aspirating (pulling back on) the needle

[VikingKitty]

Hi - just got done with my 2nd shot of Copaxone...all went well except for the crazy wasp that decided to fly frantically around the room just as I was about to insert the needle into my leg!!! Talk about bad timing!

Anyway, I was wondering if anyone else pulls back on the plunger to check for blood so as to not inject into a vein??...being that is what causes the dreaded Immediate post inject reaction....my nurse did not instruct me on this (although she was very helpful and nice otherwise) but I have researched a bit on it.

Doesn't it make sense to do so if injecting manually? I understand that you couldn't do it if using the autoinjector.

I'm sure pulling back on the needle and checking for blood isn't foolproof, but it would make me feel more confident that I'm not going to have to feel like my hearts going to flip around like a fish out of water and my heads going to explode like a ripe tomato!

Any thoughts?

[MSer102]

If it were an issue there wouldn't be autoinjectors.

It really doesn't seem to be necessary. Last time I looked even the instructions for Avonex - which goes deep in a muscle where you are more likely to hit a large blood vessel - dropped the step to pull back to see if you get blood. Even when that was in the instructions I didn't do it.

The medicine can still get into the blood vessels that got pierced on the way in that you don't have any way of knowing about so I'm not convinced it makes much difference. Especially with a shallow injection like Copaxone where you aren't likely to hit a big blood vessel anyway.

But if you feel better doing it then you should do it. It can be helpful to keep you taking your medicine regularly if you feel good about what you are doing.

[MrsBones]

You'll here both sides on this, too. I was never taught to do that either.

From personal experience, I can tell you that hitting a vein is not a guarantee of an IPIR. I have had a couple IPIR over the years and I hadn't hit a vein on any of them. Conversely, I also have hit veins, numerous times, and didn't have IPIR when I did. It's not a proven thing that hitting a vein is a key factor in IPIR. It isn't known exactly what causes them.

In fact, if you do a generic search for aspirating during sub-q injections in general, you'll find nursing presentations saying that aspirating and finding blood doesn't confirm that you've hit a vein, nor does not finding blood confirm you haven't.
http://www.stti.iupui.edu/pp07/vanco...0L.-F%2010.pdf

If it makes you feel better, go for it. You can ask your doctor if you'd like, but I don't think it's going to make that big of a difference. You will hear the other side, too, with people saying you should always do it.

Ask your dr, call Shared Solutions or your nurse and ask what they think is best. Do what you think is best based on their advice.

[aitch10]

Nope. Despite manually injecting, needles give me the heebie jeebies, so there's no way I'd prolong the process by aspirating.

::shudders::

[merganser]

I aspirate the needle when I'm doing my legs and stomach (both areas were I had IPIRs, both times after hitting blood but not realizing that until after the injection). I don't aspirate when I do my hips because I can't twist around well enough and my husband doesn't do it when he does my arms. For my hips, I make sure I wait at least a couple of seconds before depressing the plunger so I can watch for blood flashing into the syringe.

I've aspirated blood twice in the last 2 years and pulled out without injecting (then I give myself a day off...). I like to think I avoided IPIRs those two times.

[Fed Up]

Nope. Despite manually injecting, needles give me the heebie jeebies, so there's no way I'd prolong the process by aspirating.

::shudders::

I had to laugh when I read this one! Sorry, not meaning to make fun of your pain. But, I GET IT!!!

The FASTER an injection takes place the quicker the pain is over. Having given thousands...imho, that is best.

I personally, aspirate with EVERY injection (habit) and withdraw if I get a flash. But, I rather liked this answer, as well...
merganser..'if I get a flash...I give myself a day off.' plus, not wanting a second poke!

Both choices are correct, as stated.

Hiting a small vessel-vein can cause bruising and sometimes pain. Moreso; one can "mainline" the medication, if injected into the vein...and that often~Requires some work! The needle is often, larger than the vein.

Unless you are aiming for a big one, most are so tiny and irrelevant they'll deflate upon 'hitting.' Or are so small, you couldn't inject more than a drop in the vessel.

So the long and the short of it is, as stated; personal preference. I do believe it is due to the 'injection' needing to be Subqutaneous and that would be the DIFFERENCE.

Subqutaneously, you shouldn't be hitting a vessel, large enough to transit the medication, thus 'mainlining' the drug. If in the muscles, always withdraw with a flash of blood.

There are medical professionals that never 'aspirate' when they give subq meds. It is personal preference. My preference is to aspirate. But, if it is behind me..forget it, I wiggle the needle too much and that does hurt! I like painless..so I pinch myself first..and that often hurts more and takes the 'fright' out of it.

fed

[DianeD]

Never

This is a new subject for me. I never have aspirated. I just stick the needle in and hope I don't hit a vein. It's often hard to miss the little capillaries though, particularly if you have spider veins or a lot of cappilaries. I
I've have had a bit of blood come out now and then, I just wipe the injection site with a bit of alcohol. Never keeps bleeding.

Ah, the fun, the fun ...

Diane

[agate]

When I was on Copaxone I was taught not to pull up on the needle. I also understood that the cause of an IPIR is unknown. I never heard of a connection between blood in the needle and an IPIR, and I was definitely on the lookout for any information about IPIRs because, living alone, I can assure you I didn't want one.