There is a current video where a nurse is training student nurses how to give injections She uses a model but tells the student nurses that the male patient is receiving a subcutaneous injection of Heperin in his abdomen and a seperate injection at the same time of Haldol in his deltoid Very interesting that the student nurses are being trained to inject Haldol in the patient's deltoid as oposed to the buttocks (the site of choice for decades)
Psychiatric patients find IM injections extremely painful and humiliating The injections irritate the muscle tissue and the patient often has difficult and pain walking for days A NP told me that all student nurses and nurses should receive these injections at least once in their own buttocks so they will know exactly what they feel likr
Nice video. Thank you. Always aspirate. It only takes a second and now your 100% positive your good. I'm glad to see you did not pinch the skin. Again Thank You.
Ty for the information.! ❤ today in clinical skills lab we learned about injections 😬😊 but, different a little like the deltoid we can give up to 3mL and larger dose we can split it.
Thank you for this! It really helped. However in the fundamentals book my school gave us (Taylor 9th ed) it says dorsogluteal isn't a recommended site anymore b/c risk of sciatic nerve damage. Is this true in all cases or is there ever a case you would/do still use that site?
@@yogik437 The dorsogluteal is good for injecting something like the antiemetic Phenergan. It's pretty caustic, so it can have a good burn for a bit. It's most comparable to repetitive bee stings for a minute or so, depending on the person of course. It's best to dilute it in saline well, which means you're injecting more fluid than typical.
Thank you! At last nurses are realizing the danger of giving IM injections in the dorsal glut and how traumatic they are to psychiatric patients After all these years people are finally listening to me Thank God!
@@thatnursingprof2661 Z-track technique is merely to prevent injected medication from leakage. U still need to ensure your medicine isn’t injected into vessels …
OSHA and CDC not recommending gloves when drawing up vaccines (proper hand hygiene prior of course). I'm a COVID vaccine vaccinator and there is a lot of confusion about this. Can you comment?
What I have read about that is they don't want people to wear the same gloves from person to person, which makes sense and we wouldn't normally do that anyway, but because they are concerned about the short supply of gloves they have made this recommendation. Health care workers should be allowed to protect themselves if there is any possibility of being exposed to blood or other body fluids (JMO)
@@thatnursingprof2661 How can a drug leak into a subcutaneous tissue when you injected it intramuscularly which is deeper than subcutaneous tissue? The vaccine should not be given intravenously because that is so dangerous, reason that aspiration is a must to do to avoid injuries to the patient. I had experienced twice to aspirate blood in my more than 3 decades of practice in nursing. I am glad I did aspirate first before injecting.
Well, there are plenty of people out there who are still hard to inject due to such an excess of adipose tissue, even with the longer needle. I mean, some are too obese for procedures and surgery even.
Respectfully, I am aware WHO advice is not to aspirate the needle and you are following their advice, what if the new advice does not make sense? The same sense to commonsense which seems to be becoming less and less common.
I get what you are saying and that is actually a very good thing for you to be questioning this because that's how change happens in nursing. It is my job to go with the most current recommendations because that is what my students will be expected to know when they get hired. I can't say " this is what they want you to do but this is what I do instead " as an educator that's inappropriate.
Thankyou for your carefully worded and balanced reply. There is always 2 sides, sometimes 3 , to the story and we all have responsibilities and obligations which may not be apparent or considered by all . Take care.
It depends. Usually you are able to do so. If they are very petite, you may not want to stick the whole needle in. You might hit bone if you do. The patient cannot feel it, but you can and it feels gross. If that happens, you just pull back on the syringe. IM's are easy.
@@thatnursingprof2661 Using the Z track method is not a substitute for aspiration. The Z track method ensures that the medication does not leak into the subcutaneous tissue. Aspiration ensures that you have not accidentally placed the needle in a vessel. If you hit a vessel, the medication could be given intravenously and this could be deadly for the patient.
@@barbarakihm2858 I was taught aspiration in school and did it for a decade so I get what you are saying but I have to teach what the current skills recommendations are. If they change again I will change accordingly.
