Log in
Pernicious Anaemia Society
16,664 members β€’ 11,544 posts

Injection location and technique

Hi,

I've been self-injecting for about 3 weeks and it's going ok but I seem to be floundering a little with the technique. I'm doing IM in the thigh but always seem to hit a vein! Also it is hurting more than it did when supervised by the nurse, and I feel resistance when I push the needle in.

Also, where in the thigh should I inject? The nurse said upper outer quadrant, but online everywhere else says middle outer. Should I inject straight down to the floor, or if it's to the side should it be in slightly towards the leg? I feel I am somehow making this more complicated than it should be! I'm worried about hitting something I shouldn't.

Any help would be appreciated because there's nobody I can ask! It's a month until my next "official" injection with the nurse. After that I am allowed to do the 3-monthly injection at home.

Anybody else having problems?

28 Replies
oldest β€’ newest

Middle quadrant outer half. Inject down not out to side. Some tighten the skin and some bunch it together ready for injection. I get my other half whose trained to do mine and she always tightens the skin then pushes in like you'd hold a dart. Slow inject and all should be well. All make sense? Good luck

6 likes
Reply

How far out from the middle though? An inch? Two, three? I am silly and worry about hitting a bone ( or an artery! Lol!)

Reply

If I was dividing up my leg, the one that I had yesterday is showing at to the right of the middle line (right leg) down my thigh and half way between where I'd image the bone to be (middle) and the very outside of my leg as I look down. Pretty much middle from hip to knee. There was very little blood on withdrawal of needle and there was hardly any pain. The tip on warming is a good one but I tend to not bother as not a fridge line.

3 likes
Reply

It could be that you're tensing your muscle as you inject which would make it a bit more painful. If you can, just try to relax your leg muscles as much as you can and you'll probably find it easier, and less painful. I suspect it's the tense muscle that is causing you to feel you are having to press the plunger so hard. ;)

'Upper Outer quadrant' refers to the area of the buttocks for IM injections.

For the thigh, I was taught to put heel of one hand on the outside of knee and spread out fingers, then heel of other hand on hip and spread fingers out, then area suitable for injection is between 2nd and ring fingers of each hand.

I've changed to Sub-Cut injections now, with orange needle using abdomen, which gives far more options as is larger (!) but, if you are being given the needles, you might not have so much choice.

Sounds like you're doing well. It does take a little while to gain confidence though. Well done

2 likes
Reply

Yes, I think I am tensing the muscle. Strangely I seem to be getting more and not less tense! It was easier with the nurse there and I could say, is this ok? before plunging the needle in. Aaargh!

3 likes
Reply

I think I was the same, ie tensing more as the days went by. That's when I decided to try S/C and it's very much easier and no muscle to tense ;)

1 like
Reply

Oh, forgot to say -

Stick needle in at 90 degrees to the skin for IM injection, but at 45 degrees for S/C injection

;)

3 likes
Reply

are you keeping the B12 in the fridge? if so try warming it in your hand before injecting.

3 likes
Reply

Gambit, I didn't think it had to be kept in the fridge. In fact, I thought fridge was too cold for it.

To warm my ampoule, I have to say, when I take the ampoule out of the draw, I just stick it down my cleavage - so easy!!! ;) LOL

7 likes
Reply

I didn't say it had to be kept in the fridge - just asked if it was being kept in the fridge and hence cold which would make it more painful when injected.

you'll be making the gents jealous if you keep harping on about the cleavage ... though I'm sure they have other interesting nooks and crannies they could use for the same purpose :)

7 likes
Reply

Thanks Gambit

Yes, I appreciate you didn't say it had to be kept in the fridge but I was wondering if I'd missed something.

OK, I'll not mention where I keep my ampoules any more - promise!!! ;) Don't want to upset the gents, of course LOL

2 likes
Reply

I once had to have a series of very thick, long injections which the nurses warmed in their hands and then put in very slowly - no pain at all. Then one lazy night nurse did not bother to warm it and pushed it in very fast - the leg hurt for days. I never let her give one again.

Try it - warm it in your hand (or in your cleavage if you have cold hands like me) and put it in slowly.

Hope it works for you too.

6 likes
Reply

Curly gal are you drawing the plunger of your syringe back when you put the needle in?that should tell you if you hit a vein you would get blood in it.I have to say in many years of giving injections it never happened .As for where in the thigh to inject find the area when you are sitting down which is about7or8inches down from thigh bone and about the middle of the leg in the fleshy part and just plunge the needle in,,withdraw as I said and inject the contents of your syringe. You will get more confident as you go along you have overcome a lot of obstacles already.rotate the sites for each injection as that will help prevent any soreness developing.I would draw a diagram for you if I could. The area is referred to as upper outer quadrant of the thigh and upper outer quadrant of the buttocks can also be used.

