Do you prefer to insert pin swiftly or slowly?

[TGB1987]

I was wondering what is the prefered method of pinning? Do you guys like to insert the pin into the muscle swiftly or slowly? My sister is a RN and she told me to do it swiftly because it causes less muscle damage so I have been doing this since I started injecting. My girlfriend usually does my injections. Anyway today I was forced to do it myself because I pissed her off and she left me hanging because she knows I hate to do it myself lol. It was a quad inject day my least favorite. So I decided I was going to go in slowly and try to find a good spot. Well I slowly inserted the pin and had zero pain what so ever. I did end loosing my grip on the barrel when I reached for the plunger to aspirate ( I am sure I will pay for that in soreness tomorrow) but no pain. So this is what made me want some other opinions.

 

[Klutch]

Its been a long time since i pinned. i only did quads. i prefered slow.
but hgh i prefer swiftly.

 

[VictorZ06]

As quick as possible. That's another reason to use a decent size pin. If you keep the pin inside you for too long, it moves around a lot. That will cause scar tissue. And as far as aspirating, that's old school. They don't teach RNs to aspirate any more.



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.

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

 

[malfeasance]

And here I sit biting my nails just waiting for that non-aspirated injection to kill me in seconds . . . LOL! Thanks for that information.

 

[blazeftp]

^^^
I shot 1.5ml into a vein once, didn't mean to.
You just get the taste of test in the back of your throat and feel a little dizzy.
Also you will get a cough.



For me i push it in slow inject rather fast.
Once i pushed to break the skin then pushed without stopping until it was all the way in.
Was at a perfect angle but when i went to re grip to shot i got large shot of pain all the way up my leg had to stop and leave it for a minute until it died down.

 

[Mr.BIG]

As quick as possible. That's another reason to use a decent size pin. If you keep the pin inside you for too long, it moves around a lot. That will cause scar tissue. And as far as aspirating, that's old school. They don't teach RNs to aspirate any more.



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.

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

^This, Aspiration is old school, absolutely no need!

 

[TGB1987]

As quick as possible. That's another reason to use a decent size pin. If you keep the pin inside you for too long, it moves around a lot. That will cause scar tissue. And as far as aspirating, that's old school. They don't teach RNs to aspirate any more.



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.

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

I have not heard this before about aspirating. There are still small vessels you could hit and inject into. Why would they say not to aspirate? It only takes one second to do. I know I don't want to inject in any vein big or small. Every safe injecting source says to aspirate. My sister just graduated from Penn State university in 2010 as a RN. She said they taught them to aspirate. She says some do not at the hospital she works at because they don't want to take an extra second to do it because they don't care but they are told to do so. You may be right but I know I am not going to take any chances.

 

[cutright]

No aspiration for me...

 

[VictorZ06]

In the 20 some odd years of using, not once did I aspirate. Well, I tried it once, and my MD told me not to bother. Ask Heavy how many times he's aspirated....and he's been using longer than I have. Jet injections also don't require any aspiration. Medical science is always evolving.



/V

 

[VictorZ06]

I have not heard this before about aspirating. Every safe injecting source says to aspirate.

Not these guys:

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)


/V

 

[oden]

This is great stuff-and why I read this page.no more pull back for me-these guys know whats going on! seek & destroy!!!!

 

[BigBird]

Thank you Vic. Never aspirated once. Never will. Never any problems. There must not be any veins in the upper outer quadrant of my ass nor the nickel-sized area in my delts.
IMO, there is no risk because I don't get creative looking for new spots to inject. I stick to what works. Most I've ever gotten was a tiny pin-head size of a spot of blood.

 

[TwisT]

I do the good old jab method.

-T

 

[ROID]

You guys not ever hit nerves in your quads ?

I used to never have to worry about nerves in the quads but over the past few months I hot one on a regular basis.

I may start the jab method for the glutes. Its getting to the point where I have a hard time breathing when i'm bent around trying to pin my butt.

 

[TGB1987]

Do you Aspirate for intramuscular injection?

In: Health, Medication and Drugs [Edit categories]

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[Improve]

Yes, you would aspirate for IM injections to make sure you aren't in a vein which could result in phlebitis and embolus if a suspension was given intravenously.







Read more: Answers.com - Do you Aspirate for intramuscular injection​

 

[VictorZ06]

TGB1987, compare my references with yours. Wiki is not the best source of information. I hope you don't go there looking for all your info.

