Another injection point

Email 06/02/2021

Mr ______,

I've been giving injections for 17 years. There is another point that may need to be made regarding the route of administration. It is impossible to guarantee that a blood vessel is not punctured during any injection, causing injection directly into the bloodstream.

We are taught to pull the plunger back to see if we aspirate blood into the syringe. If we see blood fill the syringe, it means we're in a blood vessel. Unfortunately this isn't a fool proof method. The needle can pierce a blood vessel 'through and through'. If this happens no blood will fill the syringe because the tip of the needle is in muscle tissue. But this leaves a tiny pathway where the drug can enter the blood stream directly around the needle and through the tiny channel that the needle leaves behind.

I did this exact thing to one of my old ambulance partners with a shot of Benadryl, so I'm definitely speaking from experience on this. He's fine, by the way. He just needed a long nap afterward. lol

The route of administration matters greatly for some medications we give. For example, if I want to give Midazolam for seizures I would give 5mg intramuscular injection, but only 2.5mg if by IV. There are other medications we NEVER give by IV. Some ONLY by IV.

Also, watch the vaccination videos closely. There are a lot that never even aspirate at all. What happens when this shot goes IV???

Handy