@@barbarakihm2858 I agree with you. I am a nurse too and in my 60s. You have to use two needles when giving IMI. The first needle is to aspirate needle from the vial, otherwise, the needle will be blunt and so painful to the patient. After withdrawing from the vial, change the needle to the right needle usually gauge 23 then remove the air from the syringe before penetrating the skin deeply then pull back the plunger or aspirate to check if the needle hits a blood vessels which is very dangerous to the patient as the medication is no longer given as IMI but IVI. I am a nurse for more than 30 years and that method never changed. One of the doctors in you tube have said that the cause of injuries in Covid-19 vaccination is the needle was not aspirated when giving the vaccine.
The Word Health Organization and most foreign health services now strongly caution against giving IM injections in the buttocks because of the danger of hitting the sciatic nerve and the veins around it as well as adjacent adipose tissues For decades psychotropic medication has been given IM in the buttocks. These injections also irritate the muscle tissue sometimes for days making it difficult for the patient to even walk These injections are painful and humiliating Psychotropic patients have a deep stigma about them Unfortunately the US remains behind the rest of the world regarding the latest medical advances You mentioned the 6 rights These include the fact that a patient has the right to refuse an injection and/or to choose the injection site For decades nurses were trained to enter a patient's room saying: "The doctor has ordered: with the implication being the patient had no choice but to comply This is no longer the case and no longer flies Regarding IM injections in the buttocks Nurse I would strongly recommend that you do some research
If you hit the sciatic nerve in a butt injection you're clearly not in the good spot. Glute injections should be performed only in gluteus medius, which is far away from sciatic nerve. Apart from the fact that you can end up in a blood vessel once in a while, meaning aspiration is mandatory, the site is very convenient and not painful at all for most people
@@david-csmhaltero77 this is incorrect, when i was in nursing school, they clearly stated that gluteal injections were contraindicated, and cause more harm than good. if you have been doing injections for 20 years, and that one time you hit the sciatic nerve, you have cause harm to that one person you otherwise wouldn't have.
I noticed how aspirating doesn't seem to be done in 100% of COVID-19 vaccination shots on TV... is this proper? I've always taught students and new grads to aspirate to check if a blood vessel got hit. Doesn't this principle matter anymore? I'm curious.
Funny, no other shot in history ever needed to be aspirated. No other shot in history needed to avoid being injected into the bloodstream instead of the muscle. Sounds like they are putting out misinformation in order to blame the nurse instead of the experimental gene therapy
Even the World Health Organization now says never given an IM injection in the dorsoglutenan because of the danger of hitting the school hi attic nervethe same goes for the midglutenal What's wrong with you lady?
Don't be stupid the World Health Organization and the health services of many countries now say not to use dorsoglutenal for I M injections Psych injections given there are painful and humiliating This is the voice of experience It was terrible being forced to stand in the center of a medication room and being forced to stop my pants in front of 3 leering psychiatric technicians who laughed when the vicious mixture hit my muscle causing. great pain The muscle would continue for days=making difficult to walk THAT'S WHAT I AM TALKING ABOUT YOU JACKASS!
![[Sub Thai] APT. - ROSÉ & Bruno Mars](http://i.ytimg.com/vi/bYjhzP8x_uc/mqdefault.jpg)
I used 0.5ml for demonstration purposes because my fake skin thing leaks if I use too much, but typically IM injections in the deltoid are 1-2ml.
There is a current video where a nurse is training student nurses how to give injections
She uses a model but tells the student nurses that the male patient is receiving a subcutaneous injection of Heperin in his abdomen and a seperate injection at the same time of Haldol in his deltoid
Very interesting that the student nurses are being trained to inject Haldol in the patient's deltoid as oposed to the buttocks (the site of choice for decades)
Psychiatric patients find IM injections extremely painful and humiliating
The injections irritate the muscle tissue and the patient often has difficult and pain walking for days
A NP told me that all student nurses and nurses should receive these injections at least once in their own buttocks so they will know exactly what they feel likr
love how you always do the prelude (hand hygiene, privacy, px verification, and checks) before the demo lol helps to remember!
