Deltoid Intramuscular (IM) Injection - Clinical Skills - Dr Gill

[@NickzAndMikz]

I'm curious about the "alcohol swab not needed for immunizations." I am in medical school here in the USA and we are trained to use alcohol for any injection, is it different in the UK or new evidence to support it's an unnecessary step?

[@atticstattic]

Yeah that's weird - you wouldn't think introducing surface contamination into a puncture would be a good idea. I'm curious if you've run into the drawing the needle back, because I'd never heard of such a thing until viewing videos from the UK during the pandemic.

[@Kamila-ey5vi]

www.ncbi.nlm.nih.gov/pmc/articles/PMC6605859/ Found a few articles like this one that say there's not enough evidence either for or against using alcohol for vaccinations, so I guess it depends on preference of the practicioner

[@NickzAndMikz]

The lab that we had during medical school taught us to "draw back" (aspirate) On my general surgery rotation, the surgeon harped on it too and would stop me to ensure I aspirated before injecting local anesthetic. @@atticstattic

[@reimant1]

I think it's a change in procedure for immunisations and bloods. You don't want the alcohol interfering with the tests or provided vaccination and impacting it's effectiveness or accuracy. The needles are sterile, so for a patient who is clean and hygenic it's probably deemed a minimal risk not worth the downsides at this point. But I'm not a medic so perhaps Dr Gill will elaborate.

[@LaurenceTGreen]

Yes, I heard many people in countries like Japan were astounded that using an alcohol swab wasn't standard practice in the UK during the COVID jabs. I find casses like this where 'common sense' differs so much between countries fascinating - especially when you'd think there'd be global consensus about something medical. Who is really 'right' or 'wrong'?

[@chuckoneill2023]

In "Ye Olde" times in the US, there were some inoculations (smallpox, specifically) which the alcohol might interfere with. In those cases, acetone was often used instead. smallpox inoculations were often administered with a scratch on the surface, not an injection. Those times are long gone: That method was eventually abandoned; also smallpox has been eliminated.

[@taw8963]

Oh my goodness the asmr from the crinkly wrappers alone, let alone the content... My brain is so happy

[@OfficerKD6-3.7BladeRunner]

Simple, interesting, clear and relaxing. Simply amazing content

[@starfishgurl1984]

Fascinating, I guess I never really paid attention to two different needles being used for drawing and injecting into/with the syringe, but it makes sense thinking about it. I’m due again for my annual Covid and flu shots so it’s neat seeing the techniques employed from the outside perspective as I’m not usually able to see much myself when being injected. Also I know it’s probably weird to say but I’m one of those random people who actually enjoys the experience because I have a very high pain tolerance thanks to sensory processing disorder so for some reason shots actually activate pleasure centers in my brain even if they make my arms/muscles sore in the process.

[@MagnumDB]

As calm and comforting as you are… I still got chills seeing the needle. I am absolutely terrified of having to go to the hospital for any reason. The idea of being opened up, operated on in anyway makes me borderline physically sick with anxiety. I am terrified of getting older for that reason, the idea of laying in a hospital bed at the mercy of doctors, especially in America as they are overworked and stressed themselves. It is just so, so, so scary. :(

[@Abderrahmane_CHIKH]

Your medical insights are incredibly informative, and I appreciate the soothing quality of your voice - it's like a medical ASMR experience! Keep up the great work! Greetings from Algeria! 🇩🇿

[@DrJamesGill]

Glad it was useful

[@pickerpoker8947]

@2:38, you didn’t have gloves on, and then you miraculously did, and then @2:53 even more miraculously, you didn’t have gloves on again.

[@Brabant076]

Try looking at the socks on some videos :)

[@polly_pasta]

Thank you for this one! Would you ever do a tutorial for some other common IM injection sites?

[@DrJamesGill]

That’s the plan, I also intend to do the anatomy of those sites

[@johnathanleonardo912]

We got a new patient!

[@dsd-downshiftdave8056]

I watched several videos This is the only one that showed needle gauge , however failed to mention length of needle I use 1 inch, 23 gauge for my glutes, can the same size be used for delt, is a 1 inch inserted 2/3 of the way? Looks like you ended up going all the way in? Please clarify, thank you

[@TenkoBerry]

This was Good Information 👍

[@chuckoneill2023]

For what conditions would that particular injection be needed? Is it something which a patient could self administer like insulin? Just curious.

[@christophermusso]

I have Vitamin B-12 deficiency (pernicious anemia), and I self-administer a B-12 shot (cyanocobalamin) each month. 👍

[@DrJamesGill]

B12 is a simple one, as shown by Christopher, but many vaccines go in the deltoid as another option

[@Omni315]

Is it standard to have separate drawing and injecting needles? I've never noticed it before, but then I don't get injected often.

