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Discussion

Yikes! Flu Shot!

Just recently I went to my family doctor's office to get the 2015 flu shot. The nurse injected into my arm without swabbing with alcohol. Before I could say anything, she shot my husband too. I know I should have said something, but I just left there silently with my mouth open. BUT, then a few days later I had a blood draw at another facility and mentioned to the phlebotomist that I was given a flu shot without alcohol and she said same thing happened to her at this other facility. She had the wits to ask why no alcohol and the nurse told her, "That's how we do them now, because the alcohol doesn't do anything unless your arm is visibly dirty". What do you all think?? I know shots are given like this in the UK and Australia, but this happened in Colorado. Is this the new trend?

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    I've always thought of alcohol as "show and tell". I'm under the impression that it doesn't do much unless the contact time is substantial. I haven't observed any trend to stop using it, though.

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    You are lucky that they used a different syringe and needle for each of you. Unless...

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    We very much so I use alcohol- on patients and staff alike! The friction is important with alcohol wipes. I give a good outward circular rubbing with a moderate amount of pressure- about 15x around. Let it air dry and stab away.

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    I swab with alcohol prep pads prior to administering injections, but mostly this is done to make the patient feel more secure of my infection preventive practices. However, the efficacy of this practice is in question...

    A study on 13 people who have diabetes, found that although a five second skin preparation with alcohol swabs prior to injection reduced skin bacterial counts by over 82%, such disinfection is not necessary to prevent infection at the injection site.

    When 1,700 injections were given without an alcohol swab no infection occurred. Other studies concur with these findings and suggest that generally there was insufficient contaminating of skin to cause infection following injection.

    Another study carried out a review of best practice in relation to the prevention of injection associated infection for the World Health Organization (WHO). In association with their Safe Injection Global Network, the WHO no longer recommend swabbing clean skin with a disinfectant before giving intradermal, subcutaneous, and intramuscular needle injections.

    https://www.inmo.ie/magazinearticle/printarticle/6696

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    I swab with alcohol prep pads prior to administering injections, but mostly this is done to make the patient feel more secure of my infection preventive practices. However, the efficacy of this practice is in question...

    Yeah, I always use them on patients, but I've given myself about 53,000 SQ injections without alcohol and have never had an infection. Even when I was back country hiking and didn't take a shower for 3-4 days at a time.

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    • Expert
    Yeah, I always use them on patients, but I've given myself about 53,000 SQ injections without alcohol and have never had an infection. Even when I was back country hiking and didn't take a shower for 3-4 days at a time.
    Yep. Your point is notably salient. We've all got our unique bacterial counts and normal flora on our skin, and our own bacteria generally isn't going to harm us.

    This is one of the reasons a person can straight-cath oneself at home using nonsterile technique for many years and never develop a urinary tract infection.

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    Interesting. Wonder if that's truly their new policy or if this was just one lazy nurse. I'd definitely have asked WHY?

    I get my flu jab at employee health. They line us up like cattle and stab away.

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    I have seen people as "not visibly dirty" but I am always shocked to see what comes off after I use that alcohol pad! O_O I always cleanse my site with alcohol because that's what I was taught.

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    ^^^This! Sometimes I am shocked at how brown the alcohol pad turns after using them on someone! What the heck were you doing before you came into the hospital? Mud wrestling? Rolling around in dirt? Dirty dancing? Lil' old meemaw why are you so dirty!!??

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    An Infectious Disease doc once told me that all an alcohol wipe does is smear the normal skin flora around, and the only reason the practice has persisted is to make the civilians feel safe.

    This was 10-15 years ago.

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    I've given myself more sub q injections than I can count without using alcohol. No infection. I put my pump sites on without alcohol. I use alcohol on my pts, but really, it's so they feel comfortable with the injection being "clean". Also, I've been known to do an insulin injection through my pants as well... gross right? No infections though, 16 or so years in.

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    At my last job they stopped sending out alcohol swabs to diabetic patients unless we put in a special request. Clean skin is now thought to be enough. I still use the swab when giving a shot, but as others have said it appears this practice is losing support.

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