Principles of Testosterone and hCG Injection Technique

[madman]

Selecting the Devices

There are many different syringes and needles, suiting many different procedures. It is important to choose the needles and syringes carefully according to the type of injection to be administered. For example, the length and gauge of the needle and type of syringe must be suitable for the injection site, viscosity, and volume of medication. The size, age, and condition of the patient are other key factors in the selection process.


The anatomy of the needle

The anatomy of the syringe

Guidelines for needle length and gauge selection

Preparation

Considerations Before Device Assembly

Devices and equipment

Filling the syringe

Administration

Injection Routes

• Intramuscular
• Subcutaneous
• Intradermal




Skin preparation

Injection routes Before you start

Injection sites (refer to pages 14 and 15 for needle length)

Standard injection procedure

 

[madman]

Bevel
The sharpened angular tip at the end of the needle. There are typically four types of bevels used for skin injections.

Regular bevel: The most common bevel, used for a vast majority of applications. Typically used for intramuscular and subcutaneous injections.

Short bevel: The needlepoint geometry is designed to minimize unwanted injection depth, such as penetration through a vessel wall, and to obtain rapid withdrawal or dispersion of a fluid. Typically used for specialty applications such as arterial blood gas sampling and nerve blocks.

Intradermal bevel: The geometry of the tip is designed to allow for shallow and low-angle insertion of the needle just below the epidermis. The fluid volume is typically very small and slowly administered. This unique needle bevel is used primarily for skin testing (e.g., allergy tests).

5-bevel: The two additional bevels create a flatter, thinner surface that has been shown to be less painful.*

 

[madman]

Needle
Made of stainless steel, which is siliconized to allow easier penetration, thus minimizing patient discomfort. Available in different lengths and gauges to suit individual clinical and patient needs.


There are three types of needle walls:

Regular Wall: This is the most common wall thickness. The thickness of the steel wall allows a good flow rate and minimizes flexing when the needle is inserted into a vial stopper or patient.

Thin Wall: As shown in the diagram, the thin wall needle has a narrower steel wall, allowing a greater volume of fluid to pass through it. The flow rate is typically equivalent to that of a needle one gauge larger. This is especially important with very thin needles.

Extra Thin Wall: This has the thinnest steel wall, provides higher flow, and requires less force to deliver medication.

 

[madman]

Generally used for injections requiring a secure connection of the syringe to another device. The tip is threaded for a “locking” fit, and is compatible with a variety of needles, catheters and other devices.

A friction-fit connection that requires the clinician to insert the tip of the syringe into the needle hub or other luer connection in a push-and-twist manner. This will ensure a connection that is less likely to detach. Simply sliding the attaching device onto the syringe tip may not ensure a secure fitting.

Allows for work requiring closer proximity to the skin. Generally used for venipunctures and aspiration of fluids. (Also see luer slip instructions above.)

Used for flushing (cleaning) catheters, gastrostomy tubes and other devices. Insert catheter tip securely into catheter or gastrostomy tube. If leakage occurs, refer to your facility’s guidelines.

Most commonly found in insulin and ‘tuberculin’ syringes. Permanently attached needles, also known as integral needles, reduce the amount of medication waste and allow accurate mixing of different medications into one syringe.

 

[madman]

PDF

 

[Nelson Vergel]

Thanks for posting this great review.

 

[Sly]

When I first started TRT, they had me injecting with 22ga needles! I now inject with 25ga, much better!

 

[Nelson Vergel]

in 1992, I started with 1 1/2 inch 23 Gauge needles in the glutes (using an 18-inch Gauge needle for loading). I am so glad we have found out that deep injections are not needed in TRT!

 

[JohnTaylorHK]

It's worth researching the Z-method or Z-technique to reduce wastage and any light bleeding at the injection site. I originally got this info from a College of Nursing training manual, but there are now several sites out there. Namaste.

 

[SilverSurfer]

Thank you for clarifying what “thin wall” and “extra thin wall” needles mean. When I’ve been shopping I’ve just assumed that was some marketing b.s.

 

[madman]

When I first started TRT I was using the 1 ml BD U-100 insulin syringes 28 gauge 1/2 inch needle length.

I have been injecting T 150 mg/week (75 mg every 3.5 days) strictly sub-q in my abdominal fat for the 3 years I have been on TRT and have tried various insulin syringes (gauge/needle length) and eventually switched over to the .5ml insulin syringes.....hands down these are the best I have used as not only do I find drawing/injecting quick, virtually pain-free, minimal trauma to tissue, and the .5 ml syringes are more compact and feel better in the hand and top it off with the fact that the scale markings on the barrel can be easier for some to read when measuring accurate doses.

