2 year old injection

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:eek:I am concerned. I've only been a LPN for about 5 months. I work in home health and I take care of a 2 yr old boy. He is a JOY!!! I had to give him a Synagis injection (actually 2; one in both legs). The syringe is a 1ML. In the first injection I had to give a full 1ML. It is difficult, dare I say, IMPOSSIBLE to aspirate for blood, due to the limited amount of space to aspirate in the syringe. I proceded to give the injection. The child kicked his leg, but I maintained control of the syringe, no problem. As I withdrew the needle, I noticed the site was bleeding. Not profusely, but more than I had seen in the past. The site also had a large contusion after all was said and done. This injection was only about the 8th injection that I have EVER given. I only gave 5 or so IM's during my clinicals in school. I am so worried about this, I can't sleep. I gave the injection at the end of my shift on a Friday night. I haven't yet called my supervisor to voice my concerns with her, as I'm not sure I should be concerned. Also, I know that this injection burns as it is being administered. I am administering this injection SLOWLY...should I shoot all of the liquid in all at once quickly, or am I doing this correctly to cause less pain. HELP...I have no self confidence. The agency I work for gives VERY LITTLE guidance. Does anyone have any tricks or suggestions of how I can give the injection BETTER for the child as well as the parents and I????

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Specializes in Pediatrics.

It is probably fine. I have had injections bleed a lot and bruise, ESPECIALLY with a fighter. If they contract that muscle a lot during and after the injection, you will have a bleeder. It would be very unlikely for you to hit a vessel in a 2 year old leg even with a 1 inch needle.

Why not just put the synagis in a 3mL syringe from now on so you have room to aspirate? There isn't any reason you couldn't use a different size syringe. Most likely next time his weight will go up enough that you will end up giving him two shots, because 1 mL is the max. But for other pts, if you are going to need to give an mL, I would just move up to a larger syringe size. If you are worried about measuring the amount correctly, use the 1 mL to measure and then squirt it into a 3 mL syringe to administer.

Just out of curiosity, why is he still getting synagis at 2 years? I've never had a kid quailfy for the stuff if they are 2 at the start of the season.

As for giving better injections, the more you do that faster you will get and that makes everyone happy.

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I work in a home. The Synagis supplies are shipped by the company. I would have to reqest a 3ml syringe...don't know if it is possible. But that would help SO much. I was so worried that I would get a phone call today...don't know what would happen to the kid if the injection went into his bloodstream instead of his muscle. The child gets 2 injections; 1ml in one leg and 0.84ml in the other leg. The child has cardiac problems, GI problems, and has a trach...that is why he receives Synagis after the age of 2yrs. You made me feel A LOT better. I was so worried. Does every nurse start out with as little clinical experience as I have? And I only received 2 DAYS worth of training from this Home Health Care company. I LOVE my job, as it's day to day is not stressful at all, but I have to wonder if I shouldn't have been more scrupulous about my first job. I never hear from them unless they ask me to work extra. I received my 90 day eval via mail. I did a SELF evaluation....and I haven't heard anything from them since. It has been 2 months since then. I go to this person's home, take care of their child....and get a check in the mail. This is definitely different than I thought nursing would be. I have to go through all my textbooks, because I am forgeting what I learned in school. It is so bad, I couldn't even remember the medical term for 'BRUISE'....AAAAHHHH!!!! But I LOVE what I am doing, and, of course I LOVE my client...such a SWEET child and a JOY to work/play with. Thanks again!!!

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Specializes in Home Health.

Contusions are normal when they kick and fight you. I would change my syringe so that I could aspirate. Don't worry he should be fine.I (office setting) note everything in the chart and (depending on the contusion size) call the parent the next day and check on the pt. It eases my mind so I won't feel so bad. Also, the syringe should change as the dosage increases...at least when I was giving it the company would change the size due to the increased dosage.

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I did a stint in a vaccine/healthy kid clinic in the Philippines. Gave hundreds of kids jabs, and I started to realize the hardest ones were the 2 year olds. Some are relatively big and strong, and cannot be verbally controlled yet. You just clamp the leg down, get it in, aspirate and push. We always had the mother holding the kid on her lap, with the legs in between the mothers legs. I can spot a kicker a mile off. There were some abcesses back at the clinic (not my doing, but it is pretty easy to see how). There is not a lot you can really do about it. I figure you get about 1/50 that you might suspect some tissue trauma, advanced soreness, etc. Warm compress and some baby tylenol generally does the trick.

There is probably a pocket of young Filipinos traumatized about the friendly Americano who smiled one second, and stuck syringes into their VL and deltiods the next!! I probabably irreperably set back international relations in this area for a generation!! I jest of course. But seriously.

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