RazorsEdge
Member
I mean medical professional. Not body builder.
OK - I'm new to contributing to MG but this is something I'm pretty sure I know better than most. As a former Level 1 trauma paramedic and also having a Nurse Practitioner for a wife, it's safe to say I know injections. Nothing here will be "Bro" science but actual medical fact or practice that you would see everyday in every hospital in the USA. This is mainly for the beginner who is new to self injections but vets might find some of this info useful too.
Before getting started I want to say that if you can't give yourself an injection or it freaks you out. DON"T DO AAS! Stay Natty! Needles are a fact of life in this activity and if you can't stick yourself with one, go play with the little kids on the other side of the playground.
Also, every state has different rules but if your lucky like me and your state doesn't have laws on buying syringes, needles etc I am about to save you all kinds of time, money and pain. If your state is strict, well I'm sorry, you're stuck getting what you can.
With that out of the way...
What size syringe? 3ml minimum but 5ml will be OK too. Larger or smaller than this is just useless or awkward. Syringes are cheap so I keep both on hand but I do find 5ml easier to hold when reaching around myself to pin either shoulders or hips. I suggest B&D luer-lock but use whatever you like best.
What gauge needle? You are going to have to experiment here. Depending on the labs, the same AAS can have varying viscosity from one brand to the next but here is what the medical industry is going to use: 23 gauge for oil based IM (intramuscular) injection.
TIP #1 buy a thin wall 25G needle (yes, this exist). The inside diameter is the same as a 23G but the outer, overall diameter is a 25G.If your new to this, your probably wondering what kind of difference 2 gauge points can make. Well, when your pinning 3, 5 or 7+ times a week it makes a huge difference! No one likes to be a pin cushion.
Some will argue with me and say "well, I use a 27G or smaller" and I'll tell you going smaller isn't worth it and back it up by saying the medical industry agrees with me. The reason why is the smaller the needle, the longer you have to be in there doing your business. And longer the injection takes, the more bruising around the injection site (not superficial but deep bruising). Medical slang calls this "stirring-the-pot" and it's one of the main causes of PIP.
FYI, nurses will stir-the-pot intentionally if you're being an asshole so be nice to them if you happen to be in the hospital.
Needle Length? 5/8"-1.5" depending on injection site, injection volume and your own body fat levels. I remember being able to use a 25G 5/8" in my shoulder when I was younger during show prep and loving it (now I'm not so lucky but I'll get back to being that lean again.) Also, shallower injections generally require lower injection volume, more on this in a moment. My preference is 1" regardless of IM site.
OK, now that that's out of the way what else do you need?
Alcohol pads - cheap but if you can't get them, buy rubbing alcohol and some cotton balls. 'Nuff said.
Lower gauge sharp or blunt tip filling needles - not necessary but they make life much easier. These are almost always 18G. I prefer 18G blunt tips but they can be sharp too. You're only using it for filling.
Using ampules? Buy some filtered needles for filling. They aren't as cheap as the other supplies but there is a reason why the medical community uses them then dosing out ampule meds. Just think about injecting yourself with tiny bits of glass...
Injection site - The medical community follows S.H.T. - Shoulder, Hip (glute), Thigh. This isn't strict and pretty much any muscle can be used but the medical community uses these three regions because they tend to be the most muscular on your average person. Us meatheads, of course, are not average but for beginners, these are the places I recommend from both a medical standpoint and a personal stand point. You will eventually have a favorite (mine is vastus lateralis) just don't over do it in one area or it can cause scar tissue to start forming. Rotating sites is your best practice and just plain smart.
Injection volume - this is dependent on location. General medical rule for SHT is 1ml for shoulders, and 2ml's for hip and thighs. This is also good rule to follow when starting out (note: large volume injections, 3-5ml+ in the SHT site, are given in medicine but I do not recommended for a beginner). If you have heard the term "virgin muscle" but not experienced its true meaning you're going to want to trust me on this. Don't make your life worse by trying to shove 3ml into your delt in one go on your first injection. You'll regret it. A lot. As you get more experience your will find you can inject more into area over time. Just be patient and you will avoid unnecessary pain and discomfort.
OK, now that all of that is out of the way lets talk about sterility and procedure.
I'm going to give you the textbook and the actual practice scenarios and I am going to do this for multi-dose vials only. This post is getting long enough so you're on your own for ampules. You're smart so I'm sure you'll figure it out.
