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Aspirating during the intramuscular injection procedure: a systematic literature review

Sisson, Helen



© 2015 John Wiley & Sons Ltd. Aims and objectives: To review the available evidence on aspirating when administering intramuscular injections and suggest recommendations for practice. Background: The process of aspiration has been ingrained in the intramuscular injection procedure, and whilst many policies no longer recommend this practice, it often continues to be taught and practiced. The result is a variation in this procedure not always consistent with an evidence-based approach. Design: A systematic literature review. Methods: A systematic approach to searching the literature was undertaken using identified academic databases from inception to May 2014. Citation searching identified additional data sources. Six studies met the search criteria. Results: The majority of health professionals do not aspirate for the recommended 5-10 seconds. Administering an injection faster without aspiration is less painful than injecting slowly and aspirating. The main influences on the decision of whether or not to aspirate are based on what health professionals are taught and fear of injecting into a blood vessel. Conclusions: In the paediatric vaccination setting, the practice of aspirating during the administration of an intramuscular injection is unnecessary and there is no clinical reason to suggest that these principles may not be applied when using the deltoid, ventrogluteal and vastus lateralis sites in other settings. Owing to its proximity to the gluteal artery, aspiration when using the dorsogluteal site is recommended. Nurses must be supported in all settings, by clear guidance which rejects traditional practice and facilitates evidence-based practice. Relevance to clinical practice: Educators need to ensure that their knowledge is up to date so that what they teach is based on evidence. This may be facilitated via regular educational updates. Further research and subsequent guidance are needed to support evidence-based practice in intramuscular injection techniques in all nursing settings.


Sisson, H. (2015). Aspirating during the intramuscular injection procedure: a systematic literature review. Journal of clinical nursing, 24(17-18), 2368-2375.

Acceptance Date Jan 26, 2015
Online Publication Date Apr 14, 2015
Publication Date 2015-09
Deposit Date Apr 27, 2015
Publicly Available Date Apr 27, 2015
Journal Journal of clinical nursing
Print ISSN 0962-1067
Electronic ISSN 1365-2702
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 24
Issue 17-18
Pages 2368-2375
Keywords Aspiration, Evidence-based practice, Intramuscular injections
Public URL
Publisher URL;jsessionid=780E031242829F41F1C9CEA14EA86F22.f03t02
Additional Information Author's accepted manuscript of article: Sisson, H. (2015), Aspirating during the intramuscular injection procedure: a systematic literature review. Journal of Clinical Nursing, 24: 2368–2375. doi: 10.1111/jocn.12824


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