I have not been a nurse long and am going into the RN program soon. My biggest fear is making mistakes like this. I'm a perfectionist, and it freaks me out to think I may make a mistake on a human being. Very nerve racking for me. I've never hit bone, but ive seen it done. When i was in school the nurse i observed giving the IM did it. She pulled the needle out and it was bent she hit so hard little overkill there i thought, dont have to use that much force to pierce the skin.
I dont think the patient really felt it because they didnt react. When i give a IM to a very thin or fraile person i usually try to either go to the gluteal or if i have to give it in the vastus lateralis i deliberately move to the lateral side of the bone looking at the leg from the front and go in from the front of the thigh instead of the side. You still hit plenty of muscle, and dont hit bone. I doubt there would be any problems with hitting bone unless like was said it was a large bore needle, then you'd have a biopsy.
I just started over. He actually laughed and mumbled something about why he doesn't usually do injections. I have wicked allergies, that in the past have necessitated giving myself injections.
And I have hit bone. Awful sensation, but no pain nor any residual effect. Have also hit bone on patient- those thin little folks who have no meat on their bones. So I know exactly what you are talking about :uhoh Has 15 years experience. I hit the bone once in my 12 years as a nurse. I inspected the needle and the bevel tip was intact. No harm came to the LOM. If the bevel tip breaks off inside the pt, then there can be problems.
I've hit bone giving myself an insulin injection. I bent the needle, but not where it hit the bone, but where it attaches to the syringe when I jumped pulling it back out!
Although patients will not feel their bones being hit, the vaccine might not fully absorb into the muscle, leading to a reduced immune response. Unfortunately, nerve damage is a fairly common injury that can occur during an intramuscular injection, especially in children.
When a nerve injury is caused by a needle, most patients report immediate pain at the time of injection,11 as our patient did. Neurological sequelae can range from minor transient sensory disturbances to severe sensory disturbances and paralysis.
Although rare, IV flush syringes can introduce air embolisms into a vein, which can lead to heart attacks, strokes and respiratory failure. No one should shun them because of the small risk of shoulder injury. The consequences of getting a vaccine-preventable disease can be far more serious. It went fine. I got it in the other arm, and I did not take my eyes off the needle. The soreness was gone in 24 hours. Marlene Cimons writes frequently for The Washington Post on health, science and environmental issues.
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