IM injection checking for blood

[Daniellekai]

My doctor, when showing me to do injections, didn't tell me to pull the syringe back and check for blood, so the question is, if I follow the instructions as given, what horrible thing could happen?

Just after reading up about safety it always says to do that...

[KayXo]

I never did and I did about 100-200 injections on my own. Before that, none of the nurses who did my injections would do it either and when they taught me, they told me it was not absolutely necessary.

[RobynTx]

It's something that is supposed to be done to make sure the needle wasn't inserted into an artery or a vein.  Most injection sites that isn't an issue. 

It is an important step for someone taking a test to get qualified for doing IM injections.  I do the drawback when I do IM injections on patients but that is because most of the time I am training others to do it.

[Laurie]

I have been giving myself insulin injections for a couple years now and have always done the check as taught. I have drawn blood only a few times. When I do I poke another hole elsewhere.

Hugs,
   Laurie

[ainsley]

I was a hospital corpsman in the navy, and an emergency medical technician and I was always taught to aspirate for blood when doing an IM injection.  I simply cannot skip it because it is so ingrained in me to do it. lol

However, even this clinical study's recommendations are mixed:
https://www.ncbi.nlm.nih.gov/pubmed/25784149

The World Health Organization and Centers for Disease Control and Prevention no longer recommend aspiration during intramuscular (IM) injections. The purpose of this study was to investigate the technique registered nurses (RNs) use during IM injections and incidence of blood aspiration. This descriptive study surveyed 164 RNs. Results noted that 74% of the sample continue to aspirate at least 90% of the time. Of the participants who continue to aspirate, only 3% aspirate for the recommended 5 to 10 s. Forty percent reported having aspirated blood at least once, whereas 6 RNs (4%) noted blood aspiration ≥13 times. Blood aspiration occurred most frequently in the dorsal gluteal (15%) and deltoid (12%). Based on the findings, it is recommended that RNs use a decision-making process to select the safest technique for IM injections.  If a parental medication has different administration rates, dose, viscosity, or other concerns when given IM versus intravenously (IV), aspiration during IM administration should be implemented.

Emphasis mine.

I guess it is up to you, but the basic gist is that there are not large vessels in the typical IM injection sites, so it is not indicated to aspirate.  I do mine in my thigh.  I always aspirate.  Up to you and your situation, I guess.

[Daniellekai]

I'm a bit squeamish about the idea of drawing fluid from myself, took enough to get to jabbing needle in, sounds like it's "best practice" though.

[Rachel]

I inject in the thigh. Last time I injected 10 days ago I aspirated blood in the needle. I withdrew the needle 1/2 way and repositioned and injected. I am very glad I did. I do not know what would have happened if I injected into a vain. I have forgotten to check only a few times. I was taught to check.

[Myranda]

Well theoretically, if you also forget to check the needle for air, and then forget t oaspirate, you could give your self an embolism.

[Sydney_NYC]

Well theoretically, if you also forget to check the needle for air, and then forget t oaspirate, you could give your self an embolism.

I was talking to the nurse that taught me how to self inject about air in the syringe causing an embolism. She said it was nothing like the movies, you need a lot of air to cause that to happen. It would take an entire IV tube full of air to cause an embolism and it would have to be in the blood stream. We are injecting into the muscle, not directly to the bloodstream anyway. So there is no possible way to cause an embolism with self injection with a 5mL syringe.

[natasha]

My dr. never said anything about "aspirating". That said though I have, on several occasions, had a good amount of bleeding after an injection (must have bandaids ready ). On these occasions it also results in a pretty good bruise. I asked my dr. about it and he (and his assistant) showed absolutely no concern.

As far as "air bubbles" go, I also was told not to worry much about it. But I do my best to minimize as many bubbles as possible.

[Rachel]

I was told a small bubble is not an issue.

I had three times when injecting a good amount of blood came out. Not concerning, I just add pressure for a few seconds and that stops it.

[Jessica Lynne]

over 60 injections, I've never pulled the plunger back to find blood. You're okay. If you weren't, you wouldn't have been typing this..lol

[SadieBlake]

A year and a half injecting weekly and I think I've pulled back on the plunger maybe 3 times. I figured the worst thing that can happen would I'd get a big spike in E if I did hit a small vein and then finish the week at low E and probably in fact never notice it.

I inject into my quad and find it hard to hold the needle steady for the pull-back, can't even vaguely see how I'd do it if I were going into the glutes.

I've read that it's now considered equally effective to inject E subcutaneously and that that results in much slower absorbtion so maybe it would be a more stable way to dose but having gotten the hang of doing it IM, I'm staying with this for now.