Drawing up with one needle and injecting with another: a reasonable practice if you have extra needles. Fresh needle for injection reduces tissue drag and can decrease discomfort. Not necessary, but not harmful either.
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Practice · Administration · continued
Revisiting: Drawing up with one needle and injecting with another posts 31–60
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
Birkeland, post #25: Injection discomfort: comes from needle gauge (finer = less discomfort), volume (smaller = less discomfort), temperature (room temperature or warmed is less uncomfortable than cold), and technique (smooth, purposeful injection is less uncomfortable than hesitant). All four are under your control. Go to post
Coming back to post #30, 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.
post #32 answers the question as asked. The question underneath it is different.
Angle of injection: 90 degrees into pinched tissue ensures subcutaneous placement. It is not always necessary and shallower angles can work, but 90 degrees into a small pinch is the safest technique to learn first.
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Injecting into an area that has become firm: lipohypertrophy — thickened fatty tissue from repeated injection in one area — changes local tissue absorption. Avoid injecting into areas that are noticeably firm or lumpy and allow those areas to recover for at least a few months.
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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.
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Bleeding at the injection site: normal and usually minimal. A little blood at the needle site after withdrawal is not a reason to assume you lost a significant dose. The needle passed through tissue and there is a small amount of bleeding in the tract.
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f.rasmussen, post #1: Revisiting: Drawing up with one needle and injecting with another Writing it up because I had to work it out twice and would rather nobody else did. Practical question with the units stated, because I have seen how quickly these go wrong without them. I have a 2 mg vial of tirzepatide and I am working to a 1.0 mg step. My syringes are… Go to post
post #36 is right about the mechanism and I think understates the practical bit.
A site rotation scheme that actually works: abdomen, outer thigh, back of arm, outer hip. Rotate through them in order, move a minimum 2 cm between consecutive sites, note the site with each dose. If a local reaction appears you have the history. If you rotate properly you will not get lipohypertrophy from overuse of one area.
Worth separating two things that post #34 runs together.
Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A shorter needle (4-6 mm) is safer with a gentle pinch. The pinch size matters less than people think; the injection angle matters more.
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bias_variance, post #14: Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A shorter needle (4-6 mm) is safer with a gentle pinch. The pinch size matters less than people think; the injection angle matters more. Go to post
A genuinely late dose: the labelling generally says that if the next dose is more than a couple of days away, take it as soon as you notice. If the next dose is close, skip it and resume the schedule. The reasoning follows from the long half-life; you are perturbing a slowly moving average.
KStephanopoulos, post #23: Leak-back after withdrawal: a small amount of liquid on the skin after withdrawal is ordinary. Whether you lost a "meaningful" dose depends on concentration and your target dose, but some leak-back is universal and does not need to be treated as an error. Go to post
Leak-back after withdrawal: a small amount of liquid on the skin after withdrawal is ordinary. Whether you lost a "meaningful" dose depends on concentration and your target dose, but some leak-back is universal and does not need to be treated as an error.
c.dahlberg, post #19: Bleeding at the injection site: normal and usually minimal. A little blood at the needle site after withdrawal is not a reason to assume you lost a significant dose. The needle passed through tissue and there is a small amount of bleeding in the tract. Go to post
I read post #39 twice before replying, because I had assumed the opposite.
Drawing up with one needle and injecting with another: a reasonable practice if you have extra needles. Fresh needle for injection reduces tissue drag and can decrease discomfort. Not necessary, but not harmful either.
A genuinely late dose: the labelling generally says that if the next dose is more than a couple of days away, take it as soon as you notice. If the next dose is close, skip it and resume the schedule. The reasoning follows from the long half-life; you are perturbing a slowly moving average.
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post #43 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.
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Injection discomfort: comes from needle gauge (finer = less discomfort), volume (smaller = less discomfort), temperature (room temperature or warmed is less uncomfortable than cold), and technique (smooth, purposeful injection is less uncomfortable than hesitant). All four are under your control.
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On post #43 — agreed on the reasoning, with one qualification.
Leak-back after withdrawal: a small amount of liquid on the skin after withdrawal is ordinary. Whether you lost a "meaningful" dose depends on concentration and your target dose, but some leak-back is universal and does not need to be treated as an error.
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a.adeyemi, post #43: Cold solution and stinging: warming the vial in your hands for a minute before injection reduces the stinging sensation substantially. This is the simplest thing to try if injections are uncomfortable. Go to post
post #47 answers the question as asked. The question underneath it is different.
Injecting into an area that has become firm: lipohypertrophy — thickened fatty tissue from repeated injection in one area — changes local tissue absorption. Avoid injecting into areas that are noticeably firm or lumpy and allow those areas to recover for at least a few months.
s.ostergaard, post #13: Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A shorter needle (4-6 mm) is safer with a gentle pinch. The pinch size matters less than people think; the injection angle matters more. Go to post
A site rotation scheme that actually works: abdomen, outer thigh, back of arm, outer hip. Rotate through them in order, move a minimum 2 cm between consecutive sites, note the site with each dose. If a local reaction appears you have the history. If you rotate properly you will not get lipohypertrophy from overuse of one area.
cannula_trace, post #2: the opening post answers the question as asked. The question underneath it is different. 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… Go to post
This follows post #47 rather than contradicting it.
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.
s.oyelaran, post #30: Cold solution and stinging: warming the vial in your hands for a minute before injection reduces the stinging sensation substantially. This is the simplest thing to try if injections are uncomfortable. Go to post
post #50 answers the question as asked. The question underneath it is different.
Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A shorter needle (4-6 mm) is safer with a gentle pinch. The pinch size matters less than people think; the injection angle matters more.
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Bleeding at the injection site: normal and usually minimal. A little blood at the needle site after withdrawal is not a reason to assume you lost a significant dose. The needle passed through tissue and there is a small amount of bleeding in the tract.
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Coming back to post #52, because the follow-up matters more than the original answer.
Air bubbles in a subcutaneous injection: the honest risk assessment is low. Tiny air bubbles in subcutaneous tissue do not behave like an air embolism in a blood vessel. A few air bubbles are not a reason to restart the entire injection.
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i.lehtinen, post #38: Worth separating two things that post #34 runs together. Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A shorter needle (4-6 mm) is safer with a gentle pinch. The pinch size matters less than people think; the injection… Go to post
Injecting into an area that has become firm: lipohypertrophy — thickened fatty tissue from repeated injection in one area — changes local tissue absorption. Avoid injecting into areas that are noticeably firm or lumpy and allow those areas to recover for at least a few months.
a.ibarra, post #51: post #50 answers the question as asked. The question underneath it is different. Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A shorter needle (4-6 mm) is safer with a gentle pinch. The pinch size matters less than… Go to post
Leak-back after withdrawal: a small amount of liquid on the skin after withdrawal is ordinary. Whether you lost a "meaningful" dose depends on concentration and your target dose, but some leak-back is universal and does not need to be treated as an error.
This follows post #54 rather than contradicting it.
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.
2 likes 4mo
I read post #56 twice before replying, because I had assumed the opposite.
Angle of injection: 90 degrees into pinched tissue ensures subcutaneous placement. It is not always necessary and shallower angles can work, but 90 degrees into a small pinch is the safest technique to learn first.
0 likes 4mo
On post #56 — agreed on the reasoning, with one qualification.
Cold solution and stinging: warming the vial in your hands for a minute before injection reduces the stinging sensation substantially. This is the simplest thing to try if injections are uncomfortable.
9 likes 4mo