***guidelines have changed! NO aspiration, do not squeeze muscle-use Z-Technique, and no massaging,*** otherwise, FANTASTIC instructor! OMG! I wish I had her as an instructor! Very clear, great explanations of what not to do and what to do.. my class was never taught about the different equipment, so you all are so far ahead of the game from some institutions!
Well, I'm not a nurse, I'm not a doctor, but I'm a teacher myself and I CAN recognize an awesome teacher and she's one of them! I've been also a patient :( and believe me, we really appreciate nurses like her. It's not only about the technique, but also being human and empathetic with your patients. Great job!
Video was FANTASTIC .....I graduate in June as RMA and you really made the injection look easy ...I could watch your video over and over and learn something new ...thanks again
Pinching is for SQ injection, IM you either hold the skin taught or place your other hand against the skin and then hold the syringe for when you need to aspirate.
Ebp says to use Z track not to grab the muscle. You also don't need to aspirate any longer for IM medications. And definitely not supposed to massage the area just steady pressure and tell them to move the arm and use it as normal to help distribute the medication
Z-track method is used more in dorsogluteal IM injections because the medication being injected is thicker and more painful for the patient. So when you use the Z-track method is because you are trying to minimize (avoid, if possible) irritation to the subcutaneous tissue, so by pulling the skin to the side before injection and then releasing after injection, you are "sealing" the medication into the muscle and preventing it from going back up into the subcutaneous tissue.
Aspiration is still a practice in big muscles, but is not for the deltoid. The deltoid is the only muscle that is okay not to aspirate. At least in my state. We had a big research and hoopla about it in nursing school and had to change our instructors thinking on this.
There's different ways and they are acceptable. As long as the medication is delivered properly, patient isn't hurt and staff isn't hurt, OSHA is followed.... It's all good!
@@lrob6971 Taut is also for IM, different reason though. Other muscles that get injections need aspirating so the other hand is against the skin to hold the syringe stead after insertion.
Those of you who aren’t working in actual healthcare yet, and still learning in school. Once you enter the work field, you are going to find your own groove, and you are not going to be practicing everything that is being taught in school. I’ve worked along side nurses for about 5 years now, and they all never do the Z track method for IM injections. A 1inch needle will always hit the muscle on a average person, even if you pinch the site. Of course, heavier set people are going to need a 1-1/2 inch needle. Like I said, you’re going to find your own easier methods (following safety precautions).
She was the best... I loved how she explained everything and noticed the tensed shoulder and how it dropped right away... this lady is on her A game.... yayyyyyy
For Intramuscular injection you are supposed to stretch the arm muscle so needle can reach the muscle zone, Not pinch the flesh up which will not allow the needle to enter the muscle area.
What school is this? She is a great instructor! I like the little life hacks she provided especially if the pt bleeds. It's so much more polite than in the field. Served 5 years as a military medic now in nursing school. I can always learn something new. Remember folks, if you're judging, you're not learning. Thank you to whomever had the courage to post this vid.
I so love this video. Very detailed and PROFESSIONAL.I just watched a video prior to this one and I must say that it should be Banded! Thank you for this Instructional video and by the way can you be my instructor xoxo
Don't massage area!!!!! Not sure why or what her reasons are to massage.. Z track method is great !! No longer need to aspirate but a great way to know your in the muscle and good to administer ! Always dart quick! Don't hesitate -itll be a painful needle if you do...
I am currently a nursing student and the way she did it is how my instructor taught us. She reminded me of my instructor except mine is a bit more blunt about things but overall a great teacher because she wants you to learn. Different schools have different guidelines. In fact, I actually learned a lot from this video. Very interesting!!
I know I'm watching this 2 years later, but the acrylic nails....omg I just cant. After hearing about all the babies that died in NICU from a a nurse exposing them to a bacteria that was traced back to her acrylic nails, that is just disgusting. Aslo, never heard of aspirating and NO massaging. -2018 nursing student
Thank you for your opinion. Once you get out into the real world and aren't a student, you will see that depending on where you work and the type of patients you see, there's different guidelines. Good luck on your continued education.
@@SamSam-ke9zy I'm a student nurse and seeing this disparity in technique is a bit off to me. Some people say Z-track, some say not to, some say to pinch, others hold taut... No longer massaging the area afterwards seems to have been established best practice, but not doing z-track seems to be even newer.
@@maxvillanueva3629 it depends on the medicine and where its going. For this I was just keeping it to deltoid vaccines. Blood thinners you do not massage.
@@buggsy5 yes. this is true. these other techniques have been around as well, in addition to Z-track, and I've been told by varying staff that even Z-track isn't best practice
I'm surprised that there doesn't seem to be a consensus on the aspirating and the messaging after injection because I've heard a definite yes and a definite no to both in regards to intramuscular injections. I ain't trying to become a nurse or anything, but it's surprising to me that there is such a variety of standards across the medical field.
Nursing practice changes constantly based on evidence through research. In healthcare, we are always weighing risks and benefits because the reality is, many things nurses do have risks involved. You will notice things change as efforts are made to practice in the safest way possible.
