Injections- still pull back?

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In a staff meeting a few weeks ago, one of the nurses said that pulling back to check for blood is no longer necessary. I cannot find any documentation to that effect. Does anyone know?

In 3 years of hospital nursing I have given 2 IMs. Where are you folks working that you do these frequently? Seems like everything is IV these days.

I don't aspirate for insulin and heparin/enoxaparin, which are the SQs I give daily. I was taught it wasn't necessary.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I give frequent pain meds (like Toradol, more effective IM), MMR, Phenergan, RhoGAM, baby shots, and other injections IM in OB/GYN,where I work......

. There is quite a laundry list of medications you CANNOT give IV or SQ, really. So some of us do give quite frequent IM injections, even now.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

If you give insulin the wrong way, (e.g. intravenously)---- you could cause severe hypoglycemic problems in a patient. You should aspirate for insulin injections.

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Specializes in oncology, surgical stepdown, ACLS & OCN.
So to the people who aspirated blood- then what did you do?

I can't remember the last IM I gave- just havent had to. If its a narc do you then have to find an RN to witness the waste and start over or do you find a new site and inject ? Change the needle?

This has not happened on our unit, our meds are either sq heparin, or inslin, all other meds are IV, in surgical oncology it is very rare when we give IM

injections. Although we have been told to just change the needle and the site

then inject w/ same syringe, the blood in the syringe will not hurt anything.

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Specializes in oncology, surgical stepdown, ACLS & OCN.
Scooter, thankyou for your reply

You are welcome London Turtle.

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Specializes in oncology, surgical stepdown, ACLS & OCN.
I give frequent pain meds (like Toradol, more effective IM), MMR, Phenergan, RhoGAM, baby shots, and other injections IM in OB/GYN,where I work......

. There is quite a laundry list of medications you CANNOT give IV or SQ, really. So some of us do give quite frequent IM injections, even now.

All cancer patients have pain , post ops, medical pts and pts. recieving chemotherapy or radiation treatments. If the pain is severe we give mso4,

dilaudid, IV, never IM, we give toradal IV to 3rd day post ops right before their PCA, PCEA, is d/c'd. We even give demerol IV when pts. rigor w/ fevers. I can't tell you the last time I gave a med IM. I know sometimes our

docs will order mso4 sq and I know when all these meds are given sq or IM

they seem to last longer than IV. But like you said, we follow the orders and the 5 Rights, if an Im ijection goes into a vein that is an IV administration and is wrong, it should be withdrawn and readministered properly always

using aspiration in your practice. Like you, I wonder what they teach in nursing schools today. It is scary out there.. :)

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This has not happened on our unit, our meds are either sq heparin, or inslin, all other meds are IV, in surgical oncology it is very rare when we give IM

injections. Although we have been told to just change the needle and the site

then inject w/ same syringe, the blood in the syringe will not hurt anything.

Thank you- for the reply I have been an RN for quite a while and never had blood return occur. I have never had a colleage ask me to witness a narc waste for this reason and have never seen this listed as a reason for a waste on the narc med sheets....... so I was naturally thinking what is it that happens when the scenario is thought through to the end?? I thought the response by smilingblue eyes was rather harsh.

I would like to know from the posters who did have the experience since it is described as pretty profound what do you remember doing ? What does your unit policy say? I am going to have to some research because in our unit as I said we rarely give anything IM.

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Guess what?

It happened on my very first IM! I should have bought a lottery ticket that day, no?

:p

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It happened to me only once: when I was giving daily ACTH injestions to my own 10 month old son! You bet I still aspirate!!

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In a staff meeting a few weeks ago, one of the nurses said that pulling back to check for blood is no longer necessary. I cannot find any documentation to that effect. Does anyone know?

I just learned this in class and they said that we have to aspirate injections. The only ones that you don't are insulins and heparins.

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I still instruct all nurses to pull back on the syringe. I did have a nurse last week,insert two syringes at the same time, never heard of that before.:balloons: :flowersfo

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Ok, this is probably going to be a very scary post to all of you nurses out there because I am a new nurse...acctually pinning is on wednesday and I graduate saturday :balloons: :balloons: but I have never pulled back on any syringe. Maybe it is because I usually give everything IV, but I have given insulin, and heparin and lovenox, and such but I have never have pulled back. Am I practicing wrong? or am I just not understanding something.

I know my school told me to aspirate IM injections but recently I was told we don't give IM injections unless it is necessary because it kills the muscles. Insulin is not an IM its SQ So I am confused....:chuckle wow..and I thought I had it all figured out! lol :chuckle

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