Advice regarding IM injecting please

[yorkshiregirl4]

I self inject SC hydroxocobalamin most days but also ensure that I receive the two monthly IM injection at my GP surgery. On a recent appointment a new HCA gave me the IM injection and for the first time drew up the injection whilst I was there rather than having it prepared before I arrived, as usually happens.

The HCA snapped the ampoule, drew the contents into the syringe and used the same needle to inject the contents. I was very surprised because I use a needle with a filter to draw the liquid into the syringe and change to a thinner needle to SC inject.

I know we have very knowledgeable assistance here and wonder if this process was inappropriate and should I comment upon this for future appointments? Many thanks.

[wedgewood]

It’s not inappropriate to do that . The ampoules are designed to hold onto the liquid when turned upside down . I tried this at first when I started self-injecting . But I wasn’t very good at it and spilled b12 in the process

Also in the withdrawal process , using the one needle can lead to it being blunted ( OUCH!) on the glass of the ampoule . That’s when I took to using a long withdrawing

. But yes it is a correct way of injection to just use the one needle .

[yorkshiregirl4 in reply to wedgewood]

Many thanks for your advice. I do think the injection was more painful. I guess it is just once every 8 weeks!

[Wheat]

hello, I used to use filter needle but rather expensive. so researched and learnt that likelyhood of glass being injected and causing problems is minute. So smallest guage long needle for draw up and then use small needle to inject.

Also that medical staff do not use filter needles. It is usual for them to only use one needle. Like wedgewood this is a knack Ive not mastered. x

[yorkshiregirl4 in reply to Wheat]

I just wondered what happens at other GP's particularly as I have always had the syringe prepared before I arrive but many thanks for your reply.

[Hockey_player]

I use the same needle to draw up the B12 and to inject. The bottles have a rubber seal on them and the needle goes through that.

[yorkshiregirl4 in reply to Hockey_player]

I understand about the rubber seal as some covid jabs were prepared like that over here in the UK. My concern was in relation to shards of glass. Thank you for your advice Hockey_player.

[hdroxo in reply to Hockey_player]

You should use two....the green tip for withdrawing and the finer blue tip for injecting, you can buy 100pks which include syringe and both needles from Amazon, £24

[Hockey_player in reply to hdroxo]

Why? The family doctor who gave us instructions showed us how to do it and she said to use one needle. Why waste a second needle? What we are doing works fine. I live in Canada and won't be buying anything that costs pounds.

[Hockey_player in reply to hdroxo]

I only inject once per week. Why buy 2 years worth of needles?

[Fluffyfloo]

The pharmacist told me I needed to use a filter needle to draw out of the ampule. Then change the needle. I'm in the US.

[yorkshiregirl4 in reply to Fluffyfloo]

That's interesting. I thought that the B12 in the US was predominantly stored in a glass container with a rubber stopper. Your pharmacist obviously has high standards and I will certainly continue to use a filter needle for self injection. Thank you for your reply.

[mcg-woo in reply to Fluffyfloo]

Hmm..in the US also. I have never heard of using a filter needle. I have heard of using a different needle to draw serum from the vial with a rubber stopper and then changing to a finer gauge needle for injection.

I found the trouble and cost of changing the needle not worth the bother and the 25x1 syringe works fine to draw and inject as long as I aim for the center spot in the rubber seal and not bend the needle.

I also have some German Pascoe ampoules and am just using a Snap It tool (expensive but so worth it) to snap the top and place a 25x1 directly into the solution to draw it and then inject. Is there an issue with this process and do I need a filter needed to prevent injecting glass?

Would love to hear from both our US and UK friends on this topic. If you’re using a filter needle please post a link with example to showing filter needles.

Thanks in advance!

[yorkshiregirl4 in reply to mcg-woo]

Hello mcg-woo. As far as I am aware most of us in the UK use hydroxocobalamin and buy it in ampoules, as you have been doing for the Pascoe product. I use a filter needle because I understand there is a possibility, probably a pretty small possibility, that a tiny glass shard could be picked up in the drawing up needle after the ampoule has been snapped. However, I have to confess that on one order I requested the drawing needles without a filter by mistake and used them anyway.

The other element about using the same needle is that it is more easy to make the drawing up needle blunt by catching it on the glass ampoule, as compared to a rubber seal, and thereby making the injection more painful.

I use a 18G one and a half inches long blunt fill needle with a filter incorporated and a 30G half inch needle to inject SC. Thanks for you reply and hope my explanation is useful.

[mcg-woo in reply to yorkshiregirl4]

Gotcha, I understand. Thank you for sharing this valuable information. I hadn’t thought about a tiny glass shared entering the needle during draw. Makes sense. I will look into this. Thank you!

[yorkshiregirl4 in reply to mcg-woo]

You are very welcome! It is so fantastic to be able to share experiences so that other people benefit and equally so important that this is such a reliable site. Best wishes.

[Littlelodge123]

this is completely normal. I’ve had this done this way at my surgery for years. They taught me to self inject and I now do it at home.

[yorkshiregirl4 in reply to Littlelodge123]

Thanks Littlelodge. I change the needle between drawing up and injecting and this was the first time I had seen the procedure that they obviously use at my GP practice and was a bit surprised. Many thanks for your reply.

[scnuke]

There's nothing "wrong" with that technique per se, but while I do not use filter needle for drawing, I do change after drawing so I have a good, sharp needle for injection. But not changing is acceptable, albeit possibly a bit more painful for you, but it saves the clinic a bit of time and money.

[yorkshiregirl4 in reply to scnuke]

Many thanks for your reply scnuke. Yes, this does result in a more unpleasant experience but at least I receive the injection! Best wishes.