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Devices · Syringes & needles · continued

Fixed versus detachable needles: the trade-offs posts 31–60

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1 · go to the accepted answer.

FN
formulary_notesTL3Regular3 Dec 2024#31
journalclub_wren, post #9: Aspirating before injection: for subcutaneous injection, aspirating (pulling back on the plunger to check for blood) is not necessary and is sometimes discouraged because it is associated with more discomfort. Subcutaneous injection without aspiration is standard practice. Go to post

Dead volume: residual liquid in the hub and needle after withdrawal. Typical residual is 0.01 to 0.02 mL for an insulin syringe with a fixed needle. Accounting for it matters if precision matters.

7 likes in reply to #9 20mo
CA
c.amankwahTL2 Moderator4 Dec 2024#32
PharmNotes_Whitfield, post #3: Needle length: typical lengths for subcutaneous injection are 4-6 mm (short), 8 mm (standard), or 10-12 mm (longer). Longer needles are needed for deeper tissue or if you have abdominal adiposity. Go to post

I disagree with the reply above, and I think the disagreement is substantive rather than terminological.

The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient.

1 like in reply to #3 20mo
SC
s.chowdhuryTL3Regular4 Dec 2024#33

I read post #31 twice before replying, because I had assumed the opposite.

Fixed versus detachable needles: insulin syringes usually have fixed needles (no dead volume loss to the hub). Luer-lock syringes use detachable needles (more dead volume). Fixed needles are preferred for small doses.

33 likes 20mo
AI
an.ibarraTL2 Moderator5 Dec 2024#34

This follows post #31 rather than contradicting it.

Insulin syringe graduations: U-100 syringes are marked in units where 100 units = 1 mL. Always confirm your syringe is U-100. Confusion between insulin units and milligrams is the most common syringe error.

17 likes 20mo
EF
endo_fellow_rkTL3Endocrinology fellow6 Dec 2024#35
k.vanhecke, post #7: Thank you for the correction. I have edited my earlier post with a note rather than silently, so the thread still makes sense to read. The error was mine and it was the kind that comes from remembering a figure instead of looking it up. Go to post

Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive.

4 likes in reply to #7 20mo
YA
y.adebayoTL2 Moderator6 Dec 2024#36

Syringe barrel size: common sizes are 0.3 mL, 0.5 mL, and 1.0 mL. Smaller barrels are more legible for small doses. Larger barrels hold larger volumes. Choose based on your dose.

0 likes 20mo
TH
TL4_HalvorsenTL4Leader · Journal club7 Dec 2024#37

Insulin syringe graduations: U-100 syringes are marked in units where 100 units = 1 mL. Always confirm your syringe is U-100. Confusion between insulin units and milligrams is the most common syringe error.

25 likes 20mo
RE
r.ekstromTL2 Moderator7 Dec 2024#38

Picking up post #35: that is the part I would want checked first.

Sharps disposal: needles and syringes should be disposed in a sharps container (a rigid, puncture-resistant container). Do not put them in regular trash. Many pharmacies accept filled sharps containers.

12 likes 20mo
SG
s.grigorescuTL2Member8 Dec 2024#39
maintenance_mode, post #20: Needle length: typical lengths for subcutaneous injection are 4-6 mm (short), 8 mm (standard), or 10-12 mm (longer). Longer needles are needed for deeper tissue or if you have abdominal adiposity. Go to post

Worth separating two things that post #35 runs together.

Syringe barrel size: common sizes are 0.3 mL, 0.5 mL, and 1.0 mL. Smaller barrels are more legible for small doses. Larger barrels hold larger volumes. Choose based on your dose.

1 like in reply to #20 20mo
SR
sa.rasmussenTL2 Moderator9 Dec 2024#40

post #39 is right about the mechanism and I think understates the practical bit.

Dead volume: residual liquid in the hub and needle after withdrawal. Typical residual is 0.01 to 0.02 mL for an insulin syringe with a fixed needle. Accounting for it matters if precision matters.

0 likes 20mo
Z
ZieglerTL3Regular9 Dec 2024#41
me.eriksen, post #27: post #26 answers the question as asked. The question underneath it is different. Reading units correctly: look at the marking from the side, not from above or below. The bottom of the plunger tip is the reading. Parallax error (wrong angle) is a source of dosing error. Go to post

post #40 is right about the mechanism and I think understates the practical bit.

Needle length: typical lengths for subcutaneous injection are 4-6 mm (short), 8 mm (standard), or 10-12 mm (longer). Longer needles are needed for deeper tissue or if you have abdominal adiposity.

4 likes in reply to #27 20mo
BJ
b.jansenTL2 Moderator10 Dec 2024#42
TL4_Halvorsen, post #37: Insulin syringe graduations: U-100 syringes are marked in units where 100 units = 1 mL. Always confirm your syringe is U-100. Confusion between insulin units and milligrams is the most common syringe error. Go to post

Fixed versus detachable needles: insulin syringes usually have fixed needles (no dead volume loss to the hub). Luer-lock syringes use detachable needles (more dead volume). Fixed needles are preferred for small doses.

12 likes in reply to #37 20mo
BP
baseline_peakTL2Member10 Dec 2024#43

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

25 likes 20mo
BN
b.nwosuTL2 Moderator11 Dec 2024#44

I read post #42 twice before replying, because I had assumed the opposite.

Aspirating before injection: for subcutaneous injection, aspirating (pulling back on the plunger to check for blood) is not necessary and is sometimes discouraged because it is associated with more discomfort. Subcutaneous injection without aspiration is standard practice.

0 likes 20mo
MS
m.stephanopoulosTL3Regular11 Dec 2024#45

post #44 answers the question as asked. The question underneath it is different.

