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?
Here is what convinced me. On the other thread I posted I posted a lovely little power point summary of the aspiration debate. Check it out.
How long do you aspirate for? When I learned, I was taught to pull back on that plunger briefly and then inject away. I have observed many, many nurses giving IMs with aspiration, I would say people pull back for maybe a second. Well, come to find out that Aspiration should be performed over 5-10 seconds!
If a nurse tells me she consistently aspirates over 5-10 seconds, I flat out don't believe her.
So then, if we are to use aspiration we use a site that is highly unlikely to contain a large vessel. We then insert the needle and leave it in for 5-10 seconds longer than really necessary while performing a maneuver that can irritate tissue, increasing pain at the injection site and the perceived trauma to the patient. And after all that there is not conclusive evidence that this method actually confirms correct location.
Anyhow, I have read up on this and I know what my practice will be going forward, and it has nothing to do with laziness or not wanting to do the "correct steps". It's evidence based practice vs. ritualistic practice.
CodeteamB
473 Posts
Here is what convinced me. On the other thread I posted I posted a lovely little power point summary of the aspiration debate. Check it out.
How long do you aspirate for? When I learned, I was taught to pull back on that plunger briefly and then inject away. I have observed many, many nurses giving IMs with aspiration, I would say people pull back for maybe a second. Well, come to find out that Aspiration should be performed over 5-10 seconds!
If a nurse tells me she consistently aspirates over 5-10 seconds, I flat out don't believe her.
So then, if we are to use aspiration we use a site that is highly unlikely to contain a large vessel. We then insert the needle and leave it in for 5-10 seconds longer than really necessary while performing a maneuver that can irritate tissue, increasing pain at the injection site and the perceived trauma to the patient. And after all that there is not conclusive evidence that this method actually confirms correct location.
Anyhow, I have read up on this and I know what my practice will be going forward, and it has nothing to do with laziness or not wanting to do the "correct steps". It's evidence based practice vs. ritualistic practice.