Yikes! Flu Shot!

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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?

Specializes in Outpatient/Clinic, ClinDoc.

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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Specializes in Nurse Leader specializing in Labor & Delivery.
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.

I remember once being in the breakroom at work, and another nurse, who I had no idea had DM, was sitting in a chair with her lunch, and she got out an insulin syringe, and without missing a beat in her conversation, injected it into her thigh right through her scrub pants. I remember thinking "wow, I had no idea you could do that."

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Specializes in HH, Peds, Rehab, Clinical.

OP, are you a nurse? Chances are that the person who gave you your injection isn't! We don't use alcohol before a blood glucose finger stick, does that shock you?

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Specializes in Hospice.
OP, are you a nurse? Chances are that the person who gave you your injection isn't! We don't use alcohol before a blood glucose finger stick, does that shock you?

My husband still does, but he's old and I can't break him of the habit.

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30+ years ago in nursing school, one of our clinical instructors used to impress upon us the limited value of isopropyl alcohol as an antibacterial agent by telling us that, if we were going to clean something (injection or venipuncture site, wound, whatever) with just alcohol (no Betadine or anything ...), "you might as well just spit on it and be done!" (I've never forgotten that -- I can still hear her voice when I think about it, haha). I always swab with an alcohol swab just, as already noted, to reassure the members of the general public who expect me to do so, but I also know better than to have any great faith in alcohol as a cleansing agent.

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Specializes in Nurse Leader specializing in Labor & Delivery.
30+ years ago in nursing school, one of our clinical instructors used to impress upon us the limited value of isopropyl alcohol as an antibacterial agent by telling us that, if we were going to clean something (injection or venipuncture site, wound, whatever) with just alcohol (no Betadine or anything ...), "you might as well just spit on it and be done!" (I've never forgotten that -- I can still hear her voice when I think about it, haha). I always swab with an alcohol swab just, as already noted, to reassure the members of the general public who expect me to do so, but I also know better than to have any great faith in alcohol as a cleansing agent.

With that in mind, why do waterless hand sanitizers work? The active ingredient in foam/gel hand sanitizers is alcohol.

According to this link, alcohol (ethyl or isopropyl) is a very effective antiseptic/bactericidal:

CDC - Disinfection & Sterilization Guideline:Disinfection - HICPAC

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I worked my first flu clinic (as a senior nursing student) last week. In prep for it we did the "Just in time" training. I also did a CE unit from the CDC for flu vaccinations. Both of these recommend swabbing with alcohol first and allowing to dry completely before giving the vaccine.

I was also instructed to expel the air from pre-filled doses after attaching the needle and before removing the cap. I don't recall seeing anything about this in either of the training modules mentioned above.

Thoughts on this? Are there risks associated with giving the pre-filled dose with air still in the syringe? I'm off to research it now.

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I don't think we should give the air bubble. It's just there to protect the small dose in the vial from prematurely ejecting!😀shoot out the air 1st. It probably hurts more if injected.

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After a brief search, I don't see anything one way or the other regarding expelling air before administration. I read through the manufacturers info for the particular vaccine I received today and also found nothing.

I will say that, personally, I was unhappy that I was given the vaccine before the alcohol dried and without the air being expelled. It hurt much worse than previous vaccines. Ugh!

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Specializes in HH, Peds, Rehab, Clinical.

I don't expel the air, nor was it expelled from the one I received. I felt absolutely nothing and everyone I've given one to has said "that's the best flu shot I've ever gotten, I'm having you do mine every year!"

Purely anecdotal!

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I'll have to ask my instructor why she wants us to expel the air. Like I said, I could find no data to support doing so.

Looking at my arm today, maybe the reason the injection was more painful was due to the location? It was given pretty high up in an attempt to avoid injecting in a tattoo. (which is also not a practice supported by the current data)

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Specializes in Behavioral Health.

I did some searching. A public health document from the UK suggests the air bubble creates a temporary air lock the prevents the vaccine from leaking out of the needle track, reducing discomfort. It's a PDF, which Android is weird about, so this link may not work.

These fine folks say:

Some single-dose manufacturer-filled vaccines come with an air pocket in the syringe chamber. Do we need to expel the air pocket before vaccinating?

No. You do not need to expel the air pocket. The air will be absorbed. This is not true for syringes that you fill yourself; you should expel air bubbles from these syringes prior to vaccination to the extent that you can do so.

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