Please stand off to the side rather than in the middle of the board, helps out alot! Love your videos
Nice video. Thank you. Always aspirate. It only takes a second and now your 100% positive your good. I'm glad to see you did not pinch the skin. Again Thank You.
Aspiration is not recommended anymore.
@@alexxxisbatman you are wrong!!!!!!!!
@@dj5752it's true.
Ty for the information.! ❤ today in clinical skills lab we learned about injections 😬😊 but, different a little like the deltoid we can give up to 3mL and larger dose we can split it.
I like how you explain step-by-step instructions
going to give my practical exams tomorrow. Thank you so much very well explained.
Good luck!
for syringes with a safety lock, use the thumb to push out the lock for safety.
Aspirate for IM no longer required, time vs high risk. Z-Track Technique Great!
How do you know your not in a vein?
Thank you for this! It really helped. However in the fundamentals book my school gave us (Taylor 9th ed) it says dorsogluteal isn't a recommended site anymore b/c risk of sciatic nerve damage. Is this true in all cases or is there ever a case you would/do still use that site?
It is definitely the last resort choice but is still used in some cases. Remember the book is the perfect world not necessarily the real world.
@@thatnursingprof2661 thank you for clearing that up! Appreciate it
@@yogik437 The dorsogluteal is good for injecting something like the antiemetic Phenergan. It's pretty caustic, so it can have a good burn for a bit. It's most comparable to repetitive bee stings for a minute or so, depending on the person of course. It's best to dilute it in saline well, which means you're injecting more fluid than typical.
@@ItsAllAboutPerspective375 thank you! Good to know
Thank you! At last nurses are realizing the danger of giving IM injections in the dorsal glut and how traumatic they are to psychiatric patients
After all these years people are finally listening to me
Thank God!
What about the drawback to be sure you’re not in a vessel ?
Aspiration is no longer recommended as best practice. The Z track method is preferred now.
@@thatnursingprof2661 Z-track technique is merely to prevent injected medication from leakage. U still need to ensure your medicine isn’t injected into vessels …
@@drkuek and now they use retractable needles so they cannot aspirate!!!!! It seems wrong, I’m old school!
@@flygirlusa8460 i belief basic principles r still there :) it’z never wrong to aspirate ( i dont see the hurry to spend one second aspirate …. )
@@drkuek that is incorrect. Please update yourself with latest guidelines from the CDC.
Do you typically insert the needle all the way into the skin?
Pls why don’t you aspirate before giving the injection.I was taught aspirating prevent you from entering a vein.pls explain it to me.
Wow u explain so nicely. It's really helpful to me. Thanks a lot dear 😊
OSHA and CDC not recommending gloves when drawing up vaccines (proper hand hygiene prior of course). I'm a COVID vaccine vaccinator and there is a lot of confusion about this. Can you comment?
What I have read about that is they don't want people to wear the same gloves from person to person, which makes sense and we wouldn't normally do that anyway, but because they are concerned about the short supply of gloves they have made this recommendation. Health care workers should be allowed to protect themselves if there is any possibility of being exposed to blood or other body fluids (JMO)
@@thatnursingprof2661 Thank you!
Fantastically done! Thank you
We been taught different by a nurse, similar but we don't pull the skin
You didn't aspirate?
Z track is the most up to date evidence based way to perform this skill. It prevents drug leakage into the subcutaneous tissue.
@@thatnursingprof2661 How can a drug leak into a subcutaneous tissue when you injected it intramuscularly which is deeper than subcutaneous tissue? The vaccine should not be given intravenously because that is so dangerous, reason that aspiration is a must to do to avoid injuries to the patient. I had experienced twice to aspirate blood in my more than 3 decades of practice in nursing. I am glad I did aspirate first before injecting.
