no...
15 years of gear....never aspirated once.
Aspirating, is old school. They don't even teach RNs to aspirate any more. Don't agree? Just ask the CDC, ACIP, DHS, AAFP, DOH, or the WHO. For them to say so, it holds water. I never aspirate, and have been using AAS for over a dozen years. Even with SQ injections.
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 though. I know many who have been using AAS ED for many many years who have yet to aspirate. Read on...
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.
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