Is it okay to give an IM through clothing?

[njinsky]

In the past I've had diabetic patients who injected themselves through their clothing. Is this ok with IM injections as well? In psych we have so many traumatized patients who are resistive to injection it seems more traumatic to expose a site than just go through the cloth. Doing it with alcohol wipes and saying "there will be a little prick" etc. is fine with cooperative people in a calm setting, but what is acceptable in crises?

[Altra, BSN, RN]

No, I don't think it's OK.

I've given more IM injections in a "crisis" to agitated, combative, & intoxicated patients than I can count. It's simply a MUST to get enough help to expose a suitable site long enough to give the injection.

[BradleyRN]

It is never, ever ok. :)

Teach your patients well.

[Silverdragon102, BSN]

I think it depends, In most cases I would try to expose skin but have on a very few occasions had to give through clothing but very few and circumstances gave no other option

[skittlebear]

The only IM inj. I would think would be okay to adm through clothing would be the EPI-PEN, because you wouldn't want to take the extra time to pull their clothes off.

[nightmare, RN]

The problem with going through clothing is what you might hit on the way through! You then end up with a blunt or even broken needle tip contaminated with goodness knows what from the clothing.I also know diabetics who inject through clothing but that is their choice not a medical one.

[correctlywrong]

If I had been exposed to a nerve gas agent and was stabbing myself with an autoinjector antidote, I would give it through clothing to avoid exposing any more skin to a possible irritant than necessary.

In any less life or death situation than that, I would say that exposing skin is a must.

How can you possibly ensure the cleanliness and appropriateness of the site? I think that a diabetic who injects through clothing is asking for an abcess, but IM needles go deeper, and carry bacteria into more vulnerable tissue. A little necrotizing fasciitis introduced into someone's glutes could quickly become a life-threatening issue.

Especially considering the hygiene issues one encounters in behavioral health settings. Or in health care settings in general!

No way should IM ever go through clothing.

[CHATSDALE]

i have seen this done but in the one situation where i saw the everyone was stupified by the act

you can not clean a site, the clothes may be contaminated, and in the days of the super bugs this could not in any way be considered proper medical care

[Surgical_RN08]

i would say no to IMs or Any injection thru clothing. the clothing will get the needle contaminated. do people really do this? wow!

[leslie :-D]

it is undoubtedly very poor practice.

but in an emergent situation, one's life trumps the risk of infection.

leslie

[racing-mom4, BSN, RN]

I have given a Geodon IM through a pair of slacks before--is it common--heck no in fact I hope I never have to exp a night like that night again!!!

As far as the diabetics who give them selves insulin through their clothing--what the heck..how long does it take to expose some skin, my lord. Thats just strange.

[jeepgirl, LPN, NP]

the only thing i can think of where this would be OK is the EPI-PEN.

thats it.

those little bitty insulin needles are thin and can dull easily too... even though you don't change them when drawing up the insulin, going through the clothing too...

along with bacteria, etc when you can't clean the site.

it isn't good nursing practice.

also, i have never ever seen a diabetic who wanted to do it through clothes! that includes when i worked on a medical floor... with adults.