The Who? ... as in, the band? lol

Quote from: kestin on April 09, 2009, 10:59:09 PM
The Who? ... as in, the band? lol

as in, the World Health Organization.

I think this is a case where using the acronym makes it more complicated lol and more awesome.

Quote from: Mister on April 09, 2009, 05:25:08 PM
The WHO put out a statement years ago that aspiration is pointless on an IM injection.

I'm not sure that WHO can make a valid assessment. I'd rather have full studies (which I've been trying to find) by medical research (ideally with more than 25 subjects) to determine whether it's valid or not.

That said, I think the reality is we all have to be careful when doing the injections and we should be regularly rotating (I do agree with the OP on that point). Following instructions by your physician/nurse and learning how to do it as they recommend is the best practice.

Added after quick search: aspiration for intramuscular injections seems to be especially important for younger patients (infants, children, young teens) but seems optional. The biggest risk is to avoid airbubbles and other potential blood clotting issues (these can result in heart attacks, strokes, etc.) As an additional advice (take it as you will), it's recommended to massage the muscle after doing the injection (this might lessen pain and help spread the T.

I'm not sure that WHO can make a valid assessment.

Because they aren't the global medical authority?  If not them, who?

Anyone have a link to where WHO said so? Cause otherwise, it's kind of a pointless argument to debate.

Quote from: Miniar on April 10, 2009, 10:14:23 AM
Anyone have a link to where WHO said so? Cause otherwise, it's kind of a pointless argument to debate.

Their site is massive (and justifiably so) so it's a pain in the ass to search, but I found this.  Viewing the journal online requires database access that is typically only available for a fee or through an academic library.

Injection technique for immunisation. By: Diggle L, Practice Nurse, 09536612, January 12, 2007, Vol. 33, Issue 1
"OUTDATED PROCEDURES
Cleaning the skin with an alcohol wipe before an injection continues to be practised yet is not necessary. Although isopropyl alcohol will reduce the number of bacteria on the skin, research has demonstrated that this makes little difference to the incidence of bacterial infections after injection.( n3, n4) Current advice is that if the skin at the injection site is dirty, simply washing with soap and water is adequate.( n5)
Another outdated procedure is aspirating immediately before injection.( n5, n6) For decades, nurses have drawn back on the syringe plunger before an intramuscular or subcutaneous injection to ensure the needle is not sited within a blood vessel. In a 1930s medical journal article, it was suggested that one could mistakenly enter a vein when administering large doses of penicillin. Although critics argued that depositing vaccine in a vein when injecting at a 45° or 90° angle was almost impossible, the procedure of aspirating became widely accepted.
There is no scientific evidence to support aspiration before injecting a vaccine. Consequently, the World Health Organization (WHO), the American Academy of Pediatrics and the Department of Health have stated that this practice, which serves only to prolong the injection procedure, is not necessary."

Quote from: Mister on April 10, 2009, 10:19:09 AM
Their site is massive (and justifiably so) so it's a pain in the ass to search, but I found this.  Viewing the journal online requires database access that is typically only available for a fee or through an academic library.

Injection technique for immunisation. By: Diggle L, Practice Nurse, 09536612, January 12, 2007, Vol. 33, Issue 1
"OUTDATED PROCEDURES
Cleaning the skin with an alcohol wipe before an injection continues to be practised yet is not necessary. Although isopropyl alcohol will reduce the number of bacteria on the skin, research has demonstrated that this makes little difference to the incidence of bacterial infections after injection.( n3, n4) Current advice is that if the skin at the injection site is dirty, simply washing with soap and water is adequate.( n5)
Another outdated procedure is aspirating immediately before injection.( n5, n6) For decades, nurses have drawn back on the syringe plunger before an intramuscular or subcutaneous injection to ensure the needle is not sited within a blood vessel. In a 1930s medical journal article, it was suggested that one could mistakenly enter a vein when administering large doses of penicillin. Although critics argued that depositing vaccine in a vein when injecting at a 45° or 90° angle was almost impossible, the procedure of aspirating became widely accepted.
There is no scientific evidence to support aspiration before injecting a vaccine. Consequently, the World Health Organization (WHO), the American Academy of Pediatrics and the Department of Health have stated that this practice, which serves only to prolong the injection procedure, is not necessary."

Interesting. It's not WHO explicitly but rather a journal article. And refers specifically to vaccine injection into a vein. I wonder why the angle makes a difference? Since a vein is a pathway for blood (unless you puncture through it) if the tip is in the vein, wouldn't it enter the blood stream?

The angle is probably a factor because if you are perpendicular to a vessel wall and inject, the pressure of injection seems much more likely to burst the wall than if you are running the needle within the wall.

like i said, the WHO site is huge and basically unsearchable for a layperson, but have at it.  i've seen it before, just can't find it again.