I did my first 8 subcutaneous b12 injections as I was shown by the doctor. Since then the nurse at my g.p. surgery has been doing my injections every 2 weeks as prescribed. (She offered me the choice of continuing to do it myself or she would do it.)The consultant had told me if I wanted to give myself extra injections to do so. I still had some of the original ampoules he prescribed for me and I decided to try redoing the loading doses to see if it helped.
I've rewatched videos of how to do it but I am finding that somehow not all of the b12 goes into the syringe. There's nearly half left in the ampoule. I'm using the proper needles and syringes that the consultant told me to use. Why am I finding that so much is left behind in the ampoule? Thanks for any suggestions.
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Suesue246
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If you are using a 1ml ampoule of B12 , you do need to use a 2 ml syringe . I usually ‘ease ‘ the syringe by pumping the plunger as few times first if all . Then I pull out the plunger nearly to the top , and inject air slowly into the P12 ampoule. Slowly and carefully because if you are too robust , the B12 will spill out of the ampoule . Then I place the tip of the withdrawing needle ( 1 1/2 long coarse withdrawing needle or a blunt withdrawing needle ) onto the bottom of the ampoule , and pull out the plunger . You will find that this will withdraw every drop of precious B12 into the syringe .
Then I replace the withdrawing needle with the injecting needle ( be it a short sub-cutaneous needle or the longer Intra-musculer one ) In withdrawing the B12 you will have drawn some air into the syringe , and you will now get rid of it by carefully pressing on the plunger until a tiny bead of b12 appears on the end of the needle . I must say that if you forget to do this , it is not a serious matter ,so don’t worry yourself. It’s injecting air into a vein that should not happen . But it’s best to get rid of any air that’s in the syringe . You are now ready to inject a full quantity of B12 .
I hold the ampoule at about 20 degrees and make sure the needle has the flattened side resulting from its sharpening is faced down. I do not inject air into the solution as it makes no difference. Practice using a used ampoule etc. and practice withdrawing some water from it. Sure you will soon get the hang of it. Best Wishes.
I practised with water too in the beginning as I found loading the syringe the hardest part. It's very much about technique. Once I was shown how to do it I had no issues. I can't explain though, my sis did a quick video for me. The trick was to load it using one hand.
Thank you. I think I have either been holding the ampoule at the wrong angle or without realising maybe I didn't put the needle far enough into the ampoule.
Because the needle you are using to withdraw the B12 is not the same one as you are using to inject, it doesn't matter if it gets blunted by touching the bottom of the glass ampoule. (Blunted needles hurt !) So you can put the needle to the bottom without worry.
When you have flicked the (2ml) syringe to get any bubbles of air up to the injecting needle and out, then allow a droplet of B12 to form at the needle tip to ensure no air - don't forget to flick the syringe to remove that droplet or injection will sting. Also, if using antiseptic wipes, wait till your injection area has dried before injecting. That can be another cause of stinging.
I've never turned the B12 ampoule upside-down before - you learn something new every day here !
I only had videos to go by and with plenty of support and advice from here too, it was fine. I was quite inept and nervous at first, but I think that this is probably usual. I've now been doing this for 7 years - and getting quite good now !
The reason most people use two (longer one to withdraw B12 , shorter one to inject it) is because these needles, although very sharp, are easily damaged. If the withdrawing needle touches the bottom of the glass ampoule, the tip of the needle will probably be blunted. That can make injecting both difficult and painful.
This is most likely also the reason why people prefer to tip the ampoule upside down and withdraw the B12 downward, which would mean they don't have to scrape about to get those last few drops ---- and therefore only need the one needle (I've only just worked that one out !)
I would imagine that relevant medical professionals are trained to do it this way - certainly would save on time, materials, disposal - and costs to the NHS.
I was taught to snap the lid off the ampoule and turn it upside down. Not sure if you are doing that? The ampoule is designed to form a seal so that the liquid doesn't run out but it's easier to access. I go slowly and watch that I have the needle tip in the liquid as the level drops, and I have never ended up with any liquid left or inaccessible. I then change the needle as others have described.
Some of that advice sounds a bit messy, potentially?
2ml syringe, 1.5ml Pascoe ampoule. Put ampoule in snapper, dot forward. Flick top of ampoule until all B12 drops into bottom of ampoule. (Maybe that’s the step you are missing?) Close snapper, snap it. Insert withdrawing needle right to bottom of ampoule, don’t worry about touching bottom of the ampoule. (That’s why the withdrawing needle is used at this point). Draw up B12, keep going till you get some air also. Hold syringe with plunger downwards, needle up, and swap injecting needle onto syringe. Still with plunger downwards, push plunger slowly to drive air out of syringe, stop when the air is out and a bead of B12 appears at the top of the needle.
You are now ready to inject all the B12 into your chosen site.
Tipping the ampoule upside down is not messy at all - it's what they are designed to do! I guess everyone has their own methods, but I was taught this by the Cambridge doctor and I've never had an issue with any left over or spilling a single drop.
After reading all the great advice here I wondered if u had a larger ampoule? I thought this as u said u had half left over. I SI using 1 ml ampoules. I hope u sort your problem out 🤗💜
Sometimes this can happen if you've drawn air into the syringe. If that happens, hold the syringe so the needle is upwards and expel some of the air from the syringe without squirting any of the B12. Then go back to the ampule and draw up the rest of the B12. Remember to remove any air from the syringe before injecting.
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