1. Take your gear (pop the safety top if needed) and wipe off the top with an alcohol pad. Just a quick swipe will do fine. The rubber stoppers are antimicrobial so you don't need to scrub at it, just a quick clean will do.
2. Take an alcohol pad and clean the chosen injection site. There is a reason you're doing this before loading the syringe so be patient and hear me out.
3. Grab a syringe and filling needle (you bough some, right?) and attach the two. This is where luer-lock comes in handy. Don't uncap the needle! Even if it's a blunt tip it's still sharp. Stick yourself once and you'll know what I mean.
3. Charge the vial. No, you're not going to plug it in! You're charging the vial with air to help you draw out the good stuff! Lets say you're going to pull a 1ml dose, uncap the syringe and pull back to 1.25ml's, stick it in the vial and push the air into it. Generally you want about 25% more air than the volume you're withdrawing. It will take practice but you will know when you add too much because the vial will leak around the needle and too little will make drawing out the oil like waiting for winter to end in Alaska.
4. Draw your dose. Tip the vial/syringe to an incline, make sure the needle is submerged and draw. We've all seen it in the movies, it ain't hard. Syringes are graduated so draw to your desired dose (say 1ml). NOTE: read the dose to the side of the plunger! Plungers are slightly pointed and you use the side not the point to measure from (if I had a dime for every time I had to say this to a clinical student in my paramedic days I could buy more gear!)
5. Recap the filling needle and switch to your injection needle. (don't fill with your injection needle. You are a meat head not a heroine junky! If you could only see how dull filling a syringe makes a needle under a microscope you would know why even the Pro's in a hospital do this)
6. Uncap your injection needle and hold the syringe vertically. Very lightly and slowly push the plunger while tapping out the bubble(s) until you get a drip or two out the end of the needle. You've all seen it done in the movies so this should be hard. This not only clears the air out but also lubricates the needle. Stop laughing about poking yourself with a lubricated shaft and just trust me, it helps to do this.
7. You're ready to go! Remember what I said about cleaning the area first before spending the time filling the syringe? Here is the reason, and you can test it out if you like to see that I'm right:
Cleaning the injection site first gives the alcohol a chance to dry before the injection. Whala! No alcohol burn! That is one less added pain point to deal with, thank you very much!
Stick that needle in however you like. You can tighten the skin around the site (some do but I don't) and slam it home with a girly scream (I sometimes do) or just be a masochist and do a slow roll in. Everyone got their own way of doing it and none of them are wrong, it's just what works for you. What you do want to keep in mind is you want to make sure you bury the pin into muscle and depending on the injection site sometimes that means going perpendicular to the skin and sometimes that means an angle. We're sticking with SHT in this post so you should be going perpendicular.
8. You're in, Whats next? I want you to remember this post is about Medical Training vs. Bro Science vs Medical Practice.
Aspirate.
No, don't cough something up! Aspirate the syringe. Pull back a bit on the plunger to check and see if you draw blood. No blood, you're good to go and slowly begin to depress the plunger. See blood? Scream like a girl again, pull the pin, stop the bleeding, change the needle and go back to step #7 at a new injection site of course (remember to clean the site first!).
Now is where I am sure I am going to get people pissed off so I'm going to let you make you're own decision based on facts:
Medical Text = Aspirate
Bro Science = Aspirate
Medical Practice = FUCK THAT!
Nurses and paramedics don't aspirate! If you know someone or are one and they/you say they/you always aspirate when giving an IM injection, I will call you a liar to your face. It just isn't done except for a handful of drugs that kill if absorbed too quickly into the body. This, by the way, is a very small handful of drugs and AAS's are not one of them.
See what I mean about you can make your own decision aspirate.
BTW - aspirating has been clinically studied and shown to cause more severe PIP in patients.
9. Whether you aspirate or not, the next step is to push the plunger slowly and evenly (you'll get a feel for the speed over time) and withdraw the needle. You may bleed a bit or you may not bleed at all. Put a band aid on it if you need to (Flintstones band aids work the best) and clean up your mess. Make sure everything is capped and dispose of your nastiness appropriately.
That's it! A very un-serious, medical look at self IM injections! All in only 1970 words!
Again, I know some will argue with me about this or that but I wanted to avoid the "Bro" science part and apply medical practice so the beginner can feel confident in what they're doing. There are some techniques I won't touch upon like Z-Tracking basically because the medical community doesn't wholly subscribe to them. Again, this is for the beginner and as someone becomes more advanced they can check out techniques on their own.
Let the trolls begin...
)))