Did you request the vaccinator to aspirate?

[Namechanged4thi5]

I watched a Dr. John Campbell video where he goes into detail about how aspirating might reduce potential blood clots. So wondering if anyone requested this?

I did the SJA vaccinator training and it did come up that it used to be the practice to aspirate, but nowadays it is not recommended. Not that I've actually stuck any needles in arms due to having started a new full-on job since then! (I have done some carer shifts though).

The training is pretty comprehensive, I promise!

Yes, we were taught how to clean the skin with an alcohol wipe but were told that most sites' protocols say not to do this unless the skin is visibly dirty - if you do you have to wait 30 secs for it to dry as it would be quite painful having alcohol on the tip of the needle. I think alcohol wipes are generally only used before taking blood rather than giving injections.

we were taught how to clean the skin with an alcohol wipe

Yes, I heard that - NHS go by NICE/ PHE Green Book guidance and evidence which says alcohol wipes/ skin disinfection isn't routinely required.

www.guidelines.co.uk/immunisation-and-vaccination/phe-immunisation-procedures-guideline/455184.article

I was a bit surprised that SJA didn't follow the same guidance on this tbh.

No alcohol wipes routinely used for taking blood either anymore.

It wouldn't surprise me at all that "no aspiration" is based on probably fairly low probablilty if hitting a blood vessel.

What's worrying though is that from the earlier replies it looks like it's now deemed not necessary anymore and not just for covid jabs without qualifying why it maybe necessary in certain cases.

I always thought that there is a higher risk when a pathogen or foreign organism enters blood stream rather than muscle so it does make sense body would fight it with force.

it looks like it's now deemed not necessary anymore and not just for covid jabs without qualifying why it maybe necessary in certain cases

Do you mean aspirating? If so, that's not true - I (and I imagine) most HCP's would use clinical judgement to decide whether it is necessary or not. Same with alcohol wipes - I'd still use on a high risk patient (very elderly, sepsis/infection, immunocompromised etc).

The guidance we use (NICE/PHE) still recommends an alcohol wipes for anything more invasive/ IV - cannula, PIC lines etc. I also routinely used them on any covid wards (or any wards when the numbers were higher). If worried, patients can ask for one to be used. Asking to aspirate is a bit different.

To clarify - aspirating - I;d do if I thought necessary, but not just if asked.

Alcohol wipe - As above, but I'd also do if asked.

But all HCP's will use their own clinical judgement and reasoning on that. Basically, I will do things I can justify and give a reason for, where I think the benefit outweighs any risk. But of course I will always consider and listen to any patients requests as that is my priority, and explain what I think is best and their reasoning for that.

The problem is that not all vaccinators are HCPs and as PPs mentioned, it's no longer recommended or necessary.

[quote frumpety]@takemetomars a lot of the IM injections I give are into people who are elderly, so the muscle mass is generally much smaller, would you be confident doing an IM injection into someone who is cachexic without aspirating ? A nice plump 40 year old muscle versus a 87 yr old with COPD ? I thought at the heart of all nursing models was the idea of individualised assessment or are we going back to purely task based nursing ?[/quote]
Yes I would. The anatomy remains the same

academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab707/6353927

It's been useful reading what experienced HCPs have said here. I wonder what any think about the above article.

I can't help thinking that, even if the JCVI/MHRA thought this might possibly prevent the heart problems from Pfizer and Moderna, they might not get vaccinators to do anything different at this stage, as so few are trained to aspirate, and it's still a rare side effect.

But for a teenage son (especially one due to have both vaccines), I would feel reassured if they were going to aspirate. From this thread, it doesn't seem as though it's even worth asking for though.