Intramuscular injection usually easy, safe and anyone can learn

DEAR DR. ROACH: I give my wife an octreotide intramuscular injection monthly into the gluteal muscle. I was taught to pull back on the needle to be sure you aren’t in a blood vessel. Sometimes, I am unable to inject the medication (just can’t plunge the syringe) despite being sure the needle was working before injecting. If I try again in a different spot, it works. What’s going on?

— N.R.

ANSWER: Intramuscular injections are among the safest, and anyone can be trained to do them. However, things can occasionally go wrong.

Aspiration is the term for pulling back a little on the syringe before injecting to be sure you aren’t in a blood vessel. It is extremely unlikely that you’ll hit a blood vessel, and the practice of aspiration is now discouraged by the Centers for Disease

Control and Prevention for injecting vaccines. However, aspiration is still recommended for medications that would be dangerous to inject into the blood vessel. Octreotide is not dangerous to give intravenously, so I would recommend against aspiration for her. I suspect that you may be aspirating hard enough that the syringe is getting blocked. If you do aspirate, a light touch is sufficient.

It’s also possible that you have inserted the needle deep enough to be pressing against the hip bone, although that’s also unlikely. The hip bone is quite deep in most people. If you are unable to inject, try pulling back on the syringe a half inch or so.

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