To aspirate or not to aspirate

[Inquisitive one]

Do you aspirate for blood when you give an insulin sub q injection? What are the pros and cons? My facility bases it's policy on our pharmacy's policy, which is TO aspirate. None of the nursing schools in the area teach this and some of our new nurses are having difficulty remembering to do this. What have you been taught? Thanks.

[Spidey's mom, ADN, BSN, RN]

I've never aspirated for insulin or for any other SC medication. I just did some research and found this study (its old...1989)

http://www.nursinglibrary.org/Portal/main.aspx?pageid=4024&sid=3698

Their research showed that aspiration is "not a reliable indicator of correct needle placement." Not sure if their are other studies out there or not but my (old) clinical skills book from nursing school recommends to NOT aspirate with SC insulin or heparin citing a study done in 1995 by Ross and Soltes and 1997 by the ADA.

This article from the ADA states that aspiration is not necessary.

http://care.diabetesjournals.org/cgi/content/full/26/suppl_1/s121

Injection procedures

Injections are made into the subcutaneous tissue. Most individuals are able to lightly grasp a fold of skin, release the pinch, then inject at a 90° angle. Thin individuals or children can use short needles or may need to pinch the skin and inject at a 45° angle to avoid intramuscular injection, especially in the thigh area. Routine aspiration (drawing back on the injected syringe to check for blood) is not necessary. Particularly with the use of insulin pens, the needle should be embedded within the skin for 5 s after complete depression of the plunger to ensure complete delivery of the insulin dose.

That is my understanding as well. Anyone have anything current that says otherwise?

steph

[leslie :-D]

i found this link from abbott diabetes care.

it's a long link to type out...hope it works.

http://www.abbottdiabetescare.com/adc_dotcom/url/questionAnswerProfile/en_us/40.20:20/question_answer/QuestionAnswer_00011.htm

and i have never aspirated either.

leslie

[leslie :-D]

ok, the link didn't work.

http://www.abbottdiabetescare.com/

if you type "aspirate" in the search box, it will yield one result.

click on the blue typed "insulin".

it is the 14th question down.

question: "injecting insulin-aspirate?"

anyway, the answer is there.

no, you do not aspirate.

and the q/a is from 3/06.

leslie

[bigsyis]

Hmmm. I haven't given any in a couple of years, but it is good to know what is considered correct now.

We were taught not to aspirate when giving Heparin (and Lovenox, later), but always to aspirate when giving insulin.

[Larry in Florida]

Do you aspirate for blood when you give an insulin sub q injection? What are the pros and cons? My facility bases it's policy on our pharmacy's policy, which is TO aspirate. None of the nursing schools in the area teach this and some of our new nurses are having difficulty remembering to do this. What have you been taught? Thanks.

You do not aspirate when giving insulin SQ.

Larry RN in Florida