Flu shot reaction???

We are 2/3 of the way through our 3 Day flu shot clinic at the facility where I work. Today another nurse and I tackled (not literally) all the resident's.. By lunch time we had gotten almost all of the residents done plus a few employees without any problems... I had to give one of our CNAs her shot, she had pretty small arms, and she was a ball of nerves! The needles we're using are 1 inch, 25 gauge. I was afraid of hitting her bone so I didn't inject the needle all the way (over 3/4s tho), when I pulled the needle out she had a small amount of bleeding. But what shocked me was the site instantly swelled a bit (almost like a TB skin test would) and I could see it was starting to bruise! I've never had a reaction like that and I'm a lil freaked out. And I feel terrible because she had been nervous to get her shot to begin with... Does the swelling mean I didn't go in deep enough? She's very pregnant, could that have something to do with the reaction? Every other shot I gave before that one and everyone I gave after that one were done without any reaction or bleeding! But I'm still upset about that one shot!
Pregnancy wouldn't have anything to do with the reaction. Sounds like you nicked a vessel and a hematoma developed. That happens sometimes. I wouldn't worry too much about it. Today I was giving a flu shot to one of our midwives and I hit her bone (shudder).

I did hit the bone on one of our residents earlier in the morning, I think that's why I was hesitant to go too deep with this shot. I've never hit the bone before either so my reaction was much like yours.. *shudder* but I pulled the needle back a bit, aspirated-no blood, and the rest of the shot went fine. And the 20+ shots after that went beautifully until I did the CNA's shot.

It sounds like a hematoma developed, just watch it tomorrow if possible. I used 3/4" length needles on small armed people last year and did not have any problems. Were you using the auto-injection syringe, I have seen this cause bruising. Hope it goes better next time.

You should not aspirate for deltoid IM injections.

It is not recommended that you aspirate with vaccines. One reason is because, even if you hit a vessel in IM sites, you're not going to cannulate it & inadvertently give it IV. Vessels aren't large enough in recommended sites for IM. For the same reason, you should not be worried. Hitting a vessel is inevitable every now & then. Don't worry!

Quote from kloneYou should not aspirate for deltoid IM injections.

Quote from mariebaileyVessels aren't large enough in recommended sites for IM.

Quote from kloneYou should not aspirate for deltoid IM injections.

Yes, she did.but I pulled the needle back a bit, aspirated-no blood, and the rest of the shot went fine

Learned something new, I had been taught to aspirate on all IM injections. I'll definitely remember that from now on.

Quote from kloneWith the exception of dorsogluteal. You should aspirate if you inject there. Aspiration should be done over 10 seconds.

Quote from mariebaileyYou would never give a vaccine in the dorsogluteal; that site is associated with diminished absorption of vaccines, &, subsequently, lower antibody titers.