Would you take some anonymous guys answer for it....or the CDCs (and other organizations I mentioned)?


/V

 

[VonEric]

Fast and on the quads.. Hit a nerve once in my glute - It almost dropped me

 

[TGB1987]

Vic I checked out the CDC and it stated that aspiration is not needed because there are no major blood vessels in the injection sites. Every single anabolics book that I have ever read says to aspirate. I still believe that it is better safe then sorry. I do not want to inject in any blood vessel big or small if I can prevent it. There are still major colleges teaching their students to aspirate. My sister just went through a program at penn state where aspiration was a requirement. I am not saying what you are stating is untrue or wrong what you have posted is what the CDC says is necessary. There is no evidence that aspiration was ever needed yet they still have done it for the last 40years. I am saying that what you have said is correct and what I have said is not wrong. There is no evidence to prove that it should be done and there is nothing saying that it shouldn't be done. If you are to aspirate what are you going to hurt as long as you do it carefully, nothing. It will just waste 5 seconds of your time. I think it is especially useful for people who are inexperienced and likely to make a mistake. It is now not necessary to aspirate but I am going to do so to be safe. It is a choice. I am not wrong for aspirating and now you are not wrong for not aspirating. I am not trying to piss you off Vic, what you said is right by the CDC and other references you listed. Aspirating could still be beneficial.

 

[Swoleisback]

It's new . Things are always changing . Im getting my RN and I'm a emt/lpn . But I still aspirate with tren just cuz I really want tO try to avoid tren cough but dont for other shots .

 

[TGB1987]

I never heard of that being changed til Vic brought it up. That is two things I learned from Vic just today. Earlier I saw a post that he made saying that Vita C can actually lower estrogen not as well as an AI but 3 grams a day helps. Always something new in this world. I guess I might not aspirate in the glute anymore but I have a lot of veins in my quads and shoulders I think I am going to still aspirate there. I would feel strange not doing it.

 

[Rayman]

No more asperation for me either... Its really not necessary... And I push slow in the quads fast in the glutes... I find If I push slower in the quads I can avoid nerves easier

 

[JCBourne]

My girl does mine, she does it rather quickly in, not too fast or slow and injects pretty slow 30-45 second for 1-2mL. I usually have low soreness, and almost no pain while injecting.

 

[stronger4ever]

Yeah bro, inserting the needle can be fast or slow, but the actually injection of the oil should be as slow as possible to avoid soreness. I've been injecting with 25G needles, so doing it slow is not an option lol

 

[TGB1987]

No more asperation for me either... Its really not necessary... And I push slow in the quads fast in the glutes... I find If I push slower in the quads I can avoid nerves easier

I believe this now too. After yesterdays smooth slow quad inject I am sold on it. I had no pain at all. I must of hit the perfect spot.

 

[TGB1987]

Yeah bro, inserting the needle can be fast or slow, but the actually injection of the oil should be as slow as possible to avoid soreness. I've been injecting with 25G needles, so doing it slow is not an option lol

I use a 25G too and go very slow 1-2min per ML of oil. It really makes a difference in post inject soreness. Pushing it too fast is like a pressure washer on the muscle.

 

[SloppyJ]

25g into my quads mostly. I go really slow.

 

[Houndhog01]

^^^
I shot 1.5ml into a vein once, didn't mean to.
You just get the taste of test in the back of your throat and feel a little dizzy.
Also you will get a cough.



For me i push it in slow inject rather fast.
Once i pushed to break the skin then pushed without stopping until it was all the way in.
Was at a perfect angle but when i went to re grip to shot i got large shot of pain all the way up my leg had to stop and leave it for a minute until it died down.

It is normal to get that taste even without hitting a vein, I taste it everytime.

 

[Diesel618]

I try to go slow enough that I can feel it penetrate the muscle. I always stick to glutes with a 22g and I aspirate because why not? I've never had blood come back, but it's jsut become part of the routine. The only downside I can see to it is that it may cause some unneccessary movement of the needle in the muscle because it takes a little bit of force to aspirate when you're in a muscle, and trying to aspirate in the glute while twisting your body around and trying to keep the needle still in the muscle isn't exactly easy.

Question for you guys who use glute. Do you push down on the plunger with your thumb or index finger? I've been doing both and I can't figure out which one is less uncomfortable.

 

[Houndhog01]

hes talkin about how fast you insert the needle, not how fast you puch the plunger.

 

[Houndhog01]

I insert needle slowley