Queens Gambit is a nurse?!! 😄😄😄
Don’t they teach about aspirating during an IM injection?? I’m an RN with 47 years experience and have Always aspirated an IM injection.
This is the most current evidence based recommendation.
@@thatnursingprof2661 pls evidence based recommendation as in.pls can u elaborate it more.what if u enter a vein?
@@samiratuaziz9540 aspiration is not required for the deltoid bc there are no major vessels in that area.
@@thatnursingprof2661 Ohk so it only applies to deltoid not the other muscles for injection.
Well Done
Which is the correct position... For
I. M. Injection...... Hips... Or shoulder... If your age is about 64...and injection is vitamin k
Awesome!
It’s really hard on obese people with so much subQ fat... what are your tips for handling those?
Use the longer length needle at 1.5 inch needle available
Well, there are plenty of people out there who are still hard to inject due to such an excess of adipose tissue, even with the longer needle. I mean, some are too obese for procedures and surgery even.
Cute haircut!
Thank you
Perfectly explained
Ma'am your explanation and vedios awesome👌👌💚💚💚
Well done
Respectfully, I am aware WHO advice is not to aspirate the needle and you are following their advice, what if the new advice does not make sense?
The same sense to commonsense which seems to be becoming less and less common.
I get what you are saying and that is actually a very good thing for you to be questioning this because that's how change happens in nursing. It is my job to go with the most current recommendations because that is what my students will be expected to know when they get hired. I can't say " this is what they want you to do but this is what I do instead " as an educator that's inappropriate.
Thankyou for your carefully worded and balanced reply. There is always 2 sides, sometimes 3 , to the story and we all have responsibilities and obligations which may not be apparent or considered by all .
Take care.
No aspiration?
do you have to insert the entire needle?
Funny how she responds only to other health professionals it seems. She doesn’t answer anyone’s real question unless they’re healthcare people lol.
It depends. Usually you are able to do so. If they are very petite, you may not want to stick the whole needle in. You might hit bone if you do. The patient cannot feel it, but you can and it feels gross. If that happens, you just pull back on the syringe. IM's are easy.
We no longer withdraw?
Do you not squeeze the muscle anymore?
No we only have to do that for a Subcutaneous injection
Most Nurses are pretty and thats a fact
Should the needle be fully inserted?
Yes
What about drawing the needle back after penetration but before injecting to check whether a blood vessel has been pierced?
That's called aspiration. Most up-to-date evidence based practice encourages the Z track method instead.
@@thatnursingprof2661 Using the Z track method is not a substitute for aspiration. The Z track method ensures that the medication does not leak into the subcutaneous tissue. Aspiration ensures that you have not accidentally placed the needle in a vessel. If you hit a vessel, the medication could be given intravenously and this could be deadly for the patient.
@@barbarakihm2858 I was taught aspiration in school and did it for a decade so I get what you are saying but I have to teach what the current skills recommendations are. If they change again I will change accordingly.
@@barbarakihm2858 I agree with you. I am a nurse too and in my 60s. You have to use two needles when giving IMI. The first needle is to aspirate needle from the vial, otherwise, the needle will be blunt and so painful to the patient. After withdrawing from the vial, change the needle to the right needle usually gauge 23 then remove the air from the syringe before penetrating the skin deeply then pull back the plunger or aspirate to check if the needle hits a blood vessels which is very dangerous to the patient as the medication is no longer given as IMI but IVI. I am a nurse for more than 30 years and that method never changed. One of the doctors in you tube have said that the cause of injuries in Covid-19 vaccination is the needle was not aspirated when giving the vaccine.
Respectfully, what if the current advice doesnt make sense?
Maam is it ok to use distilled water to disinfect the injection site?
No you should use alcohol
Great and very helpful
The Word Health Organization and most foreign health services now strongly caution against giving IM injections in the buttocks because of the danger of hitting the sciatic nerve and the veins around it as well as adjacent adipose tissues
For decades psychotropic medication has been given IM in the buttocks.