I was taught you don't massage the site, only apply gentle pressure, since massaging can cause the medication to rise back up to the skin's surface. I'm confused. :/
How you supposed to give in right spot at drive through sites when people are wearing long sleeve shirts Two or three finger lengths below shoulder? No more than 2 inches?
There is so much wrong going on here I'm at a loss for it all. I don't care how "nice" or "agreeable" her personality is or that she sounds like an "informative" or "great" instructor. Never give an injection to a standing patient. Like Kyle Hillman says, what if they faint? Opening a sterile syringe without regard to the sterility of the Luer-lock tip and flopping it onto a non-sterile field is a giant error and break in technique. Sure the needle was applied using sterile technique but it doesn't matter because the syringe is probably contaminated. The tip must remain sterile. Pinching a deltoid injection site is wrong and violates the standard. It is to be stretched taut while injecting by the non-dominant hand ABOVE the site and ready to stabilize the syringe for aspiration after darting the muscle. This is not the type of video I will normally comment on. Unfortunately for this class there will probably be more errors in technique and teaching in the future.
@@dawncampellone3925 Yeah. Some probably still teach bleeding for various "ill humours". Just because something is taught does not mean it is the best or correct.
@@chocomimi9945 The CDC says that massaging is incorrect. It irritates the needle track and can force the injected material into the fatty tissue or cause some to leak out of the puncture.
You don’t need to aspirate and you definitely don’t need to massage afterwards either. That damages the tissues further. Those are outdated nursing practices.
LOL, I wish they'd shown the glute shot. I want to see if other people howl in pain like I did when I got a Rocephin shot in the behind. Words can't describe how much that hurts. Given anywhere else other than the behind you'd probably pass out from the pain. To me if felt literally like my ass was being branded with a hot iron.
Hi I was wondering do u have to aspirate every i.m injection u give to see if any blood comes out ie if it has hit a nerve. And how do you aspirate. As I will be using a pre filled syringe. Thanks
bot06 Yes. You have to aspirate and look to be sure that you don't have blood in the syringe. If there's blood upon aspiration, that means that you are inside of a vessel. As Medical Assistants, we do not inject medication into vessels. So, if there's blood in the syringe upon aspiration, you have to immediately take the needle out and start completely over.
Great video!! Also I just wanted to add you are a GREAT instructor! I wish all the instructors I ever had in nursing school were like you and that we could use each other as guinea pigs! However I just wanted to say that aspiration is an OLD practice, and depending on where you are from you may learn that it is required but in other health authorities, provinces, states and countries it differs. For myself, we learned to aspirate at the beginning of my nursing program but it has now been phased out that IM injections no longer require aspiration, and that is with the BC CDC who is the one telling us not to anymore.
The reason behind aspirating when inserting a needle is because you do not want to inject a medication directly into a vein if it is not intended that way. It could cause adverse reactions in the patient since the medication is going directly into the bloodstream. Or so I have been taught.
@@berenicechavez183 There are no vessels large enough to be a problem in the deltoid injection area. The lack of need to aspirate has been known and published since 2005, or even earlier. If ALL nursing schools and nursing protocols have not been updated then it is due to either inertia (We have been doing it for 100 years - so why change) or simple ignorance of all the research that has occurred.
always clean to dirty so cover injection/puncture, then wipe away from site she simulated wiping “blood” up towards open area still wrong covered with dressing or not clean to dirty 👍
I would probably ultrasound them to see what depth is required to reach the muscle. However, vaccines are preferably administered in the deltoid in adult patients.
OMG The instructor forgot the first rule most important.... Wash Your Hands before gloving or even starting. I am sure this was overlooked due to demo hand washing is really important.
No no no! Evidence based practice shows that massage is not indicated. Hold steady pressure to stop bleeding and have the patient do ROM to help distribute the medicine
@@dawncampellone3925 Or, to put it more in layman terms - the length depends on the amount of body fat. The thickness (viscosity) of the medication determines the range of needle sizes that are suitable.
Why do people have to be know-it-alls? Don't pinch, no air, don't massage, sit down. Ugh!! I know this is an older video but I think she did an excellent job.
Thank you Teresa!!!! I've been thinking the same thing reading all the critical comments. I've been an RN for 13 years and wish she had been my instructor. This was only a tiny portion of something she was teaching, and all the "experts" are so quick to point out anything they think is missing. She could have gone over all that stuff with them a thousand times before and she was just focusing on a particular thing here. Yes, some things have changed, but reading through the comments, it's very obvious that many nurses still believe in how they were taught, probably due to the reasoning they have been given for it. Things are ALWAYS changing in nursing! Different countries, states, and even facilities can have conflicting policies and standards by which they practice, so not every nurse is updated on every new change! And there are different ways of looking at things (nursing = gray areas everywhere). Pinching the arm- depending on how it's done, and the size of the patient and needle, it may be just fine. For tiny, skinny arms, pinching it up can help ensure the needle doesn't hit the bone! Ugghhh!!! Anyway, I enjoyed the video and think she did a wonderful job and her students are probably good practicing nurses at this point ❤
