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Discussion

Rocephin Injection

I work in a Peds office only PRN so I don't do injections all to often. Today while working I had to give a Rocephin injection. While injecting the med into the child's leg, he started moving his leg around a lot that I hit bone. I've been a little uneasy thinking about the incident. Is there any harm that could occur, other than some pain and brushing at injection site, that I should worry about? I feel like the needle was moving around in his leg scraping his bone a little bit while I and the other nurse with me were trying to stabilize the patient better. Could I have possibly hit a vein during this incident even though I aspirated at the beginning and no blood? Thank you for your thoughts.

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    • Experts

    Aspirating before an injection has nothing to do with hitting bone. It generally isn't harmful to hit bone, but the child should really be restrained to prevent movement during the injection. Someone should have the child securely in a "comfort hold" while you give the injection. Also, if the Rocephin is reconstituted with lidocaine, it will minimize the discomfort of the injection. Check to make sure this is appropriate for peds, however. I've not given antibiotic shots to children, only vaccines.

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    I'm sure it's all fine. If you are afraid that you accidentally gave the Rocephin in a vein, rest peacefully. IV push medications have a very rapid action; almost immediate. The child wouldn't have gotten off the table before its effects hit. Plus, Rocephin is a drug that is given IV all the time, though granted not as a bolus. You're just stressing yourself out.

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    IM Rocephin should be mixed with a little lidocaine especially in kids because it burns like hell.

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    • Author

    Yes that was my main concern. Child was calm and content immediately after. I tend to stew on things when I get home from my shift and it stresses me out. Thank you for the response!

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    • Experts
    Yes that was my main concern. Child was calm and content immediately after. I tend to stew on things when I get home from my shift and it stresses me out. Thank you for the response!

    Had a feeling that you just needed a little reassurance. I've been known to stew and stress after work myself many times, guess it takes one to know one, LOL

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    I've only hit bone once in a person before and it turned out fine. That person didn't even notice and there were no undue effects as a result of me hitting bone.

    I've worked with Peds and you definitely need to review your restraining techniques. Usually I have a parent do a bear hug and then have another nurse/MA/Doctor/RT/WHATEVER stabilize the leg. I was taught to aspirate but subsequent literature and studies say that you don't have to aspirate so I don't anymore. Anybody who gives you a hard time for asking to help with restraint in a child is ridiculous. Sometimes I've even had to get a 4th person as toddlers can bring quite strong.

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    It's not as harmful as you think. When giving the vitamin K shot to a one pound baby it's easy to hit the vone and I've had our doctors say it's not harmful.

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