These injections also irritate the muscle tissue sometimes for days making it difficult for the patient to even walk
These injections are painful and humiliating
Psychotropic patients have a deep stigma about them
Unfortunately the US remains behind the rest of the world regarding the latest medical advances
You mentioned the 6 rights
These include the fact that a patient has the right to refuse an injection and/or to choose the injection site
For decades nurses were trained to enter a patient's room saying: "The doctor has ordered: with the implication being the patient had no choice but to comply
This is no longer the case and no longer flies
Regarding IM injections in the buttocks Nurse I would strongly recommend that you do some research
Yes I’m scared to go into buttocks but everything else I’m okay with !
Deltoids only
If you hit the sciatic nerve in a butt injection you're clearly not in the good spot. Glute injections should be performed only in gluteus medius, which is far away from sciatic nerve. Apart from the fact that you can end up in a blood vessel once in a while, meaning aspiration is mandatory, the site is very convenient and not painful at all for most people
Yeah my school isn’t currently teaching it. Closest we go is the ventrogluteal
@@david-csmhaltero77 this is incorrect, when i was in nursing school, they clearly stated that gluteal injections were contraindicated, and cause more harm than good. if you have been doing injections for 20 years, and that one time you hit the sciatic nerve, you have cause harm to that one person you otherwise wouldn't have.
Nice.
Don't you need to push the needle all the way to the hub into the deltoid?
It depends on the size of the patient and with my fake skin thing its best not to
@@thatnursingprof2661 thanks!
Depends on how fat the patient is. Average person could do shallow IM at 1/2” or 5/8”
what's the name of the syringe that you used?
It is a 3mL Luer Lock syringe.
u so jolly, witttyyyyy i like uuuu
What is correct position to give hepatitis B vaccine for adults ???
All IM injections are done at a 90 degree angle.
So 185lb male Q2 QUARDRENT OF GLUTE A 1" NEEDLE is o.k
really very good ,love you you are so cute also.
I noticed how aspirating doesn't seem to be done in 100% of COVID-19 vaccination shots on TV... is this proper? I've always taught students and new grads to aspirate to check if a blood vessel got hit. Doesn't this principle matter anymore? I'm curious.
Aspiration is not the current recommendation. They want us to do Z track for IM injections.
Funny, no other shot in history ever needed to be aspirated. No other shot in history needed to avoid being injected into the bloodstream instead of the muscle. Sounds like they are putting out misinformation in order to blame the nurse instead of the experimental gene therapy
Thanks I love you
Nice
Even the World Health Organization now says never given an IM injection in the dorsoglutenan because of the danger of hitting the school hi attic nervethe same goes for the midglutenal What's wrong with you lady?
Dorso gluteal is really common what are you talking about
Don't be stupid the World Health Organization and the health services of many countries now say not to use dorsoglutenal for I M injections
Psych injections given there are painful and humiliating
This is the voice of experience
It was terrible being forced to stand in the center of a medication room and being forced to stop my pants in front of 3 leering psychiatric technicians who laughed when the vicious mixture hit my muscle causing. great pain
The muscle would continue for days=making difficult to walk
THAT'S WHAT I AM TALKING ABOUT YOU JACKASS!
Thank you
the only thing missing is how deep to go
The length is either 2 inches or
2 1/2 inches
This shoulld answer your questions about depth
They still almost always hurt like hell
Uhm, that’s real deep, it think it’s win the 1-2 in range
@@danielbanando5167 you’re tripping the needle is 1-1.5in
You forgot to aspirate !, what if you hit a blood vessel
This video is about the Z track method, we don't aspirate when doing this method
Pull back on the plunger to check if point of needle is in a blood vessel before injecting.
They dont require that anymore!
@@meghoog Injecting the vaccine into a blood vessel seems to be associated with more serious side effects. Occurs approx. 1/3000 times.
Thnq
Thanks for the video! So I've seen some nurses massaging the area but others don't do it, is it ok to massage after the z track method ?
It's not the textbook way of doing it. It's not really necessary.
👍
ur cute
You are beautiful
Excellent video thankyou.