Desperate for tips on Prolixin, Haldol Decon. IM injections!

[DaisyChains]

i'm new to the injectable drugs that are so oily and while i've not recieved many complainers, i have a few concerns that i'd like some help with.

1: is using ztrack preferred? any reason not to use it, or to use it? today i noticed a good bit of the prolixin running right back out of the hole the needle left in the pt's glut. i've not seen that happen before.

2: push fast or slow? i was taught that slower is less painful and allows more effective absorbtion, yet today a pt told me "the other nurse" pushes fast and it doesnt hurt him. what do i say so i don't make the other nurse look bad?

3: size needle? what's the smallest you've used successfully? all i have available is 20g 1.5in needles. if i were able to get a smaller gauge needle, what would be preferred for such a thick med that is for deep im?

4: bevel up and in at a 90 degree angle? right? i really do want this to be as painless as i can make it. when i first started giving im's, i was thrown out on my own and apparently gave painful shots. (that was a terrible job, i have a wonderful job now)

5: leave a small air bubble to make sure all the drug is in? i read this somewhere, and it just scares me. how do you feel?

6: if i did hit a vein, what is the worst that would happen? this never occured to me, but someone asked and i didn't know the answer. i know it's not desirable, but what would happen, in regards to these drugs?

7: use a dry needle after drawing up? does that mean changing to a fresh needle? does that make it less painful?

at my new, wonderful job, i am giving the prolixin and haldol depots on a regular basis, and if i can make the injection less uncomfortable, the pt is more likely to comply with coming in to get "shot". also, i want to build a therapeutic relationship with my clients, and if they think of me as the lady that gives bad shots, i don't think are as likely to warm up to me.

thank you for everyone that helps me out here!

[RochesterRN-BSN, BSN, RN]

The Z track does help with the leaking issue. A 20 gauge needle is quite big, I prefer something smaller. This does make it so the shot goes slower but.........Where are you placing it? Choose a big muscle.........NOT the deltoid. Drawing in one needle and then switching needles does help--I always do this.....the drug is not on the outside of the needle and the skin on the way in is not in contact with the drug so it stings less. Also be sure you are letting the alcohol dry before you give the shot. If you wipe and give immediately after the alcohol is not dry and some of it goes into the skin and makes the sting worse--in an acute situation this is not always possible but with a Depo you have the time so wipe and give a minute for it to dry--just don't blow on it, of course--

As far as getting the drug into the blood stream.......this is why you draw back after getting the needle in and if you get any blood you pull the needle out just a bit before actually injecting the drug. You should do this with all injections --except insulin and heparin--though those are SQ, not IM. It is gonna hurt to some extent no matter what you do--you are sticking a needle in the patient. So try to minimize but don't let it bother you to much--oh and when you push in the needle do it like a dart--quick, not slow....hurts less. So find a good meatly large spot, pull your skin to the side, push in your clean needle quickly, and then stop, pull back and if no blood push in slowly and let go of the skin after you get the needle out. You can then rub itm which I find helps with all IMs--as it spreads the fluid in the muscle out as it is the fluid displacement of the muscle that is painful. I rub every IM I get to myself and it does help.

Good luck!