injection technique

[ZAROZINIA]

I am gathering research together on injection technique, cannulation, and venepuncture. Anyone have any up to date research?

Iam mostly interested in the best way to administer an intramuscular injection , how quickly or slowly to do it is a point being debated on our ward at the moment. It is generally thought that inserting the needle slowly gives the patient less pain, as a quick insertion might cause muscle spasm.What is your experience?

[debbyed]

Always used the "dart"approach with lots of wrist action. Get complimented frequently that they never felt the needle, but boy did that medicine hurt.

Never tried it slowly. Thinking about it makes my arm hurt.

[P_RN, ADN, RN]

Quick dart for over 35 years. Guess it works. Usually they say "When are you going to give it?"

I think the students might be a little anxious and thus give it slowly.

[fiestynurse]

This is what I tell the students in my injection workshops:

TEN TIPS FOR EASING THE PAIN OF INTRAMUSCULAR INJECTIONS:

1) Select the correct needle size

2) Engage the patient in conversation and tell them what to

expect

3) Ask the patient to be as still as possible

4) Grasp the injection site firmly to reduce the discomfort

5) Distract the patient right before giving the injection

6) Insert the needle at a 90 degree angle

7) Dart the needle quickly on insertion

8) Stabilize the needle

9) Inject solution slowly

10) Remove the needle in one quick smooth motion

[KatWright]

I do the quick dart. But I tell my patients to "take a deep breath, blow it out, take another deep breath, blow it out." I have always had compliments on the technique and they really like having something else to think about.

[ZAROZINIA]

So is there anyone out ther who does insert the needle slowly?

[KatWright]

If your patient has experience with shots, ask THEM how they want it. Once in a while I will have a patient ask that I do it slowly but in my practice that is the exception not the rule.

Kat

[kids]

Does anyone have suggestions on not giving injections thru tattoos?

Two years in a row the MAs at my MD insisted that you should *never* do it (news to me) and gave my 'flu shots in less than ideal deltoid locations. BTW- I've had many done thru the tattos and have had no problems.

-nancy

[mcl4]

Originally posted by fiestynurse

This is what I tell the students in my injection workshops:

TEN TIPS FOR EASING THE PAIN OF INTRAMUSCULAR INJECTIONS:

1) Select the correct needle size

2) Engage the patient in conversation and tell them what to

expect

3) Ask the patient to be as still as possible

4) Grasp the injection site firmly to reduce the discomfort

5) Distract the patient right before giving the injection

6) Insert the needle at a 90 degree angle

7) Dart the needle quickly on insertion

8) Stabilize the needle

9) Inject solution slowly

10) Remove the needle in one quick smooth motion

These ten steps should be in every nursing text book. Excellent information.

[KatWright]

If you are giving an IM don't forget to aspirate !!

[ohbet]

I was taught to give the shot differently ,not to hold the syringe like a dart,but to grasp the entire syringe with 4 fingers,like your making a fist over the syringe,then inject,but its more like your making a stabbing motion rather than a darting motion,then with your thumb of the same hand holding the syringe aspirate.

I have a question,when I give dorsal gluteal shots,I still mark out the landmarks,finding the trocanter,the posterior superior illiace and the illiac creast. I guess I should just start eye balling where the shots should go,like everyone else,but Im afraid of hitting the sciatic nerve,am I being to paranoid?

[CashewLPN, LPN]

you should not give injections through tattoos if it can be avoided... Why? the needle can damage some very expensive artwork, that often has to be fixed...AND, remember, the ink sits in the epidermis, and some people can react to it if its forced down further... if it has to be done, use the smallest needle, and excellent technique cleaning the site... (had a friend get a case of cellulitis after an injection... blistered up, and lost a big part of a nice tattoo...)

and I also agree with the fist over the needle, inject with the thumb... tends to work best for people withj leather skin... and, i di still look for landmarks before I give an injection... safer that way.

--Barbara

[jayna, RN]

painful or not, it depends on the type of medication you're about to give , the amount and the type of needle...

I think technique is the least, becos everyone has different technique on how to give injection..

if you're in tropical countries and give quinine injection for severe malaria...make sure to give it slowly..it's 10 mls...... But for 0.5, 1,2, mls fast is great.....as for powder antibiotic ...slowly but not tooooooo slowly..who wants needles sticking out for more than 30 sec.....

But in the tropics, like they used IMI often, and the antibiotics are powdered , it is recommended to give it slowly, and watch out for reactions like anaphilactic shock

and always, upper outer quantrant...

ta

:D