Hitting an artery would be tough but a vein? Not that hard at all. If your shoulder injecting the cephalic vein is of concern, if your injecting flutes the deep femoral vein can be hit. They are less than 1/2" diameter in most cases so I'm sure you'll be fine...
I think I'll steer clear of the Russian roulette and keep taking the extra 2 seconds to aspirate.
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You do know that you can still hit a vein when aspirating, right? Plus, medical science researches these things. Aspirating for IM injections has been out of favor for a long time. Feel free to do what you like, just understand that it is not necessary, or recommended.
To aspirate or not to aspirate? The latest evidence on
intramuscular injection techniques
Vangilder, M. and Walden, A.
ABSTRACT
Rationale
According to the CDC, more than 20 immunizations are recommended for
children prior to their eighteenth birthday and adults may receive a
number of intramuscular (IM) injections throughout their remaining
lifetime. Since many shots are given via IM technique, nurses should
know the latest research on methods to make the experience safe,
effective, and as painless as possible for patients of all ages. Aspiration,
or drawing back on a syringe to check for blood prior giving an injection
into muscular tissue, has been a standard practice taught in nursing
programs for decades. The authors reviewed current literature to
determine if this practice is backed by evidence-based studies. To narrow
the scope of research, a focus on aspiration’s effect on pain was selected.
Objective
This study was conducted to determine the latest scientific evidence
regarding the pain effects of aspirating prior to administering an
intramuscular injection to children.
Methods
A meta-analysis literature review of evidence-based practice studies and
practice guidelines from the last 10 years was conducted.
Results
A variety of study types were found including meta-analysis, randomized
controlled trials, quantitative studies, descriptive studies, and current
practice guidelines. These studies all agreed, regardless of study type,
that the practice with the best outcome and least amount of pain was
quick administration of an intramuscular injection without aspiration. In
addition, several studies reviewed current nursing practices to find that
many still use the outdated standards of aspiration. It was also found that
with proper education, nurses can and will change their injection practice
to mirror current guidelines.
Conclusions
Although the authors were most interested in aspiration’s effects on
injection-related pain, other injection technique evidence-based
information was also gathered. Literature review conclusions were:
• A rapid IM injection technique without aspiration results in less
pain.
• Aspiration does not confirm correct needle placement.
• As a result, aspiration is not a recommended procedure for IM
injections in any age group.