Do you still aspirate, and what does a 'positive flashback' actually change?
Taught to aspirate before injecting with a needle, but I keep reading debate about it. What's the current teaching and how much do you rely on it?
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We teach aspiration with a needle as one layer of safety, not a guarantee. A positive flashback (blood into the hub) tells you the tip is likely intravascular — stop, withdraw, reposition, don't inject there. But a negative aspirate does NOT prove you're safe: it can be falsely negative (small vessel, gel viscosity, technique, needle gauge). So aspiration is a useful check that never replaces the things that actually reduce risk: sound anatomical knowledge, correct plane and depth, moving the needle/using a cannula, low injection pressure, and small aliquots injected slowly. Treat a positive flashback as a hard stop; treat a negative one as 'proceed carefully', not 'guaranteed safe'.
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