Subcutaneous Injection Training – Injecting the Medication

so now we're actually going to go through the steps that are involved in doing the draw up of the medicine and then we'll do the injection in just a moment so the first thing I say is you should always have your bandaid ready to go you would be unwrapping your syringe getting that all set the first thing to do is to take the testosterone bottle and if it's brand new you're gonna be grabbing this with your fingernail and just peeling off the top and once it's off like I said you're gonna throw it away because it's not going to go back on then even though this is a brand new bottle we're gonna clean it three times with alcohol swabs so here's the swab there is a tiny pair of scissors with a dotted line on the side but you can ignore that the easiest way to open it is just grab it firmly from the edge rip across the center the swab comes out and then you're going to take the first swab and just make good contact with the top of that bottle give it a good rub and we're gonna do that two more times so that bottle is now clean and the top will have a little bit of alcohol residue on it but that'll be drying out while we're getting our syringe ready so then to put the syringe together with the needle with this type of threaded style you're gonna make contact and then give it about 2/3 of a turn until you feel like it stops and then good uncapping technique is to take the needle and syringe in the hands that are opposite pull apart and do it this way what you don't want to do is you don't want to do one-handed uncapping where you take your hand and do something like this pulling it off with one hand or pulling it off with your hand over the needle because if the needle touches your skin obviously it's no longer sterile then once we've actually taken the needle and the cap is off we're gonna put as much air in the syringe as we're going to be taking medicine out of the bottle so in this instance we're going to do a hundred milligram injection and recall that for each 0.1 milliliter quantity there's a twenty milligram amount of medicine in that so 100 milligrams is a 0.5 quantity of liquid the other thing is that the syringe itself when you look at this stopper it has kind of two lines on it and really you want to make sure that the top of the plunger aligns with the 0.5 demarcation so that may be a little bit hard to see but just bear in mind that you want the amount of liquid to be 0.5 when you're doing the draw up so you then take the needle and grab the bottle and can either do this on the counter you can do it with your hands but you just want to make contact with the top of that rubber stopper and plunge the needle in just like that and then you typically turn the bottle upside down one of the important things about such a small bottle is if you push the needle all the way up inside like this after probably the first injection that will be above the level of the liquid inside the bottle so it's really important to only put the needle in just as far as you need to to make sure that it's well underneath the level of a liquid so now that the needle is in and it's well below the level of liquid in the bottle we're basically gonna push up on the plunger which you can see bubbling up inside the bottle and then we're going to draw down on the plunger it's going to then start filling into the syringe I always tell people to overfill the syringe so I'm actually drawing back to 0.8 right now and the reason for that is because there is a little bit of air here at the top of the of the syringe and the reason to overfill it is because now that we're at 0.8 we can go back to 0.5 that pushes the air back up inside the bottle and will leave us with just 0.5 or 100 milligrams of actual liquid inside the syringe itself so that means we're all ready and we can basically then turn the syringe over and remove it from the top of the bottle before you actually take the needle off of the syringe it's important to remember there is a lot of medicine inside the metal shaft of the needle as well as inside the hub that's screwed on we don't want to waste that so before you actually take that needle off you're going to be backing down on the plunger again going back to 0.7 or 0.8 in this instance but about three tenths of a milliliter of air to make sure that you pulled all the medicine down into the syringe and at that point then you can take off that needle we're going to then exchange it for the smaller needle that we'll use for the injection itself and once again it's about 2/3 of a turn to get it locked on really nicely and then we're going to uncap one fell swoop and then we're going to advance the plunger back up to chase all of that extra air back out so that we're priming the need and we're gonna keep going until we see just a little bit of liquid coming out the tip of the needle there's a little ball of liquid that's now formed on the end of the needle which means there's no more air left in the syringe it's also good to know that if there's any bubbles that are in the liquid that you've drawn into your syringe if they're small it's probably not a big deal but if you see larger bubbles you should tap the side of the syringe to try to chase those up and you can go up and down a couple times with the plunger if you need to to make sure those are all gone so now this syringe is ready to go we're going to be using this for an injection in just a moment and when we do there are a couple things that I like to talk about and that will be the angle of approach for going into the skin so now we're ready to do the injection and what I usually tell patients to do first is to mark a location where they're going to do the injection you can do an injection anywhere that you can pinch an inch so for instance here there's plenty of fat to do an injection over here people are