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Accidental Intra-arterial Injection of Penicillin

Nicholas G. Tsoulos, MD
JAMA. 1980;243(8):733. doi:10.1001/jama.1980.03300340013009.
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To the Editor.—  In the report on accidental intra-arterial injection of penicillin G by Schanzer et al (242:1289, 1979), the authors contend it is not possible to create a negative pressure with the tubex method of injecting penicillin. It has been my personal experience that aspiration is possible with the tubex. Attention is directed to the small V-shaped portion of the syringe where it joins the needle. After insertion of the needle into the muscle, negative pressure is applied to the plunger before injection.Approximately nine years ago, I had occasion to administer bicillin C-R to a patient. Aspiration before injection resulted in blood appearing in the syringe. I kept that tubex taped behind my desk for quite a while as testimony to the need for aspiration prior to every injection.Intra-arterial injection of penicillin G is indeed preventable by the invariable practice of aspiration before injection.


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