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Devices · Syringes & needles

A ten-fold dose error caught before injection

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CB
c.boatengTL2 Moderator12 Feb 2025#1

A ten-fold dose error caught before injection — setting out what I have, and where I think it stops being reliable.

Reporting something rather than asking about it, in case the pattern is useful to anyone else.

Over 26 weeks I logged this consistently: date, dose, time of day, and a simple severity score from 0 to 4 for each symptom. That is 201 data points, all self-reported, all unblinded, and collected by someone who knew what he expected to find. Treat it accordingly.

The reason I am posting is that my experience does not match the shape people usually describe here, and I would like to know whether that is unusual or whether the usual description is just the loudest version.

20 likes 17mo
CN
cohort_notesTL2Member18 Feb 2025#2

Thank you for the correction. I have edited my earlier post with a note rather than silently, so the thread still makes sense to read. The error was mine and it was the kind that comes from remembering a figure instead of looking it up.

3 likes 17mo
ZA
z.adeyemiTL2 Moderator22 Feb 2025#3

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.

0 likes 17mo
R
RidgewayTL3Regular26 Feb 2025#4
cohort_notes, post #2: Thank you for the correction. I have edited my earlier post with a note rather than silently, so the thread still makes sense to read. The error was mine and it was the kind that comes from remembering a figure instead of looking it up. Go to post

post #3 is right about the mechanism and I think understates the practical bit.

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.

31 likes in reply to #2 17mo
AK
an.kirchnerTL2 Moderator2 Mar 2025#5

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.

15 likes 17mo
EF
erratum_fileTL3Regular5 Mar 2025#6

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.

6 likes 17mo
HJ
h.jansenTL2 Moderator8 Mar 2025#7

On post #3 — agreed on the reasoning, with one qualification.

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

1 like 17mo
G
GEldridgeTL3Regular11 Mar 2025#8
Ridgeway, post #4: post #3 is right about the mechanism and I think understates the practical bit. 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. Go to post

post #7 answers the question as asked. The question underneath it is different.

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.

0 likes in reply to #4 17mo
VK
v.kjaerTL2 Moderator14 Mar 2025#9
an.kirchner, post #5: 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. Go to post

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.

3 likes in reply to #5 16mo
DB
d.bramleyTL3Regular17 Mar 2025#10

This follows post #7 rather than contradicting it.

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.

0 likes 16mo
CL
c.lundgrenTL2 Moderator20 Mar 2025#11

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.

21 likes 16mo
NN
n.nybergTL2 Moderator23 Mar 2025#12
cohort_notes, post #2: Thank you for the correction. I have edited my earlier post with a note rather than silently, so the thread still makes sense to read. The error was mine and it was the kind that comes from remembering a figure instead of looking it up. Go to post

Two things before anyone answers the substance.

First, the context in the first post is clear and specific. Second, the question is framed so that an answer can actually address it. Both are the norm here and both matter more than they sound.

0 likes in reply to #2 16mo
ZL
z.laurentTL2 Moderator26 Mar 2025#13

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.

0 likes 16mo
HE
h.eriksenTL2 Moderator28 Mar 2025#14

Worth separating two things that post #10 runs together.

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.

5 likes 16mo
CG
c.grimaldiTL2 Moderator31 Mar 2025#15
n.nyberg, post #12: Two things before anyone answers the substance. First, the context in the first post is clear and specific. Second, the question is framed so that an answer can actually address it. Both are the norm here and both matter more than they sound. Go to post

Picking up post #12: that is the part I would want checked first.

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

28 likes in reply to #12 16mo
DO
dr_okonkwoTL4 Moderator2 Apr 2025#16
cohort_notes, post #2: Thank you for the correction. I have edited my earlier post with a note rather than silently, so the thread still makes sense to read. The error was mine and it was the kind that comes from remembering a figure instead of looking it up. Go to post
Staff post. Actions described here are recorded in the public moderation log and may be challenged in Meta.

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.

0 likes in reply to #2 16mo
TP
t.pereiraTL2 Moderator5 Apr 2025#17

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.

2 likes 16mo
FV
f.villalobosTL2 Moderator7 Apr 2025#18

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.

9 likes 16mo
L
LundqvistTL2Member10 Apr 2025 · edited#19
z.adeyemi, post #3: 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. Go to post

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.

10 likes in reply to #3 16mo
FL
f.laurentTL2 Moderator12 Apr 2025#20

I read post #18 twice before replying, because I had assumed the opposite.

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.

22 likes 15mo
D
DOdendaalTL3Regular15 Apr 2025#21
c.grimaldi, post #15: Picking up post #12: that is the part I would want checked first. For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use. Go to post

I read post #19 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.

30 likes in reply to #15 15mo
BT
b.teixeiraTL2 Moderator17 Apr 2025#22

This follows post #19 rather than contradicting it.

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.

15 likes 15mo
ED
e.dalgleishTL3Regular20 Apr 2025 · edited#23

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

3 likes 15mo
RI
r.ilungaTL2 Moderator22 Apr 2025#24

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.

0 likes 15mo
SG
s.grahameTL2Member24 Apr 2025#25

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.

22 likes 15mo
ER
e.roosTL2 Moderator27 Apr 2025#26

Picking up post #23: 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.

10 likes 15mo
BS
buffer_sheetTL3Regular29 Apr 2025 · edited#27

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.

1 like 15mo
AK
a.kravchenkoTL2 Moderator1 May 2025#28
e.roos, post #26: Picking up post #23: 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. Go to post

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.

0 likes in reply to #26 15mo
GH
g.haalandTL3Regular3 May 2025#29
c.grimaldi, post #15: Picking up post #12: that is the part I would want checked first. For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use. Go to post

Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive.

16 likes in reply to #15 15mo
ID
il.dumitruTL2 Moderator6 May 2025#30
v.kjaer, post #9: 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. Go to post

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.

6 likes in reply to #9 15mo