Getting the "shot" question.

[John Schmidt]

I've noticed often when getting the flu or other injections, they always go straight in rather than at a slight angle. Why is that? In the past I've rec'd. shots where they did go in at a slight angle and the muscle soreness from the penetration itself was nonexistent. Other times when going straight in I usually have no reaction to the meds itself but the penetration remained sore for 2-3 days, depending on the size of the harpoon in use. Why is it always straight in? Any medical folk out there able to shed some light on it? Really PO'd me a couple years back when I told the gal doing the shot I want it at an angle and she refused, so I told her get someone else or no shot. She got the head nurse, she went in about a 45 deg. with no discussion. I felt a little prick but no associated muscle soreness. 

[ridingron]

A good question. I have never noticed the angle thing one way or the other. I have noticed some left my arm hurting and other don't.

[Chrisj CMA]

An IM (inter muscular) injection does not require an angled approach. A (sub q) subcutaneous injection goes in at an angle and shouldn’t cause muscle pain because it not put into a muscle. You can recognize a sub q shot if the person giving the shot grabs a pinch of skin near where they stick the needle

[Farside]

An IM (inter muscular) injection does not require an angled approach. A (sub q) subcutaneous injection goes in at an angle and shouldn’t cause muscle pain because it not put into a muscle. You can recognize a sub q shot if the person giving the shot grabs a pinch of skin near where they stick the needle

+

[G-Man]

An IM (inter muscular) injection does not require an angled approach. A (sub q) subcutaneous injection goes in at an angle and shouldn’t cause muscle pain because it not put into a muscle. You can recognize a sub q shot if the person giving the shot grabs a pinch of skin near where they stick the needle

 

I've given thousands of injections and I have never had a patient request the specific angle that the needle went in.  Interesting, though. 

[Tx Bohemian]

I assume your talking about the TRUMP vaccine!

[John Schmidt]

I assume your talking about the TRUMP vaccine!

No...any injection.

PS: It's spelled "you're" 

[Dave Ritsema]

I am sure Connie will jump in at some point and she is definitely the subject expert but I believe it depends on the type of injection in terms of how the needle is angled.

Subcutaneous (into the fat layer between the skin and muscle) 45 degrees

Intramuscular (deep into a muscle) 90 degrees

[The emperor has no clothes]

I am sure Connie will jump in at some point and she is definitely the subject expert but I believe it depends on the type of injection in terms of how the needle is angled.

Subcutaneous (into the fat layer between the skin and muscle) 45 degrees

Intramuscular (deep into a muscle) 90 degrees

What would be the reason for whether in to muscle or fat ? Would they not both be absorbed in to the body ?

[Wizzard]

There are some shots that must be given sub Cu and some must be intramuscular. They cannot be confused.

[G-Man]

Watch Dr. Sandra Lee, aka Dr. Pimple Popper.

All of her procedures begin with subcutaneous injections of local anesthesia.  She goes in a angles way less than 45 degrees and the technique is to lift the skin up as the just the tip of the needle is inserted under the skin and then inject causing a "bubble" of injectible to form (raising a wheel).   

This technique is also use for the test for TB.  A wheel is raised under the skin and the Dr. or nurse checks for induration in the area after a certain amount of days.

[Chrisj CMA]

Watch Dr. Sandra Lee, aka Dr. Pimple Popper.

All of her procedures begin with subcutaneous injections of local anesthesia.  She goes in a angles way less than 45 degrees and the technique is to lift the skin up as the just the tip of the needle is inserted under the skin and then inject causing a "bubble" of injectible to form (raising a wheel).   

This technique is also use for the test for TB.  A wheel is raised under the skin and the Dr. or nurse checks for induration in the area after a certain amount of days.

That picture is not a subcutaneous injection. That is an intradermal injection used for TB tests

[John Schmidt]

Well FWIW(very little I assume), I've had numerous injections that go into the muscle and still done at an angle. I've asked the person involved why some do and some don't give it at an angle, the answer in most cases has been a shoulder shrug followed by "this is how I give all my shots..I just vary the depth depending on if it's muscular or sub-cu." I guess it's generally easier to go straight in, then so be it. I was just curious as to the whys and wherefores, nothing more.

[semo97]

Sub Q absorbs slower, intermuscular absorbs faster due to more blood in the muscle. When we vaccinated our cows different vaccines were administered different and different parts of the body.

[f6gal]

I am sure Connie will jump in at some point and she is definitely the subject expert but I believe it depends on the type of injection in terms of how the needle is angled.

Subcutaneous (into the fat layer between the skin and muscle) 45 degrees

Intramuscular (deep into a muscle) 90 degrees

Haha!  There are several people here qualified to answer the question; some (including you) have answered correctly.