I purchase these as I live in Canada!

BD 324920 INSULIN SYRINGE 0.5ML, 31G X 6MM NEEDLE

If I were injecting daily or EOD than I would definitely switch over to the .3 ml syringes same gauge/needle length.

US
BD Ultra-Fine Insulin Syringes | 6mm Insulin Syringes | Total Diabetes Supply

 

[madman]

It's worth researching the Z-method or Z-technique to reduce wastage and any light bleeding at the injection site. I originally got this info from a College of Nursing training manual, but there are now several sites out there. Namaste.

The z-track method has been around for decades and although it can be beneficial when injecting the wastage/light bleeding can be minimized to a great extent or avoided simply by injecting using a low dead space fixed needle insulin syringe and using the proper injection technique.

 

[madman]

Skin preparation

BD alcohol wipes are great because the swabs are thick/soft and soaked in isopropyl alcohol unlike a lot of the other brands which tend to have thin swabs that seem to hold less isopropyl alcohol and tend to dry out much quicker.




CANADA
BD Alcohol Swabs

US
BD Alcohol Swabs | Alcohol Swabs Bulk | Total Diabetes Supply

 

[Sakuraba39]

eventually switched over to the .5ml insulin syringes.....hands down these are the best I have used as not only do I find drawing/injecting quick, virtually pain free, minimal trauma to tissue, and the .5 ml syringes are more compact and feel better in the hand and top it off with the fact that the scale markings on the barrel can be easier for some to read when measuring accurate doses.

I switched over to the .5s and I'll never go back to anything else. I use the Covidien monoject with low dead space syringes.

 

[madman]

For Canadians on trt:

Syringes (Sure Comfort, BD, Terumo) FREE SHIPPING

My Everything Store - Canada's largest online supplier of medical supplies

One of the largest online supplier of medical supplies & home medical equipment

myeverythingstore.ca

BD ALCOHOL SWABS

BD SAFE-CLIP Needle Clipping & Storage Device (Stores 1,500 Needles)

My Everything Store - Canada's largest online supplier of medical supplies

One of the largest online supplier of medical supplies & home medical equipment

myeverythingstore.ca

Sure Comfort Insulin Syringes 27-31 gauge (1/2",5/16") box 100

Perfect for subcutaneous injections (low dose T daily/EOD)

BD INSULIN SYRINGE 0.5ML, 31G x 6MM NEEDLE

BD INSULIN SYRINGE 0.3ML, 31G x 8MM NEEDLE

 

[rayrock1]

madman how long do you take to inject once the needle is in? to inject your 75 mg e3.5d? I count 5 seconds during my injection time to push the plunger all the way down using a 27g 1/2 inch.

 

[madman]

Canadians on trt.....great for daily or EOD sub-q injection protocols!

Amazon.com

 

[DJXS]

in 1992, I started with 1 1/2 inch 23 Gauge needles in the glutes (using an 18-inch Gauge needle for loading). I am so glad we have found out that deep injections are not needed in TRT!

What do you use now? I'm looking at moving from 23g x 1.5" to 27g x 1.25", or maybe even 29g x 0.5". I inject med. into quads.

 

[DJXS]

For Canadians on trt:

Syringes (Sure Comfort, BD, Terumo) FREE SHIPPING

My Everything Store - Canada's largest online supplier of medical supplies

One of the largest online supplier of medical supplies & home medical equipment

myeverythingstore.ca

BD ALCOHOL SWABS
View attachment 10543

BD SAFE-CLIP Needle Clipping & Storage Device (Stores 1,500 Needles)
View attachment 10544

My Everything Store - Canada's largest online supplier of medical supplies

One of the largest online supplier of medical supplies & home medical equipment

myeverythingstore.ca

Sure Comfort Insulin Syringes 27-31 gauge (1/2",5/16") box 100
View attachment 10547








Perfect for subcutaneous injections (low dose T daily/EOD)

BD INSULIN SYRINGE 0.5ML, 31G x 6MM NEEDLE
View attachment 10545

BD INSULIN SYRINGE 0.3ML, 31G x 8MM NEEDLE
View attachment 10546

No problem pushing cyp. oil through these 31g needles? And here I am on the fence, leaning towards going with 27g, concerned that a 29g might be problematic. 29g, let alone 31g, sure would make daily or EOD injections easier to run with.

 

[Nelson Vergel]

31 gauge is way too small for me. I am always afraid they will break inside my delts (I know guys who have this happened)