To aspirate or not to aspirate?!

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I work at a Peds office and I am constantly administering immunizations (lucky me)! I am a recent new grad, and remember being taught to aspirate, however I have noticed very few nurses who actually do this. I am continuing to aspirate because I figure it's what I was taught in school, however, when my kindergardeners are screaming, kicking, and fighting the 4 shots I need to give them I begin to question, do I really NEED to be doing this?! Im curious to hear what everyone thinks...

mlok

99 Posts

Aspirate. Do what you were taught.

Better safe than sorry.

A couple extra seconds of screaming isn't going to hurt anymore than it already does.

CECE,RN

66 Posts

I am a new graduate also and we were taught to aspirate with IM injections, just as you were. I feel like we should always aspirate although the odds of you ending up smack dab in the middle of a vein is very small. But what if you are that one unlucky person that just happens to inject into a vessel. :cry: Just consider the complications versus the one second it takes to aspirate and do what is comfortable for you. FYI: the CDC does not think it is necessary to aspirate with vaccinations. :twocents:

nursel56

7,045 Posts

Specializes in Peds/outpatient FP,derm,allergy/private duty. Has 47 years experience.

One of my previous jobs, giving injections for a multi-specialty clinic-- I always took the time to aspirate even though I never got a blood return. The "what-if" question in my mind just never went away. I always felt that the most important factor was to make sure the child is properly restrained- I wouldn't give a shot to a child who is kicking and flailing around. Screaming, yeah, well they get to do that!!!

Specializes in Cardiac, ER. Has 18 years experience.

I've been giving injections for over 15yrs. I too, was taught to aspirate,.and I do. A few months ago I was having some of the same thoughts you are having,...why? is it really necessary? In all the years I've been giving IM injections I've never aspirated blood,..so why waste the time?

WELL,....not long ago,...3am,.busy ER,.crazy psych pt,..6 staff members and security holding this crazy woman down (perfect time to skip the aspirate I thought),...gave a B52 to the thigh,..I did aspirate out of habit,..I got an nice strong return of blood! First and only time it ever happened in all these years! ASPIRATE!

BabyLady, BSN, RN

2,300 Posts

Specializes in NICU, Post-partum.

All you need to do is ask yourself ONE question:

What happens to the child if you inject the immunization into a vein?

I am a new grad, I aspirate...no matter what, unless the protocol doesn't call for it. Nurses that don't are playing Russian roulette with that patient. Yes, the chances are low that you'll hit a vein, however, it only takes one time to cause significant damage to your patient.

nrsang97, BSN, RN

2,602 Posts

Specializes in Neuro ICU and Med Surg. Has 22 years experience.

I too was taught to aspirate and I still do.

Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU. Has 19 years experience.

Always always always always ASPIRATE!!!!!!!!! 18 years of IM injections here---it is inevitable you will hit a vascular area and the last thing you want is to kill somebody.

lerabelle

34 Posts

Specializes in office&hospital(med-surg). Has 14 years experience.

I agreee......ASPIRATE! I've been a LPN for 13 years and I always aspirate. In the 13 years I have hit a vein once. So the odds are low but it can happen.

lisamc1RN, LPN

943 Posts

Specializes in LTC/Behavioral/ Hospice. Has 4 years experience.

It only takes an extra second to aspirate. I give IM's a lot and even when a resident is combative, I aspirate.

Specializes in Vascular, Neurosurgery, Urology.

Always aspirate!!!!!!!

Think of the worst case scenario. How would you explain yourself if you accidentally went into a vein and there was some sort of complication because of this? That you didn't do what you were suppose to do?

And, I once got a tetanus shot and the nurse that was giving it to me aspirated blood so it does happen. :nurse:

Jules A, MSN

8,863 Posts

Specializes in Family Nurse Practitioner.

While I'd agree that it is a safe practice I find it hard to believe that someone is going to be successful in hiting an actual vein and would guess that instead it is just knicking a small blood vessel. In any event in psych it becomes more of a priority to get it in the kicking, swinging, biting, spitting patient rather than in one of my staff or myself so aspiration is often not an option. :(

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