But, since you asked, I'll add a little bit to the discussion.  The image below depicts typical injection training.  The angles are to help ensure that the injector delivers the medication to the intended tissue level.  That said, if an experienced injector is sure of the tissue level, an angled approach may be preferable (for instance, for a 90 y/o, 90 lb woman without much muscle or sub-q tissue, entering at an angle may prevent striking the bone).  

I see no reason that the entry angle would impact the level of discomfort.  

The best techniques I've learned for giving painless IM injections:

• Warm the solution a bit by rolling the vial in your hands first.
• Depending on the medication, if appropriate, consider dilution with lidocaine instead of sterile water.
• Spread the skin/muscle, instead of pinching (this separates muscle fibers, instead of bunching them, giving more space for needle and medication
• Distraction
• Puncture quickly; inject slowly (varies); remove needle quickly

[Jersey mike]

No matter how it’s done I hate shots.

[semo97]

I noticed using non refrigerated vaccine vs refrigerated that cattle and horses do not like the cold stuff. The vet told me it burns, that is why they will jump, kick struggle a bit. I have had to inject my horses and have been kick at, pawed at and some have tried to bite. Got to know where to stand, the guy holding the lead rope needs to pay attention.

[Pete]

Just FYI, I like a really sharp needle, and always request one. 

[The emperor has no clothes]

No matter how it’s done I hate shots.

I don't mind them at all. I just don't want to watch them. Seeing guys in the Navy just drop like a rock while watching others get the shot trained me to look the other direction.

[baldo]

I am sure Connie will jump in at some point and she is definitely the subject expert but I believe it depends on the type of injection in terms of how the needle is angled.

Subcutaneous (into the fat layer between the skin and muscle) 45 degrees

Intramuscular (deep into a muscle) 90 degrees

Haha!  There are several people here qualified to answer the question; some (including you) have answered correctly.

But, since you asked, I'll add a little bit to the discussion.  The image below depicts typical injection training.  The angles are to help ensure that the injector delivers the medication to the intended tissue level.  That said, if an experienced injector is sure of the tissue level, an angled approach may be preferable (for instance, for a 90 y/o, 90 lb woman without much muscle or sub-q tissue, entering at an angle may prevent striking the bone).  

I see no reason that the entry angle would impact the level of discomfort.  

The best techniques I've learned for giving painless IM injections:

• Warm the solution a bit by rolling the vial in your hands first.
• Depending on the medication, if appropriate, consider dilution with lidocaine instead of sterile water.
• Spread the skin/muscle, instead of pinching (this separates muscle fibers, instead of bunching them, giving more space for needle and medication
• Distraction
• Puncture quickly; inject slowly (varies); remove needle quickly

Great visual.

I definitely agree with the warmer temp. If I inject my insulin cold from the fridge, it freakin hurts.

[Serk]

No matter how it’s done I hate shots.

I gave up a free ride through pilot school and a career as a pilot because I didn't want a blood draw I hate needles so much.....

[scooperhsd]

No matter how it’s done I hate shots.

+1. And it hurts. Especially ones in the mouth (especially the roof of the mouth) (Yeah - I've had ALOT of dental work done).

[John Schmidt]

The one shot I got in the USAF that was really painful was for strep throat, had the consistency of Elmers Glue. My strep was bad enough they put me in the dispensary for a few days. While there, this pretty young 2nd John came around with a cart, stopping at each bed and the occupant held his breath while she decided if he was on her shot list. I happened to be so it was roll over sunny side up and grab the rails on the headboard, grit your teeth and hang on. I think it was called bicillin or something like that, that was over 60 yrs. ago so memory tends to fade a bit. I just remember it was sooo painful going in and I had a lump like a third glute for a week.  

[Jess from VA]

My favorite shot of all time was Novocain.

I'd already had about 4 of them in the mouth for a root canal (and those are unpleasant enough), but as he was drilling down into the live root, I was still having a lot of pain (and straitening out like an ironing board).

So, for the last one, he just dripped the Novacain out of the syringe down the open hole in the tooth right onto the live root.

No penetration at all, but searing-lightning pain like you never had in your life.

I thought about asking him to kick me in the nuts, just to take my attention off the tooth.  

Then he wonders why I don't come in twice a year for a checkup.

Are you sh!tting me, you might find something that needs more work!  

[scooperhsd]

I'm about to that point - screw 6 month checkups, they will just find another tooth that needs taken out (and counting my last - I'm up to 13 gone now).

THE very worst one - I was having another root canal done, and I was still having pain after 4 novacaine shots. So the dentist decided I needed another shot (this time of Lidocaine), and further - he had to put it into the roof of my mouth . MY God  - if you EVER need to torture someone to get information out of them - I'd start there !!!!