Thread: Injecting - Aspiration

I aspirated 99% of the time just to be safe. Yeah an air bubble will enter the syringe if no vein is hit

When doing an IM injection, just pull back slightly on the plunger. If you are in a muscle, you will see a small air bubble pull up into the barrel. You probably won't have to pull back very much. If you hit blood, then pull out and inject at another site.

Not sure on the SQ injection as I've never done one, but I wouldn't think you would need to aspirate. Fatty tissue doesn't have near the blood supply that skeletal muscle tissue does. But I would bet someone more experienced will be along to answer shortly.

Kudos on trying to figure this out before you start

Originally Posted by KJohnT

Noob questions on injecting:

I've read many places to aspirate prior to injecting the oil into a muscle. In fact, I've read to aspirate when doing a sub-q injection with hCG. I've also read there is no need to aspirate at all. So what is the deal here? Yay or nay?

Also, I don't understand how it works. If I understand correctly, one pulls back the plunger of the syringe very slightly to see if blood enters the syringe? I don't understand the alternative... given that a good location is found inside of the muscle tissue and a vein is not hit, doesn't blood still come into the syringe if the plunger is pulled back? What else would come up into the syringe? Air?

How much does one pull back the plunger to aspirate?

Like I said, noob questions; I've yet to inject and I must be certain I understand exactly how it is supposed to be done. Thanks fellas.

Yes, you should ALWAYS aspirate...

Air can cause death via blocking blood flow...This is why you aspirate.

As for oils...I hear it feels like death for about 5 minutes and you recover slowly...

Maybe this will help you out...

How to inject anabolic steroids, intramuscular injection

It gives directions on how to find the right spot in your glutes, thighs & deltoids...It also tells you HOW to inject properly...

Good luck to you and stay safe...

You'll find some on here that do aspirate and some don't...

I tried both ways and aspirate some times, but I don't aspirate if it is hard for me to do so (location)...blood will not come out if your in the muscle tissue and if you try to aspirate and its hard to...like the syringe has a suction per say, then your in a muscle and gtg...just push down on the plunger.

You only have to pull back a little, just enough to see the rubber on the bottom of the plunger..maybe like a few ticks up on the syringe

No need to aspirate hcg at all...just make sure your in the fatty tissue at a 45 degree angle and just inject.

Sub-Q...no aspiration
IM...aspirate.

As far as "injecting air" into a vein and killing yourself, you would need a lot (10mL+). Don't quote me, I read this or was told by a professor.

Numerous times, prefilled syringes of meds always have bubbles. Even experienced "amp and vial-drawers" still get air into the syringe. I have seen it more times than once. You aspirate because you don't want go inject the "med" into a vein. You have to let the oil get absorb slowly into your muscle. That's why the shit hurts sometimes or when you get IM flu shots, it's sore for a few days.

I have replied here a few times before about proper injection techniques and ways to prevent the "aftershot" soreness....I'm just to tired to link them right now.

Originally Posted by djlance

.....

As far as "injecting air" into a vein and killing yourself, you would need a lot (10mL+). Don't quote me, I read this or was told by a professor. ...

It will take more than just a small bubble of air to hurt you but even 1ml or 2mL is enough to be dangerous. It of course will depend on many things that cannot be covered fully in a forum. The best rule of thumb is not to inject any air into a vein.

every study I've read says injecting oil will not be fatal unless it's a pretty large amount, more than you're going to inject. Plus many people say the small blood vessels you're likely to run into will collapse if you push oil into them, and by aspirating you move the pin more than the thickness of a vessel anyway. I still aspirate though I really don't know why as I'm convinced it's safe not to, doctors aren't even tought to aspirate for IM injections anymore. Anyway it only takes a little pressure on the plunger, one finger is enough. I've aspirated a tiny bit of blood one time, and the plunger pulled out very easy. If it takes more pressure than that or if you see a small bubble form then you're g2g.

Originally Posted by hypno

It will take more than just a small bubble of air to hurt you but even 1ml or 2mL is enough to be dangerous. It of course will depend on many things that cannot be covered fully in a forum. The best rule of thumb is not to inject any air into a vein.

Oh I don't disagree with you one bit. They drill that into our heads (health care field) about getting as much air our of the syringe as possible.

Basic rule is...don't inject air...period!

Aspirating, is old school. They don't even teach RNs to aspirate any more. Don't agree? Just ask the CDC, ACIP, DHS, AAFP, DOH, or the WHO. For them to say so, it holds water. I never aspirate, and have been using AAS for almost a dozen years. Even with SQ injections.

The EBP and ACIP also do not recommend aspiration. Some argue not to aspirate vaccines, but to aspirate other drugs. Jet injections are not aspirated though. I know many who have been using AAS ED for many many years who have yet to aspirate. Read on...

According to the CDC they state-

"Aspiration - Aspiration is the process of pulling back on the plunger of the syringe prior to injection to ensure that the medication is not injected into a blood vessel. Although this practice is advocated by some experts, the procedure is not required because no large blood vessels exist at the recommended injection sites."