typically a little bit thinner and it might be harder to do an injection but we'll talk about how to do it in those locations and the love-handle is also fair game if you would like to do that another thing is to make sure that you move the injection around because if you're doing the injection in the same place week after week that place will get sore so I like to take the end of the needle that was actually threaded on to the syringe and use that to make a dot on the abdomen so just press it firmly into the skin it'll leave a little round circle like this that's a nice target so you can pay attention to where you're wiping with an alcohol swab so then again it's three swabs start in the middle of the spot go around in a circle getting a little bit larger as you go you're gonna do that three times so as we then wait for that to dry one of the things I like to suggest is that when you hold the syringe you can figure out what's comfortable for you but you need to grip it firmly and typically you're going to be using one finger to push on the plunger there are these wings on the back of the syringe those are nice for kind of gripping your fingers onto and when you push in you can push as hard as you like go as fast as you like it's only gonna go in one speed which is just based on the caliber of the needle that's being used the other thing is that the needle is only five eighths of an inch long and we want to do an injection one inch deep so we are going to be pushing the plastic into the skin about 3/8 of an inch further to make sure we're deep enough we typically don't prescribe the longer needles because they're psychologically less comfortable even though they really do feel the same when you have a larger and longer needle so when you do the injection you can see the spot right here that we've made that circle basically going to pull the skin outward away from the belly and when we go in bracing the arm on the opposite side makes it nice so that you can just move your wrist to get in and when you go in you basically want to get as close as you can to the skin and then in one movement you don't want to peck at the surface of the skin because obviously for each time you touch the needle to the skin you're gonna be feeling a little prick so I always tell people to grip firmly and actually cause some pain with the pinching hand because that distracts from the pain of the actual needle entering the skin once the needle breaks through the skin there's no pain as you slide in so bear that in mind as well so you can see the circle here my needle is in position just giving a good pinch and then moving the needle right through the skin rather than stopping on the surface like that you actually do want to dimple in a little bit so you can kind of see now the plastic is indenting the skin to a certain extent and at that point you can then start pushing on the plunger doing the injection and then you're going to count to five before you actually pull out so we're gonna give that a four three two one and then pull out and you're done so if there is bleeding have a band-aid close by you can certainly put that on if you like if you don't see any bleeding at all you probably don't need to use it but it's at least nice to have it close by when you're ready so once you're done with your injection remember that you're gonna be throwing the needle itself into a sharps container like this one here and it's a little bit more difficult to try to unscrew the needle from the end of the syringe but if you do put the top back on you can actually use that to form a grip on that plastic hub and then unscrew and then when you're ready to throw it away and you're doing this at home I would suggest it might be worth just throwing away the needle itself because if you do just the needle it'll take you almost forever to fill up the sharps container that you have at home you don't need to throw either the cap or the syringe itself into the sharps container it's really just the needle itself like I said so we just throw that in and off it goes once your sharps container is full you'll need to take it to a hazardous waste site usually most cities will have that you can also sometimes take it back to the pharmacy and they'll charge you a nominal fee to dispose of it for you so the last thing I'd like to say in summary is that if you do the injections at home this technique can be used for both estrogen and testosterone injections if you also notice that there's any redness swelling discomfort or itching or a knot forms underneath the skin the day after you do the injection or even a couple days later you should always let your physician know sometimes there can be a sensitivity or allergy to the oil that the medicine has floated in and physicians can change the formulation so that it's more agreeable for you so this concludes our subcutaneous testosterone injection instruction video I hope you found it helpful


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  2. Only video I could find that includes an explanation of the pinching process. I was unsure of whether or not I should let go of my skin after the needle is in, and this video showed/explained the whole process clearly.

  3. Thank-you for showing how to prep the needle! I've been given injectable Buscopan since the tablets are on shortage and I've been super anxious about air bubbles

  4. I am very skinny! it is really hard. First time even the nurse hit my muscle (my pressure went low; with cimzia) Now I have to do it myself

  5. Thank you for this instructional video. Just switched from oral to injection methotrexate, and was very anxious about doing it myself even with the instructions provided to me in person. Your video helped alleviate my anxiety, and I helped me with my first injection. So, thank you! πŸ™‚

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