped off in surgery, a disturbingly high rate of hospital acquired infections, deaths from routine procedures, etc.

Don't be one of the nurses who cuts corners on every chance they get, because their perception is that "it's not their own hide they are risking, it's someone else, so what's the big deal?"

If you work hard enough at it, you can probably find a way to rationalize any kind of corner cutting. It's almost human nature, to deny that the worst will happen to you, or to your patient. The difference should be, that while you can afford to take those risk with your own life, as a professional, you should never take those risk with the lives of others.

How do you think the pt would reply if you said "I know I'm supposed to wash my hands, use an alcohol swab, and aspirate before injecting you with this medication; but frankly, I don't feel like wasting my time. Is that OK with you?"

Regardless of what others say, follow the standard of care. If in doubt of changes, contact the BON

[KariZayBSN]

Per the CDC, as stated in the earlier thread responses, aspiration is not required. Additionally, aspiration has been found to contribute to pain with injection.

Source CDC.gov Vaccine administration PDF: "Because there are no large blood vessels in the recommended sites, 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."