Needle gauge: smaller numbers (30G) are finer and less painful. Larger numbers (25G) are courser. For subcutaneous injection, 27-30G is typical. Finer needles take longer to draw up but hurt less.

1 like 20mo
NN
n.norgaardTL2 Moderator12 Dec 2024#46
y.adebayo, post #36: Syringe barrel size: common sizes are 0.3 mL, 0.5 mL, and 1.0 mL. Smaller barrels are more legible for small doses. Larger barrels hold larger volumes. Choose based on your dose. Go to post

On post #42 — agreed on the reasoning, with one qualification.

Reading units correctly: look at the marking from the side, not from above or below. The bottom of the plunger tip is the reading. Parallax error (wrong angle) is a source of dosing error.

7 likes in reply to #36 20mo
RG
r.girardTL2 Moderator13 Dec 2024 · edited#47

Dead volume: residual liquid in the hub and needle after withdrawal. Typical residual is 0.01 to 0.02 mL for an insulin syringe with a fixed needle. Accounting for it matters if precision matters.

18 likes 19mo
CS
c.silvaTL2 Moderator13 Dec 2024#48

Needle gauge: smaller numbers (30G) are finer and less painful. Larger numbers (25G) are courser. For subcutaneous injection, 27-30G is typical. Finer needles take longer to draw up but hurt less.

0 likes 19mo
AZ
a.zamoraTL2 Moderator14 Dec 2024#49

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

11 likes 19mo
DT
d.tammTL2 Moderator14 Dec 2024#50
an.ibarra, post #34: This follows post #31 rather than contradicting it. Insulin syringe graduations: U-100 syringes are marked in units where 100 units = 1 mL. Always confirm your syringe is U-100. Confusion between insulin units and milligrams is the most common syringe error. Go to post

Worth separating two things that post #46 runs together.

Needle length: typical lengths for subcutaneous injection are 4-6 mm (short), 8 mm (standard), or 10-12 mm (longer). Longer needles are needed for deeper tissue or if you have abdominal adiposity.

24 likes in reply to #34 19mo
CO
c.ostergaardTL2 Moderator15 Dec 2024#51

Fixed versus detachable needles: insulin syringes usually have fixed needles (no dead volume loss to the hub). Luer-lock syringes use detachable needles (more dead volume). Fixed needles are preferred for small doses.

31 likes 19mo
HS
hana.satoTL4 Moderator15 Dec 2024#52
Staff post. Actions described here are recorded in the public moderation log and may be challenged in Meta.

Picking up post #49: that is the part I would want checked first.

Syringe barrel size: common sizes are 0.3 mL, 0.5 mL, and 1.0 mL. Smaller barrels are more legible for small doses. Larger barrels hold larger volumes. Choose based on your dose.

15 likes 19mo
FA
f.amankwahTL2 Moderator16 Dec 2024#53

Two things before anyone answers the substance.

First, the context in the first post is clear and specific. Second, the question is framed so that an answer can actually address it. Both are the norm here and both matter more than they sound.

6 likes 19mo
EP
e.piresTL2 Moderator16 Dec 2024#54
r.girard, post #47: Dead volume: residual liquid in the hub and needle after withdrawal. Typical residual is 0.01 to 0.02 mL for an insulin syringe with a fixed needle. Accounting for it matters if precision matters. Go to post

Sharps disposal: needles and syringes should be disposed in a sharps container (a rigid, puncture-resistant container). Do not put them in regular trash. Many pharmacies accept filled sharps containers.

1 like in reply to #47 19mo
NV
n.villalobosTL2 Moderator17 Dec 2024#55
m.lindqvist, post #24: Worth separating two things that post #20 runs together. Insulin syringe graduations: U-100 syringes are marked in units where 100 units = 1 mL. Always confirm your syringe is U-100. Confusion between insulin units and milligrams is the most common syringe error. Go to post

Aspirating before injection: for subcutaneous injection, aspirating (pulling back on the plunger to check for blood) is not necessary and is sometimes discouraged because it is associated with more discomfort. Subcutaneous injection without aspiration is standard practice.

23 likes in reply to #24 19mo
BI
blank_injectionTL2Analytical chemist17 Dec 2024#56

Reading units correctly: look at the marking from the side, not from above or below. The bottom of the plunger tip is the reading. Parallax error (wrong angle) is a source of dosing error.

10 likes 19mo
HB
h.bakkerTL2 Moderator18 Dec 2024 · edited#57

Worth separating two things that post #53 runs together.

Insulin syringe graduations: U-100 syringes are marked in units where 100 units = 1 mL. Always confirm your syringe is U-100. Confusion between insulin units and milligrams is the most common syringe error.

3 likes 19mo
MS
m.strand_rphTL3Pharmacist19 Dec 2024#58
b.nwosu, post #44: I read post #42 twice before replying, because I had assumed the opposite. Aspirating before injection: for subcutaneous injection, aspirating (pulling back on the plunger to check for blood) is not necessary and is sometimes discouraged because it is associated with more discomfort. Subcutaneous injection without aspiration is standard… Go to post

Needle length: typical lengths for subcutaneous injection are 4-6 mm (short), 8 mm (standard), or 10-12 mm (longer). Longer needles are needed for deeper tissue or if you have abdominal adiposity.

0 likes in reply to #44 19mo
RL
r.lundgrenTL2 Moderator19 Dec 2024#59

Coming back to post #57, because the follow-up matters more than the original answer.

Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive.

0 likes 19mo
QZ
q.zhao_qaTL3Quality assurance20 Dec 2024#60

Insulin syringe graduations: U-100 syringes are marked in units where 100 units = 1 mL. Always confirm your syringe is U-100. Confusion between insulin units and milligrams is the most common syringe error.

29 likes 19mo