More help for the injection impaired
March 28, 2010 11:16 AM   Subscribe

More help and reassurance for the injection impaired, please! I found this question but I'm still a bit freaked about having to give myself a subcutaneous injection.

I always close my eyes when someone gives me a shot, so while I have some written instructions about what to plug into what, I'm still flapping my arms about it. I also have to do it in the restroom at work (ick), so I'm less than happy.

Ok, so in the previous question, someone said to aim for a 45 degree angle and someone else said to pinch the skin. And to aim for the fatty tissue, not too close under the skin, and not into the muscle.

So do I pinch the skin and then stick the needle in lengthwise (along the pinched bit)?
How do I know I have the right tissue?
What if I don't get all the air bubbles out, is that dangerous?
What is better, belly or thigh?
How fast do I squirt it out?
I'm thin...any advice on account of that?

Thank you very much for anything you can tell me!
posted by Omnomnom to Health & Fitness (11 answers total)
 
When I had to do it, I found the top of the thigh was easiest. I picked the thickest part of my leg (starting ~4" above the knee), wiped a small patch with an alcohol swab, slid the needle in with a smooth motion until the plastic area above the needle touched my skin (at almost a 90 degree angle), and then pushed gently (think tiny coffee press pot) until the plunger hit the backstop. I removed the needle, pressed the alcohol swab over the tiny whole until the one or two drops of blood scabbed, and then put it in a reasonably puncture-proof container (glass bottle).

Don't overthink it. Take your time: the needle is plenty sharp and too thin to be painful. Removing it is no big deal either, just slide it out in a smooth motion and have something to put it in.
posted by Inspector.Gadget at 11:25 AM on March 28, 2010


There are plenty of instructional videos online you can watch that will help answer your questions.
posted by procrastination at 11:27 AM on March 28, 2010


Here's the first piece of advice. Relax. It seems like a big thing to you now, but it will turn out to be routine in a while. Roll with it.

As to the specific questions, yes you stick the needle in lengthwise. The word pinch may be a bit of a misnomer. You want to gather up a bit of skin between thumb and forefinger, but not hard enough to be painful. You're just trying to pull up some skin so you don't stab down into the muscle. The skin is loose, so if you just pull a little bit of it up, you will have the right tissue.

Air bubbles are not a serious problem if you properly evacuate the syringe and tap it with a slight flick. I am assuming you were instructed on how to fill and evacuate a syringe(?) If you have doubts, go back and ask the nurse. S/he should be happy to help you again.

You do not want to "squirt it out." Just a gentle, slow push on the syringe will do the job. You'll get the hang of it. As to thin. Thin is better as long as you get that nice fold of skin between your thumb and forefinger. As I said above, soon this will become routine.
posted by Old Geezer at 11:29 AM on March 28, 2010


So do I pinch the skin and then stick the needle in lengthwise (along the pinched bit)?
When i give myself injections, I pinch the skin and stick the needle in perpendicular to the skin.

What if I don't get all the air bubbles out, is that dangerous?
No, at least that's what my nurse said. The air bubble thing is a problem when injecting into a vein. Too much air could distort the amount you're injecting, though.

What is better, belly or thigh?
I think belly, but I am not skinny, and so it hurts less to stick the needle into my pudgy belly than into my thigh. But if you are skinny and trying to avoid muscle, then I would think that the thigh is a bad idea.

How fast do I squirt it out?
As fast as you can handle it? I have to inject 1 ml when I do mine and that's quite alot so I take it slow and I let it sit for a few seconds before pulling out the needle. But if you're injecting small amounts, you can just slam it in.
posted by cabingirl at 11:34 AM on March 28, 2010


I forgot to add that I use a pretty large needle (25 gauge, not the thin insulin type) and so my advice is skewed that way.
posted by cabingirl at 11:35 AM on March 28, 2010


The word pinch may be a bit of a misnomer. You want to gather up a bit of skin between thumb and forefinger, but not hard enough to be painful.

Yeah, in my line of work, we would say you "tent" the skin. I think it's a little more descriptive, as it looks like a little tent. For a subcutaneous injection, you want to gather a small amount of skin between your first finger and thumb, then pull it up so it's kind of stretched out, like a tent. You then insert the needle lengthwise just under where your fingers are. You want the bevel of the needle to face up, and insert the needle just far enough that the bevel is inserted all the way, maybe a half cm or so. The speed with which you deliver the medicine isn't terribly important, but you probably don't want to do it too fast, as it can end up coming back out the injection site. Once it's injected, gently pinch the skin around the needle as you remove it, and hold the skin for a few seconds to make sure you got the medicine in there. You'll see a little bubble of fluid just under the skin, which is how you'll know that you didn't accidentally insert the needle too deep.
posted by lexicakes at 11:38 AM on March 28, 2010


It does become routine, but I remember well the anxiety. Best advice I got was to not hesitate when giving yourself the injection. I liked a quick jab to get the needle in. I found it hurt less when I went into fattier tissue. I was fairly slim too, so the area around my belly button had the most fat. I had to go into my belly, so I have no experience with thighs. You will get the hang of actually pressing down the plunger. I like the example of a coffee press...it's exactly the same. Don't worry about going into the right tissue. As long as you gather a fold of skin/fat, the needle is short enough that you won't go into muscle. Do you have to go into a stall to give yourself the injection? I hope not. Lay everything you will need down on a clean piece of paper towel in front of you so you are ready with the alcohol swab, syringe, vial, and then alcohol swab again. I carried a pop bottle for syringes when I was away from my sharps container. You'll be fine.
posted by ms.v. at 11:38 AM on March 28, 2010


Thanks! I'm a big ninny and your explanations really helped. I'm marking lexicake's answer because the tent description suddenly clicked in my head, but the other answers are also good (and made me less nervous).
posted by Omnomnom at 12:59 PM on March 28, 2010


You may be a "big ninny" by your own definition, but your question is very valid.

While I don't inject myself, My wife has RA and needs injections that she feels funny about giving herself (sound familiar?).

Try to find a conference room or an office at work that is not being used.
You might want to involve the HR department and ask them for permission and help in finding a location that is not the restroom.
I am not saying this because of the health (ick) factors, but rather your personal comfort factor. It will be much easier for you to relax for the procedure if you can place your materials on a desk or table (instead of your lap or a tiny shelf) and have more relaxing surroundings.

Try not to shoot it in all at once if there is a large volume to inject. Go slowly until you are accustomed and comfortable.

I was told by the registered nurse that air bubbles are not a great concern. Try to minimize them, but don't go overboard. The "killed by an air bubble in a syringe" plot in the murder mystery over plays the concept. It takes a pretty good sized bubble to create an embolism.
posted by Drasher at 7:52 PM on March 28, 2010


If I may *ahem* inject this here.....

(N00b's pictorial guide to insulin injection set on flickr)
posted by Lynsey at 8:53 PM on March 28, 2010


Follow up: I survived! And i will never be a ninny again!

And I probably shouldn't have been surprised, but it turned out to be just like you said it would. Thank you for the help!
posted by Omnomnom at 10:58 PM on March 30, 2010


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