[@DrJamesGill]

Ideally so yes. Esp with glass vials, the drawing needle should have a filter then

[@TheAbabinili]

Insert the needle fully before administering medication, checking for flashback is not usually necessary. Apply a slight pressure on the injection site, after you pull out the needle. Always have your equipment prepared and ready for use(E.g. plaster).

[@DrJamesGill]

The flash back is a variable one I find. Very much not needed for subcutaneous, but for deep IM, personally I think it’s a reasonable safety check, esp for something we are looking for slower absorption of

[@xumuk1]

Inserting the needle fully is quite dangerous since the needle can break, and it'll be hard to pull it back, so we were reccomended to insert it only for 2/3 of it's length.

[@DrJamesGill]

100% and commented a such in the video. Also full insertion could potentially pass through the muscle in a slight person

[@ChancellorBeeHaw]

couldn’t help notice the mark on your left arm, near the wrist. apologies if im rude or ignorant in asking, did you hurt it somehow? if so i hope everything is okay! :) a concerned subscriber

[@OttoRoth-k6v]

A little bit of over kill wiping down a tray and emesis basin. Plus that 23 ga needle was a bit dull the way it was shoved in hard!

[@Mrkutq3]

Wat else can we use doc?

[@Ay0ub24]

I was told for my b12 injections that once they pierce the skin they have to hold the injection for 10 seconds before injecting? Just noticed you were pretty much in and out so was wondering is it different down in england compared to scotland?

[@DrJamesGill]

I’m not really sure why that would be. That frankly would prolong the injection, which isn’t great. Perhaps they meant the SPEED of the injection - as you should inject (ie depress the plunger) at 1ml over 10 seconds so it doesn’t sting.

[@CK-ki4ub]

King Dr Gill 👍

[@beepityboopity]

Could you ask her where she got those overalls please? 🤣 I need them

[@jaiboibiscuit2363]

search for "lucy & yak" :)

[@charliejones4590]

Look like Lucy and Yak maybe?

[@JeremyCoolDude]

@@charliejones4590 Yep, definitely Lucy and Yak. Have a pair of overalls from them and they've been good!

[@alisonmace3719]

Thank you! They are Lucy and Yak!

[@DevRSVR]

The circus i would have thought!

[@Waynzo-i3w]

What happened to the sound half way through?

[@igobivo]

Is that an air bubble on 2:47

[@atticstattic]

No

[@harryjamessmithmusic7762]

I like your channel but I must say I get my B12 injections only into my buttocks, so this surprised me. Maybe injections into the buttocks could be less sore or painful? Also, I noticed that your B12 liquid was colourless like water, but my B12 injections are always red. Greetings to the UK!

[@DrJamesGill]

This is not actually b12, this is just water for injections as it’s a demo However it can also be done in the deltoid like this without issue

[@harryjamessmithmusic7762]

@@DrJamesGill Thank you so much! Merry Christmas!

[@SirWeibrot]

Where does Dr. Gill keep finding these good looking people? Not to mention that he's pretty good looking himself Maybe those hospital dramas where everyone is basically a supermodel weren't too far off lol

[@davidsebastian7955]

Why you didn't insert the entire needs at first?

[@amuthealmighty]

Maybe a tutorial on how to self inject with heparin? After having my leg broken and later after a c-section I had to make myself heparin injections in my belly area. I always found it very difficult to break the skin, then it was okay 😂

[@DrJamesGill]

Great suggestion!

[@ARO323]

I can not wait 😁😁😁

[@Wandering869]

This is the dentist lady!

[@courtneylockwood3425]

Man that needle poke was sooooo slow that had to have hurt, if you do it more like a dart it hurts way less

[@CatastrophicalPencil]

I think the injection clip is at half speed for the demonstration

[@ianmurphy9955]

As a needlephobe I had to look away 😂, although I chose to watch the video. Go figure lol

[@Dark00Spade]

Disappointed for the lack of lollipops at the end 😔

[@lucadreier22]

woop

[@j.v.santos3101]

This voice. 😳😳😳

[@johnathanleonardo912]

Pretty sure its a woman. Some woman especially British have a deeper tone

[@standol]

First

[@guilhermenunes4275]

oh my lord she's gorgeous

[@Abderrahmane_CHIKH]

She was panicked before the injection 😂

[@unicorn3025]

So i click on your video i didn't realize until i read it what it said Im sorry nope nope not for me Too scary for me 🙈🙈🙈🙈🙈🙈🙈 Im sorry 😞 💔😔💔😔💔