injections

I pinch...

...and I map.

Regarding sub.cues.,yes we pinch but after you insert the needle do you then release the pinched skin and then inject? or do you maintain the pinched skin and inject into the pinched skin.

The reason why I ask is that I read,I think it was RN mag. that you must release the skin before you inject,because this avoids injecting the drug into compressed tissue and irritating nerve fibers. But in school I was taught to inject into the pinched skin , releasing before injecting wasnt even mentioned,it wasnt an issue.

ohbet: I think it was RN mag. that you must release the skin before you inject

Me: So why pinch at all? If you're not sure which is less painful, try it on yourself with both techniques and let us know the results of your study.

To pinch or not to pinch, THAT is the question...

i dont pinch at all , there is no need to. I also dont map out the site as close as i used to, after so many i can tell . i also do ztrack method most of the time. And change needles after drawing up all meds.

I map but I don't pinch. Gary

MAPPING, PINCHING, PINCHING, MAPPING, I ALWAYS DO BOTH......

Pinch............ sometimes...depends on how thin the patient is, the medication and whether or not the right size needle was stocked in the drawer for the job.

Mapping always. I map and palpate the area prior to selecting my site. If the patient has received lotsa prior injections, (and there are some lousy shot-givers out there)... then frequently, I would be injecting into sterile abcesses (previously given injections that the medication did not absorb or disperse)... or into scar tissue.....if I didn't palpate first. So, I always palpate to make sure the site I have selected is best for the injection. About 1/3 of the time, I choose another site.

Have you seen patients whose hips are all lumpy and bruised.?? Poor injectionists. Don't be afraid to use a long needle. My favorite for IM's is 22 gg and 1 1/2 " long.

Inject slowly as the previous poster said. I usually massage it in. (pain and nausea meds, not heparin and insulin,, of course)

As far as the pinching....my hands are small, and I find I can give a better , more controlled , non-painful injection if I do not pinch. Pinching with one hand leaves me with the syringe and plunger to deal with with only one hand...I guess I never did it enough to "Perfect" my technique. But I definitely do when the patient is thin ...

after drawing up the med, i change the neddle. i pinch and hold on sq injections and still map my sites.

question to anyone? regarding the pinching:

if the order calls for an injection to be given sq , and depending on the size of the patient/neddle, if you didn't pinch and hold, would not you be giving an im instead?

LPN,Future, RN asks: If the order calls for an injection to be given SQ , and depending on the size of the patient/neddle, if you didn't pinch and hold, would not you be giving an IM instead?

Me: Depends on the size of the needle and thickness of the skin/subcutaneous fat. Most SQ needles - 25g 1/2" are probably not going to make it to the muscle unless the pt has little fat.

So why pinch? I do it to see if there IS enough fat to give a SQ injection. If I can pinch up enough fat so that I know the needle won't be injecting into muscle, then I feel better about the injection location/route.

What about Heparin injection..I have always been taught the were givin SQ at a 90 degree angle unless they are very thin. My preceptor thinks its 30-45 degrees...???

As a new LPN (just based Boards last week)- I can still hear my Pharm Instructor tellings us to always give at 90 degrees, unless the pt. is emaciated or a child. than it's 30-45 degrees.

As for the question of to pinch or not to pinch- I was taught to pinch, insert and release before injection. The excepetion being Z-track.