Immunizations

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Okay, so I have a few questions. I am going to start working in an office where I have to give immunizations. I was wondering if I am supposed to aspirate when giving the IM immunizations. I have heard both yes and no so I thought I would ask the experts. Also, do you pinch the skin and then give it IM in the child or do you not pinch ensuring that it goes in IM. Also, how much space between each injection if they are in the same thigh? I do know that MMR and Varicella are SQ and they are not aspirated. Thanks for all your help! Can you tell I am nervous and excited all at the same time.

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Specializes in DOU.

I was taught to aspirate and Z-track IM injections.

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Specializes in RN- Med/surg.

We were taught to asperate IM and Z-track any irritating injections. However....I'm interested to see others responses. As a parent...I've NEVER seen a nurse asperate on my infant's or children's injection...as they're just in and out as quick as you can.

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Specializes in Geriatrics/Family Practice.

When you have a strong screaming 5 y/o you do what you have to do. If I tried to aspirate for IM's shots, the needle would be yanked right out as the child flipped out. As far as SQ, you also do your best with that and hope the child doesn't jerk and somehow make the shot IM. I've asked my preceptor and did research and if SQ is accidently given IM, it's still just as effective and if you can figure out a way to aspirate when your holding down a strong, angry child, let me know. So far I've hurt noone and had no adverse reactions to my technique. I know someone will have some type of comment to dispute what I've said, but I've also asked the doctor I work for, and he basically as long as you get the med in, it's better than nothing. Also during my family practice clinicals, I witnessed very experienced nurses say and do the same things I'm doing and saying.

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Specializes in RN- Med/surg.

Well said...I'm quickly learning that while we should try to do everything the "right way"....real life just isn't always compatable. I've never thought ill of my kids nurses...and never will for not asperating lol.

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Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.

Previously, all nurses were taught to aspirate with IM injections. In the past few years new guidelines have come out stating that aspiration is no longer needed, and many nursing schools are no longer teaching it. Many of us older-schooled nurses do not feel safe not aspirating, I personally have gotten blood return twice in my career of thousands and thousands of injections. So....one will find some nurses aspirating and others not.

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Specializes in CNA; LPN Student.

I'm not in NS yet so I don't know anything LOL, but is blood return bad? I ask bc I have 2 small children (18 months and 4 months) and when I bring them in to get their immunizations (they get them in the thigh, so is that IM?) there is almost always blood return. Of course I know its hard to give a shot to a screaming infant or toddler, but is blood return something to worry about if it happens almost every time they get there immunizations?

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Specializes in DOU.
I'm not in NS yet so I don't know anything LOL, but is blood return bad? I ask bc I have 2 small children (18 months and 4 months) and when I bring them in to get their immunizations (they get them in the thigh, so is that IM?) there is almost always blood return. Of course I know its hard to give a shot to a screaming infant or toddler, but is blood return something to worry about if it happens almost every time they get there immunizations?

They aren't talking about blood coming out of the injection site, but rather blood aspirating into the syringe, which indicates that the injection is about to go directly into a vein, and that is not good.

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