"Aspiration is not indicated for SC injections of vaccines, immunizations and insulin."

"Aspiration is not indicated for IM injections of vaccines and immunizations."

STTI International Nursing Research Congress Vancouver, July 2009


Organizations which state aspiration is not necessary:


Centers for Disease Control (CDC)
Advisory Committee on Immunization Practices (ACIP)
Department of Health Services (DHS)
American Academy of Family Physicians (AAFP)
U.K. Department of Health (DoH)
World Health Organization (WHO)


References:

1. Atkinson, W. L., Pickering, L. K., Schwartz, B., Weniger, B. G., Iskander, J. K., & Watson, J. C. (2002). General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP). Morbidity and Mortality Weekly Report, 51, RR2. 1-33.

2. Chiodini, J. (2001). Best practice in vaccine administration. Nursing Standard, 16(7), 35-38.

3. Diggle, L. (2007). Injection technique for immunization. Practice Nurse, 33(1), 34-37.

4. Gammel, J. A. (1927). Arterial embolism: an unusual complication following the intramuscular administration of bismuth. Journal of the American Medical Association, 88, 998-1000.

5. Ipp, M., Taddio, A., Sam, J., Goldbach, M., & Parkin, P. C. (2007). Vaccine related pain: randomized controlled trial of two injection technique Archives of Disease in Childhood,92,1105-1108.

6. Li, J.T., Lockey, R. F., Bernstein, I. L., Portnoy, J. M., & Nicklas, R. A. (2003). Allergen immunotherapy: A practice parameter. Annuals of Allergy, Asthma, & Immunology, 1-40.

7. Livermore, P. (2003). Teaching home administration of sub-cutaneous methotrexate. Paediatric Nursing, 15(3), 28-32.

8. Middleton, D. B., Zimmerman, R. K., & Mitchell, K. B. (2003). Vaccine schedules and procedures, 2003. The Journal of Family Practice, 52(1), S36-S46.

9. Nicoli, L. H., & Hesby, A. (2002). Intramuscular injection: An integrative research review and guidelines for evidence-based practice. Applied Nursing Research,16(2), 149-162.

10. Ozel, A., Yavuz, H., & Erkul, I. (1995). Gangrene after penicillin injection: A case report. The Turkish Journal of Pediatrics, 37(1), 567-71.

11. Peragallo-Dittko, V. (1995). Aspiration of the subcutaneous insulin injection: Clinical evaluation of needle size and amount of subcutaneous fat. The Diabetes Educator, 21(4), 291-296.

12. Roger, M. A., & King, L. (2000). Drawing up and administering intramuscular injections: A review of the literature. Journal of Advanced Nursing, 31(3), 574-582.

13. Talbert, J. L., Haslam, R. H. & Haller, J. A. (1967). Gangrene of the foot following intramuscular injection in the lateral thigh: A case report with recommendations for prevention. The Journal of Pediatrics, 70(1), 110-114.

14. Workman, B. (1999). Safe injection techniques. Nursing Standard, 13 (39), 47-53.

15. World Health Organization (2004). Immunization in Practice, Module 6: Holding an immunization session. Immunization in Practice: A practical resource guide for health workers –2004 update,1-29.

16. Center for Nursing History at Misericordia University: http://www.misericordia.edu17. Levels of Evidence, Canadian Medical Association & Centre for Evidence-Based Medicine (2001). Available at:http://www.cebm.net/index18. Melnyk, B. M., & Fineout-Overholt, E. (2005). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice. Philadelphia: Lippincott, Williams & Wilkins.



/V

Check this older thread out, you will see some more responses from other vets.

Hard to Aspirate..?


/V

No need at all to aspirate for subcutaneous. Intramuscular you can if you want to, but most medical personnel and healthcare provides don't even do it nowadays, so you're safe leaving it out if you know how to do a proper injection.

Originally Posted by VictorZ06

Aspirating, is old school. They don't even teach RNs to aspirate any more. Don't agree? Just ask the CDC, ACIP, DHS, AAFP, DOH, or the WHO. For them to say so, it holds water. I never aspirate, and have been using AAS for almost a dozen years. Even with SQ injections.

/V

Very true V. I have seen this first hand. Nursing is focusing a lot more of evidenced-based research to justify what we do instead of the "that's the way we did it for years!" method....

honestly bro its 50/50 on this site do w.e. makes u conterable simple and plain. if u feel safer aspirating then do it. if it doesnt make a difference to u then shoot the shit up. u wont get a clear anser and everyone from both sides has valid points

Originally Posted by sofargone561

u wont get a clear anser

I'm not sure how much clearer I can get. Health and drug administrations and organizations from all over the world no longer condone aspirating....

