Blood welling up at puncture site after IM injection

[baquettes]

I've been on HRT for a year and a few months, and sometimes after doing an injection in my leg, a lot of blood will gush up after withdrawing the needle. I aspirate every time before injecting, and also alternate between legs to give the other one time to heal.

 

I'm assuming I'm puncturing a blood vessel? But it's more than a few drops, it like pools out. When it does that, should I be seeking medical attention? As far as I know, I don't have a blood clotting condition. Could it also maybe just be I'm pulling the needle out at an angle? 

 

I've also noticed over the past couple of months, that it's getting increasingly harder to get the needle to break through the skin, let alone muscle. It took me two hours last night to do my injection because I couldn't get the needle in my leg no matter how much pressure I used (you can bet it hurt like hell too). So maybe there's excessive bleeding due to trauma? 

 

Thanks for the replies in advance!

 

(If needed, I have pictures that I can post if mod says it's okay to. They're not gory, just shows that it's more than a few drops.)

[VickySGV]

I do not use injectable hormones, but I do inject insulin a few times a day and have had the bleeding happen. Holding the alcohol swab on the hole when you pull it out will help the problem.  If you use exactly the same site even on opposite legs every time, there is going to be scarring in the area which makes it harder to push through the skin.  Moving a short ways away from the site you are using by only an inch or two can help the problem.  My suggestion is to call your doctor and have an RN coach you on where and how to do the injection and give you pointers (pun intended) on using the needle.  One of your injections could have created a small hematoma pocket that you keep hitting.

[baquettes]

Alright, thank you!

I do try to do it in a different place each time, but I get so anxious about the site being incorrect ? 

 

This may also be a silly question and I don't know if you'll have the answer, but does the length of the needle depend on weight? I've lost 10-15 lbs since the last time I've seen my doctor; I get anxious that my needle is too long now.

 

I'm hoping to set up an appointment soon

[VickySGV]

You are aiming for a muscle that is below the skin and fat layers of the skin. As long as you hit the actual bulk of the muscle and not the fascia at the ends of it, it will not matter how deep it goes in the muscle.  It is scary puncturing yourself and you should get the doctor or a nurse to help you find the right spot where the muscle is bulkiest.  I hope you are using disposable single use needles for this and have not been using one needle the whole time.  That would totally explain why you are having pain and problems of piercing the skin, because skin dulls the needles badly.  You also run a high risk of infection if you do  not use a new one each time.   My insulin needles come in packs of 100 and I use one and a half packs per month. 

[baquettes]

No worries, I use a new needle each time.

 

Thanks for answering my questions! Much appreciation ?

[VickySGV]

Just now, baquettes said:

No worries, I use a new needle each time.

It is possible the needles could be defective then.  I had a few packages like that once.  Check with your pharmacist about that possibility. 

[Briana]

Hi Baquettes,  definitely follow up with your MD where the team can help you sort things out.  While some blood can be normal after an IM injection, the bleeding you describe sounds like a wee bit too much.  One thing post injection; do apply pressure but use a clean 2x2 gauze pad, a cotton ball, or something similar - not an alcohol wipe.  Alcohol can inhibit clotting leading to continued bleeding.  And don't rub the site.  This used to be encouraged to alleviate discomfort and "distribute the medication".   In general, rubbing/massaging the site of an IM injection can lead to bruising and continued bleeding below the skin. 

 

And as Vicky mentioned, you may also have a batch of defective needles but now days it's not very common.  While in general, all needles used for injection look the same, quality can vary greatly depending on manufacturer etc.  I've run into whole lots where there were burrs left post-sharpening but that's been some time ago.  Although you'd generally need a magnifine glass to see them, you can generally tell when you use them.  One thing we see when we run into bad needles is excessive bleeding at the injection sites.  So ya never know.

[VickySGV]

5 minutes ago, Briana said:

something similar - not an alcohol wipe.  Alcohol can inhibit clotting leading to continued bleeding. 

 

Thank you for correcting me on that one.

[baquettes]

Thank you for the advice! I have an appointment scheduled soon and will bring it up with my doctor :^)