To aspirate or not to aspirate?!

[RNStephNicole]

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...

[BabyLady, BSN, RN]

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 tetorifice shot and the nurse that was giving it to me aspirated blood so it does happen.

Second injection I ever gave in nursing school was Phenergan.

I aspirated and got a huge flash of blood.

Could have been nasty!!!!

[Bobylon]

Chiming in with the aspirate crowd - takes next to no time, and the knowledge that you haven't hit a blood vessel is priceless. Was taught that way, will always do it that way - no good argument exists for skipping the step, as it takes moments, in the scheme of things.

[NotFlo]

Does anyone know exactly what will happen if an immunization of injected directly into a vein?

[PostOpPrincess, BSN, RN]

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.

I have hit a vein. It CAN happen. Hopefully it doesn't happen to you. While I would like to believe that you're probably pretty darn good at giving these injections, you are making assumptions that it won't happen to you.

That is dangerous thinking.

[moz]

Aspirate.

I've been a nurse for 16 years and 1 time only aspirated blood, and that was on a newborn.

[stephanienicole87]

I do aspirate all IM's I give which are not very much these days. I was curious if any SUB Q injections could go into a vein?

[RNStephNicole]

Thanks so much everyone. I will continue to aspirate! I didn't clarify before that I was specifically talking about IM immunizations, not IM injections in general. I have also heard that the CDC says it's not necessary to aspirate for immunizations, but I wasn't sure if it was true or not.

[fiveofpeep]

I worked in an imz clinic this semester and my instructor said that the only problem with hitting a vessel would be that you wouldnt have the localized inflammatory reaction necessary to initiate the antibody production so the imz would be ineffective.

if they're gonna have respiratory difficulty and anaphylaxis, they'll have it regardless of it was in the vein or not

just what I heard though...I havent looked it up

[nursel56]

Even if the CDC has said it's not necessary, I'm just a tad too OCD to let it go at that. It does seem like long odds that you would be in a blood vessel large enough to essentially be giving an IM med IV, but I still feel better doing it.

[laurenproemsey]

Thank you for asking this question. As a nursing student, I sometimes find myself wondering...ok, I was TAUGHT to do this, but do I really NEED to when I get out there in the real world? It's great to see everyone's feedback on questions like this one.

[CountyRat]

aspirate. this is a first principle issue. aspirating might protect the patient from harm, so do it. in 28 years of nursing i have hit red pipes two times. that is very few, and, injecting into a vein might not hurt the patient much, depending on the medication. but why take that risk? also, there is an alternative technique for holding a syringe that lets you have both your second and third finger on the plunger (thumb and forth finger on the syringe body). makes aspirating and then injecting very fast and smooth, as if they were one motion. also makes it easier to stabilize the hand on a stuggleing child.

[BabyCatchr, ADN, ASN, RN]

Thank you for asking this question. Now I will always make sure they aspirate when giving my children their injections.