Centers for Disease Control (CDC)
Advisory Committee on Immunization Practices (ACIP)
Department of Health Services (DHS)
American Academy of Family Physicians (AAFP)
U.K. Department of Health (DoH)
World Health Organization (WHO)

Aside from the organizations above, where would one find a clearer answer? Who would know better than them? I've never had a doctor aspirate an injection on me....never. But hey, if aspirating makes you feel better...by all means, ignore the current updated medicinal science and do what you want to do. To each his own.


/V

Originally Posted by VictorZ06

I'm not sure how much clearer I can get. Health and drug administrations and organizations from all over the world no longer condone aspirating....

Centers for Disease Control (CDC)
Advisory Committee on Immunization Practices (ACIP)
Department of Health Services (DHS)
American Academy of Family Physicians (AAFP)
U.K. Department of Health (DoH)
World Health Organization (WHO)

Aside from the organizations above, where would one find a clearer answer? Who would know better than them? I've never had a doctor aspirate an injection on me....never. But hey, if aspirating makes you feel better...by all means, ignore the current updated medicinal science and do what you want to do. To each his own.


/V

no no i didnt mean it like that i should have reprashed it.. i ment like you one get one solid answer everyone has different views opinions or even medical or profesional experaqicne thats why im saying do what makes you comterable. ive read both sides of the argument and i agree with many things from both sides

edit: i cant reemeber ever having a doctor aspirate on me if that helps at all... i spend the last year and a half on a military base and a lot of that was spent in germanyt before i went i got a whole bunch of shots and shit and not once did he aspirate.. if that helps in anyones answer.. im no expert im here learning just as much as everyone else

I usually don't aspirate and I've never had a problem. That being said, if I have a bad feeling or an injection hurts more than normal I will aspirate. As long as you are injecting in the proper locations you should have nothing to worry about. The deltoid rectangle, upper-outer glute quadrant, and posterior quad. They are chosen for a reason because they contain the least amount of nerves and blood vessels. Not to mention that the vessels are so small you will usually pin right through them. This is also why sometimes your injection site will bleed, and sometimes it will barely bleed or not at all.

aspirating is not necessary except at the dorsoglute (glute) site since you run a greater risk of hitting a major artery.

current recommendations are to not aspirate, but also to not inject in the dorsoglute (most dangerous of all recommended injection sites) and use the ventroglute (hip) instead when possible.

so if you inject in your ass aim for upper outer and aspirate.. otherwise no need.

Originally Posted by ooa4oo

aspirating is not necessary except at the dorsoglute (glute) site since you run a greater risk of hitting a major artery.

current recommendations are to not aspirate, but also to not inject in the dorsoglute (most dangerous of all recommended injection sites) and use the ventroglute (hip) instead when possible.

so if you inject in your ass aim for upper outer and aspirate.. otherwise no need.

glute is rly the most dangorous area?

yea.. gluteal artery and sciatic nerve.. updated textbooks are recommending nurses not poke there.

but for running cycles its probably easy to include the glute and aspirate since you're poking yourself so often especially with large volumes. i've only injected glute and ventroglute so far and they were both easy.
but ventroglute by far is the best. did not feel anything and there is zero PIP

all this info makes me more nervous lmao

lol no..
think of how many injections have been given in the dorsoglute... especially in the past.. compared to the number of lawsuits over sciatic nerve. risk but really low risk.
if you want to be safe the 3 most common spots in clinical are ventroglute quads and shoulder.. way more than enough since you're gonna run enth too right?

Originally Posted by ooa4oo

lol no..
think of how many injections have been given in the dorsoglute... especially in the past.. compared to the number of lawsuits over sciatic nerve. risk but really low risk.
if you want to be safe the 3 most common spots in clinical are ventroglute quads and shoulder.. way more than enough since your gonna run enth too right?

ya enth and only 250mg x2 weekly no other injections... i got a 1 and 1/2 inch needles tho isnt that way to big for shoulders? im not nearly as big as some of you guys lmao idk why but quads freak me out.

don't need to go all the way in with the needle.
or you also have your insulin pins for the hcg too you can use.

Originally Posted by ooa4oo

don't need to go all the way in with the needle.
or you also have your insulin pins for the hcg too you can use.

i already have these pins tho im not looking to buy more ive spent enough money so far lmao. maybe next time around. how far should i go in then? spot injections.com is nice but i would rly like some videos... any sites with videos?

actually nvm too much volume for ur shoulder prolli :x
you should be good with glute, ventroglute, and quads.
or even just 2 of those 3.
hm iono i didn't use vids

for your butt and legs you can go in almost all the way but leave a bit of the needle exposed so you can pull it out in case it breaks or some random mishap

Originally Posted by ooa4oo

actually nvm too much volume for ur shoulder prolli :x
you should be good with glute, ventroglute, and quads.
or even just 2 of those 3.
hm iono i didn't use vids

i no a lot of epople dont use videos ive just never injected anything b4 and not the biggest fan of needles i just want to make sure i dont fuck myself up!