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Devices · Syringes & needles

Follow-up: Dead volume across syringe and needle combinations

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Solved by journalclub_wren in post #6
Picking up post #3: 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.

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ST
stopper_traceTL2Member13 Jun 2024#1

Dead volume across syringe and needle combinations — setting out what I have, and where I think it stops being reliable.

Practical question with the units stated, because I have seen how quickly these go wrong without them.

I have a 10 mg vial of tirzepatide and I am working to a 5.0 mg step. My syringes are U-100 insulin syringes, 0.5 mL barrel.

I can do the arithmetic and I have done it twice, getting the same answer both times, but I would like someone to check the reasoning rather than the number — specifically whether I have thought about the residual volume correctly, and whether the graduation I am landing on is one a person can actually read.

0 likes 2.1y
NE
n.ekstromTL2Regular19 Jun 2024#2

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.

19 likes 2.1y
SV
s.vukovicTL2 Moderator23 Jun 2024#3
n.ekstrom, post #2: 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

Worth separating two things that the opening post runs together.

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

8 likes in reply to #2 2.1y
SS
steady_stateTL3Regular27 Jun 2024#4

post #3 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.

2 likes 2.1y
YA
y.asanteTL2 Moderator1 Jul 2024#5

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 2.1y
JW
journalclub_wrenTL3Regular Solution4 Jul 2024 · edited#6
steady_state, post #4: post #3 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. Go to post

Picking up post #3: 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.

26 likes in reply to #4 2.1y
EH
e.halonenTL27 Jul 2024#7
DH
dietitian_hollisTL3Dietitian10 Jul 2024#8

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.

4 likes 2y
ER
e.roosTL2 Moderator13 Jul 2024#9
e.halonen, post #7: On post #3 — agreed on the reasoning, with one qualification. 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

I read post #7 twice before replying, because I had assumed the opposite.

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.

0 likes in reply to #7 2y
CI
citation_indexTL2Member16 Jul 2024#10
journalclub_wren, post #6: Picking up post #3: 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. 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.

0 likes in reply to #6 2y
AD
a.delgadoTL2 Moderator19 Jul 2024#11

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.

0 likes 2y
MH
m.haddadTL2Regular22 Jul 2024#12

I read post #10 twice before replying, because I had assumed the opposite.

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.

3 likes 2y
SA
s.adebayoTL2 Moderator25 Jul 2024#13

post #12 is right about the mechanism and I think understates the practical bit.

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.

10 likes 2y
WP
weekly_pinTL2Regular27 Jul 2024#14
dietitian_hollis, post #8: 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

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.

22 likes in reply to #8 2y
RW
r.weissTL2 Moderator30 Jul 2024#15

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 2y
AL
aliquot_lineTL3Regular2 Aug 2024 · edited#16

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

6 likes 2y
KM
k.marchandTL2 Moderator4 Aug 2024#17

post #16 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.

15 likes 2y
FT
fr.translation_moTL2Translator · FR7 Aug 2024#18

On post #14 — agreed on the reasoning, with one qualification.

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.

30 likes 2y
FP
f.piresTL2 Moderator9 Aug 2024#19
a.delgado, post #11: 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. 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.

2 likes in reply to #11 2y
GD
glossary_deskTL3Regular12 Aug 2024#20

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.

9 likes 2y
ED
e.dalgleishTL3Regular14 Aug 2024#21

I read post #19 twice before replying, because I had assumed the opposite.

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.

11 likes 23mo
RI
r.ilungaTL2 Moderator17 Aug 2024#22

This follows post #19 rather than contradicting it.

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.

3 likes 23mo
SG
s.grahameTL2Member19 Aug 2024#23

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.

0 likes 23mo
ER
e.roosTL2 Moderator21 Aug 2024#24
n.ekstrom, post #2: 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

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 in reply to #2 23mo
BS
buffer_sheetTL3Regular24 Aug 2024#25

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.

7 likes 23mo
BW
b.wikstromTL2 Moderator26 Aug 2024#26
citation_index, post #10: 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. Go to post

Picking up post #23: that is the part I would want checked first.

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.

1 like in reply to #10 23mo
BE
bench_entryTL3Regular28 Aug 2024#27
y.asante, post #5: 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

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.

0 likes in reply to #5 23mo
PD
p.dialloTL2 Moderator30 Aug 2024#28
b.wikstrom, post #26: Picking up post #23: that is the part I would want checked first. 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. 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.

18 likes in reply to #26 23mo
BJ
b.jankowiakTL3Regular2 Sep 2024#29

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.

24 likes 23mo
RM
r.mensahTL2 Moderator4 Sep 2024#30
e.dalgleish, post #21: I read post #19 twice before replying, because I had assumed the opposite. 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

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.

11 likes in reply to #21 23mo