Injections: to pinch or not to pinch

[TRINI_RN]

I have been hearing different things from different instructors....confused here. When doing a subcutaneous injection I know that you pinch the skin to determine the angle of injection(measure the amount of adipose), but do you keep the skin pinched as you inject the needle? Also, for Intramuscular injections do you pinch? Thanks in advance.

[nurse4theplanet, RN]

It depends on the size of the person whether I pinch during SQ Injections. If the pt is very lean, then I pinch. I do not let go of the skin until I have injected the med and pulled out the needle. I do not pinch the skin when giving an IM.

[jmgrn65, RN]

SubQ you pinch and keep the pinch until finished with injection, otherwise it might not go where it is intended.

Intramuscular no pinch needed. :}

[psalm_55]

the general rule of thumb is: if the patient has an inch to pinch, then pinch' otherwise, don't.

[HididiScribbler]

We were taught that you CAN pinch with SQ if you want, but it's not necessary...

We were also taught to do Z-track with IMs, no pinching, but pull the skin back, keep it pulled back until you've aspirated, injected, and taken the needle out. It helps with the med absorption...I haven't seen anyone do it at the dr's office, or hospital, but you know nursing school-they want us to do it the BEST way

[CyndieRN2007]

HididiScribbler said:

We were taught that you CAN pinch with SQ if you want, but it's not necessary...

We were also taught to do Z-track with IMs, no pinching, but pull the skin back, keep it pulled back until you've aspirated, injected, and taken the needle out. It helps with the med absorption...I haven't seen anyone do it at the dr's office, or hospital, but you know nursing school-they want us to do it the BEST way

I agree with pinching or not for SQ. Z track for all I'm injections is warranted. This will facilitate medication staying within the muscle and not leaking back thru inejction site.

[CHATSDALE]

if the pt is very thin you might be want to pinch for im to avoid hitting bone

[Achoo!, LPN]

jmgrn65 said:

SubQ you pinch and keep the pinch until finished with injection, otherwise it might not go where it is intended.

Intramuscular no pinch needed. :}

Ditto that:)

[locolorenzo22, BSN, RN]

Our instructors tell us that generally subQ is a pinch, IM is a spread, and z-track is a spread to the side, inject, and release as you remove needle.....

[BoonersmomRN]

I was taught to pinch and keep pinched for SQ. Just my expreience. Even on a teeny tiny person.

Z track you pull and stay pulled to the side until after injecting- then let go.

[solumedrol]

yeah. for SQ injections we were also taught to pinch the skin and keep it pinched until you have injected all the medication. for instance, when injecting Heparin SQ you keep the skin pinched until all the Heparin is injected because if you let go it may go IM instead of SQ. and that is a bad thing because IM has a different rate of absorption than SQ, plus injecting Heparin IM can cause hematomas.

for IM injections, we were taught that you don't really have to pinch. also, you don't need to do z-track method everytime you inject depends on what medication your injecting. just inject the needle 90 degrees then bam! :)

[April1986]

For SQ's we were taught to pinch, especially for thinner people otherwise you aren't sure what you are injecting into (sub-Q or muscle). For IM's, they are starting to teach z-tracking for all IM injections as best practice, even if it is a not irritating medication because it helps improve absorption, and if it is irritating, it isn't going to come back up throught the port of entry and unneccesarily irritate the tissue it passes through.

April