2 likes
Reply

Do you mean 7 or 8 inches down from the hip bone?

Reply

Curly gal the groin I think if you look on line some where there should be a diagram illustrating the sites for injections. I see someone uses the same needle to draw up from the solution that they inject with.am surprised they are not complaining of stinging on the site due to the needle picking up solution it is better to use a different needle to inject with.again though different strokes for different folks.I hope I haven,t confused you more. It is a pity I can,t trot around and give you a demonstration.

1 like
Reply

The tip to warm the ampoule before injecting is a good one, I didn't do it the other day when the temperature had dropped, and really noticed the difference!

Hitting a blood vessel occasionally is almost inevitable, and isn't dangerous - the B12 I use says in the packet it's also suitable for IV injection, so wherever it ends up, it isn't dangerous!

If you're injecting with the support of your GP practice, you could always go back to them and ask for some further guidance/reassurance.

Good luck!

5 likes
Reply

They don't know I am supplementing the injections. I am only allowed 3-monthly injections but nurse taught me to do it myself. However I have to have one more "lesson" next month then nurse will give me needles, sharps bin etc. I will ask for guidance when I see her then though.

2 likes
Reply

This may seem crazy but I too needed to give myself extra courage so :-

I lay on my bed so my leg is stretched out.

Get the needle ready and know where you are going to inject. (Some ppl depress the fingernail on the spot to identify it).

Give the spot a hard slap. Either bunch up the skin or not as preferred.

Count 1,2,3 and insert needle.

Honestly you should hardly feel a thing.

Depress very slowly and twiddle your toes to help relax the muscle.

Remove needle and compress with a makeup remover pad.

I think the slap interrupts your brain's anxiety. It works for me so give it a try. The brain is amazing and the more you worry the more you will be tied up!

Certainly, when I injected into the outer edge of the thigh (the bit that hangs over a chair, say) I had blood squirt out so I go further in towards the middle of the leg.

Good luck. Keep thinking of how much better you are feeling with this treatment and you will get there.

Always inject after eating and don't jump up too soon after. You can do it!

Ask the nurse to draw on your leg the spot she recommends.

3 likes
Reply

If you really lose confidence before then, pharmacists at pharmacies offering needle exchange services should be able to show you how to inject correctly/safely. This service should be completely anonymous.

2 likes
Reply

HiCurlygal when my son showed me he said to tense muscle so you can see where it is and keep to outer part of that muscle middleish .Relax the muscle completely and push straight down.He said there's nothing major to hit if you stick to that area .I feel nothing when doing this and its like stabbing butter.However it takes me ages to actually psych myself even though I never feel a thing.As others have said pull the plunger back and if no blood then your fine.

2 likes
Reply

Well I managed it today without mishap or pain but got a bit concerned there seemed to be a bubble in the syringe which wouldn't shift? I didn't inject it all because I was worried about the air bubble. Also for some reason my left leg is much easier than my right! I don't know what is going on πŸ€”

Reply

I used to be terrified of air bubbles. If I can't get rid of it I turn the syringe on its side and flick till it moves up. If that fails I inject it back into the vial and draw up again slowly. once you have drawn it up pull plunger back a little so that there is a little air to at the top.this should help the bubble move up easier

Reply

Curly gal tap the syringe you should see the air bubble float up.then be careful to push the plunger up so you have a full syringe as for the legs it is easier to reach the site from where you are injecting if you are right handed you can reach the left leg easier and vice versa.you will soon be an expert it is not so intimidating as one becomes accustomed .

1 like
Reply

Thanks Retren I'm sure I will be ok, I don't plan on stopping anytime soon so it has to get easier! Practice makes perfect πŸ˜€

The bubble though was at the top after I had pushed the plunger up, seemed a bit weird. I had already pushed it up so a little liquid came out of the needle.

Reply

Just wanted to say a big thank you to everyone who replied, I really appreciate it πŸ˜€πŸ™†

Reply

Personally I find the injecting in the thigh painful and psychologically difficult for some reason. For me IM a prefer the deltoid (shoulder) or if it's a small volume, anything up to 1 cc I prefer Subcutaenous in the belly fat. Very easy from my perspective. Hope that helps.

Cheers

1 like
Reply

Hi,

much good advice here. One thing I learned for myself was that it seems to make it easier to use the syringe if I push the plunger in and out 3-4 times before fitting the needle -- I found the first push could be a bit stiff which added resistance to the injection. This is now part of my ritual (as is warming the ampoule the same way as JMN2017.... I have to keep it in the fridge atm because my apartment is very hot).

1 like
Reply

Why don't you try subcutaneous? You can use an small insulin pin, much easier,

Reply

You may also like...