Question about IM vs IV injection, when to aspirate, what to look for

[jeshicuhx3]

Hello everyone!

I am in nursing school right now, and my father has diabetes.

We recently went over our prescription drug coverage for the year,

so his doctor decided to have him do weekly IM injections at the top of his glutes.

Since he can't do it himself, obviously, they showed me the procedure for doing it.

However, I have a couple of questions (that I forgot to ask at the time).

I've done some research, and some sites say that you don't have to aspirate before doing an IM injection, and some sites say that you have to aspirate, and when you do, if you draw back blood that means you hit a vein/artery. So my first question is thus: do I aspirate or not? And if so, I make sure that no blood draws back, right?

When they showed me how to do it, I don't recall her aspirating, she just quickly "jabbed" the needle in (that's the best way I could describe it, it kinda shocked me since I'm not that far into my training lol).

My third question is this: for IV injections, if you draw back blood, that always means you are in a vein, correct? And there is no chance that you hit a muscle, right?

All responses are greatly appreciated!! I'm about to apply to TWU in February, and I'm so excited! I have a 3.9 GPA (just .1 more point would be so great! lol), and I have 3 more years until I have my BSN!!! :] Science is my life, and I can NOT wait until I can become a neonatal nurse and take care of newborns :] I'm also excited that I have the chance to practice certain things like injecting medication for my parents (my mother has MS and I sometimes help her injecting her daily meds). I also have a 3 year old, so cleaning boo-boos and taking care of her (giving her medicines when she is sick) is something I love. I don't necessarily enjoy her being sick, but it makes me feel good to have the knowledge of how to take care of her when she is sick or hurt.

Sorry to ramble, but I just wanted to give a little background information so people aren't like, "how do you not know this if you're in nursing school?" I haven't quite gotten to the point of doing clinicals yet, or anything like that. However, I am a fast learner, and it's always better to ask questions if you don't know something.

Anyways, if someone could clear up this confusion for me, that would be great!

I put the 3 questions I had in bold, so that it is easier for everyone to see them in my long, rambling thread, lol.

Thanks again everyone for the help!

Jess

[AOx1]

Think of, oh, poking a chopstick into a three-layer cake with frosting in between the layers to make a hole all the way to the plate. If you stick it straight in, the hole goes from the plate to the top. If, however, you push the layers sideways so they make sort of a stepwise look, push the chopstick straight down in, remove it, and replace the layers they way they came, there is no hole from the plate to the top, because the layers closed it off when they slid back into place. That's Z-track.

Gee, thanks, GrnTea. Now all I can focus on is caaaaaaaaake......frooooooosting!!!!

[Covaryx]

What I learned is that if you get a blood return you're in a vessel (doesnt necessarily mean it's a vein) and if you continue on to inject, you're no longer giving an IM... youre shooting it into the bloodstream...which would not be the right route anymore. The only exception to aspiration is immunizations. You just inject those....This is a recent change as you used to aspirate those too. I recently asked for the rationale supporting this but I can't seem to find anyone who knows (and im too busy to look it up lol)... I think a textbook cited the CDC...Pretty vague, I know. All other IM injections require you to aspirate. Blood return= no go...do over. As a disclaimer, I'm sure there are always some unique circumstances with particular drugs or patients. .. I'm stating the most current basics of IM.[/quote']

We keep being checked off on this every semester. So, you aspirate for just about anything except immunizations is what we do too.

Also, we were told to no longer give inj in the dorsalgluteal area bc studies or something have shown nerve damage and stuff there. Our 3 places of IM inj in an adult is the deltoid, Vastus lateralis and ventrogluteal.

[dream'n, BSN, RN]

I was taught way back when to aspirate with IM injections. In the years since I've given multitudes of them, though not for the last 7-8 years. I have had blood return on aspiration twice. And by blood return I mean that I could have filled up the syringe with blood in a second. First incident was with Lupron in the old (and now unused) DG site. The second incident was with a Td immunization in the deltoid. Therefore I am suspicious of the recommendations not to aspirate for immunizations in the deltoid. I have had it personally happen to me. Just because this research says it is not possible to aspirate blood from the deltoid with an immunization, I personally know it is very possible.