A ten-fold dose error caught before injection — one year on

On the subject in the title: A ten-fold dose error caught before injection — one year on Working notes rather than a conclusion.

A question about technique rather than about dose.

I have been doing the same thing for 5 months and it works, and then I read one of the documentation pages here and realised I may have been reasoning from a misunderstanding the whole time. Nothing has gone wrong; I would just like to understand why it has not.

What I do, exactly, is described below. Please tell me which parts are load-bearing and which are superstition.

Needle length: typical lengths for subcutaneous injection are 4-6 mm (short), 8 mm (standard), or 10-12 mm (longer). Longer needles are needed for deeper tissue or if you have abdominal adiposity.

post #2 is right about the mechanism and I think understates the practical bit.

Fixed versus detachable needles: insulin syringes usually have fixed needles (no dead volume loss to the hub). Luer-lock syringes use detachable needles (more dead volume). Fixed needles are preferred for small doses.

Worth separating two things that post #3 runs together.

Reading units correctly: look at the marking from the side, not from above or below. The bottom of the plunger tip is the reading. Parallax error (wrong angle) is a source of dosing error.

Picking up post #2: that is the part I would want checked first.

Aspirating before injection: for subcutaneous injection, aspirating (pulling back on the plunger to check for blood) is not necessary and is sometimes discouraged because it is associated with more discomfort. Subcutaneous injection without aspiration is standard practice.

Sharps disposal: needles and syringes should be disposed in a sharps container (a rigid, puncture-resistant container). Do not put them in regular trash. Many pharmacies accept filled sharps containers.

Insulin syringe graduations: U-100 syringes are marked in units where 100 units = 1 mL. Always confirm your syringe is U-100. Confusion between insulin units and milligrams is the most common syringe error.

This follows post #6 rather than contradicting it.

Dead volume: residual liquid in the hub and needle after withdrawal. Typical residual is 0.01 to 0.02 mL for an insulin syringe with a fixed needle. Accounting for it matters if precision matters.

I read post #8 twice before replying, because I had assumed the opposite.

Needle gauge: smaller numbers (30G) are finer and less painful. Larger numbers (25G) are courser. For subcutaneous injection, 27-30G is typical. Finer needles take longer to draw up but hurt less.

Worth separating two things that post #7 runs together.

Syringe barrel size: common sizes are 0.3 mL, 0.5 mL, and 1.0 mL. Smaller barrels are more legible for small doses. Larger barrels hold larger volumes. Choose based on your dose.

I disagree with the reply above, and I think the disagreement is substantive rather than terminological.

The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient.

Aspirating before injection: for subcutaneous injection, aspirating (pulling back on the plunger to check for blood) is not necessary and is sometimes discouraged because it is associated with more discomfort. Subcutaneous injection without aspiration is standard practice.

Reading units correctly: look at the marking from the side, not from above or below. The bottom of the plunger tip is the reading. Parallax error (wrong angle) is a source of dosing error.