Is it okay to give an IM through clothing?

Published

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?

Specializes in Nursing Home ,Dementia Care,Neurology..

The diabetics I know who do this do it like this only if they are in a public place,like a restaurant, where 'baring some skin' might be a bit embarrassing!

Up Vote Up Vote ×
Specializes in Day program consultant DD/MR.
The diabetics I know who do this do it like this only if they are in a public place,like a restaurant, where 'baring some skin' might be a bit embarrassing!

I would think even in this case they would hit the bathroom for a bit of privacy. If not for the fact that onlookers have no idea what is being injection and may even call 911 if they suspect an illigal drug being used.

I have never heard of giving any injection through the clothes. I can see the epi-pen in an emergent situation but that is an exception.

Up Vote Up Vote ×
Specializes in Nursing Home ,Dementia Care,Neurology..
I would think even in this case they would hit the bathroom for a bit of privacy. If not for the fact that onlookers have no idea what is being injection and may even call 911 if they suspect an illigal drug being used.

I have never heard of giving any injection through the clothes. I can see the epi-pen in an emergent situation but that is an exception.

Well they view this in much the same way as breast feeding mother do,why should they have to go and hide in a public restroom to give their ,lifesaving,injection? It is nothing to be ashamed of,but dropping your pants in public might be a touch to much!:chuckle

Up Vote Up Vote ×
Specializes in Day program consultant DD/MR.
Well they view this in much the same way as breast feeding mother do,why should they have to go and hide in a public restroom to give their ,lifesaving,injection? It is nothing to be ashamed of,but dropping your pants in public might be a touch to much!:chuckle

Thank you for offerring that point of view I had not looked at it like that. Personally if I was a diabetic though I would want privacy. I do not look at it as hiding as much as for privacy.

Up Vote Up Vote ×

why would a diabetic have to drop their pants to self-inject?

leslie

Up Vote Up Vote ×
Specializes in Emergency, Case Management, Informatics.

In an absolute psychotic crisis, I think it would be acceptable to go through clothing to give the injection. I have never done this, but wouldn't rule it out in an extreme emergency. While it's poor practice and a risk for infection, you have to weigh the danger to staff/pt against the danger of infection.

In an ideal world, you would have plenty of staff to assist you in completely restraining the pt to allow time to remove clothing and expose a site. In the real world, it just doesn't always happen that way, especially in a small facility. Sometimes all you have is a couple of small-framed folks to hold the person's arms and you do what you have to do. Fortunately, I've never been in a situation where I needed to do this, but I can see it happening.

I wouldn't try to find the nastiest, poop-and-pee-stained area of the pt's clothing to inject through, though. :D

As for diabetics routinely injecting through clothing, that's not only a risk for infection - it's just plain lazy. You mean to tell me that you can't expose a 1" area of your belly to give an injection, but you'd still rather inject yourself in public with uninformed people gawking at you wondering if you're a drug addict? The logic isn't there. :down:

Up Vote Up Vote ×

Why would a diabetic need to routinely give themselves IMs, anyhow? Insulin's SC-- am I missing something?

Up Vote Up Vote ×
Specializes in Emergency, Case Management, Informatics.
Why would a diabetic need to routinely give themselves IMs, anyhow? Insulin's SC-- am I missing something?

Probably. I think the focus is the injection through clothing, not the specific injection route. :rolleyes:

Up Vote Up Vote ×
Specializes in Nursing Home ,Dementia Care,Neurology..
In an absolute psychotic crisis, I think it would be acceptable to go through clothing to give the injection. I have never done this, but wouldn't rule it out in an extreme emergency. While it's poor practice and a risk for infection, you have to weigh the danger to staff/pt against the danger of infection.

In an ideal world, you would have plenty of staff to assist you in completely restraining the pt to allow time to remove clothing and expose a site. In the real world, it just doesn't always happen that way, especially in a small facility. Sometimes all you have is a couple of small-framed folks to hold the person's arms and you do what you have to do. Fortunately, I've never been in a situation where I needed to do this, but I can see it happening.

I wouldn't try to find the nastiest, poop-and-pee-stained area of the pt's clothing to inject through, though. :D

As for diabetics routinely injecting through clothing, that's not only a risk for infection - it's just plain lazy. You mean to tell me that you can't expose a 1" area of your belly to give an injection, but you'd still rather inject yourself in public with uninformed people gawking at you wondering if you're a drug addict? The logic isn't there. :down:

Well you can quite discreetly inject under a table cloth in a restaurant just before your meal,straight through pants into leg and nobody is the wiser!

Up Vote Up Vote ×
Specializes in Geriatrics/Med-Surg/ED.
I would think even in this case they would hit the bathroom for a bit of privacy. If not for the fact that onlookers have no idea what is being injection and may even call 911 if they suspect an illigal drug being used.

My aunt is a diabetic & always injects her insulin discreetly right at the table- she just lifts the bottom of her shirt or sleeve & gives it. Nobody in the restaurant ever seems to notice- the fact is other people just aren't THAT interested in other diners!! Call 911?? PULEEZE!!!! (not like she's sitting there holding a tourniquet on her arm injecting into a vein like some junkie!!!!) :chuckle

Up Vote Up Vote ×
Specializes in district nurse, ccu, geriatric.

If you know diabetics who are injecting themselves through clothing, you should probably tell them not to because they are more susceptible to infections and anything could be on there clothing.

Up Vote Up Vote ×
I would think even in this case they would hit the bathroom for a bit of privacy. If not for the fact that onlookers have no idea what is being injection and may even call 911 if they suspect an illigal drug being used.

My aunt is a diabetic & always injects her insulin discreetly right at the table- she just lifts the bottom of her shirt or sleeve & gives it. Nobody in the restaurant ever seems to notice- the fact is other people just aren't THAT interested in other diners!! Call 911?? PULEEZE!!!! (not like she's sitting there holding a tourniquet on her arm injecting into a vein like some junkie!!!!) :chuckle

Gee sometimes I take my vitamins or an aspirin in a restaurant- I suppose I could be taking "illegal" drugs and some well meaning (aka psycho) nosey busybody could call 911........... not to mention how much emergency personnel LOVES to be called for NOTHING!!! Sheesh!! That IS a little far-fetched! (& that pipe you're smoking........ it could be illegal too!!) :chuckle

Up Vote Up Vote ×
+ Join the Discussion