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Practice · Administration · continued

Completing a dose with a second syringe, and the dead-volume arithmetic posts 31–60

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

BV
b.vestergaardTL2 Moderator23 Apr 2026 · edited#31

Worth separating two things that post #27 runs together.

Drawing up with one needle and injecting with another: a reasonable practice if you have extra needles. Fresh needle for injection reduces tissue drag and can decrease discomfort. Not necessary, but not harmful either.

0 likes 3mo
B
BGiordanoTL2Member26 Apr 2026#32
PSundberg, post #8: Coming back to post #6, because the follow-up matters more than the original answer. Leak-back after withdrawal: a small amount of liquid on the skin after withdrawal is ordinary. Whether you lost a "meaningful" dose depends on concentration and your target dose, but some leak-back is universal and does not need to be treated as an error. Go to post

post #31 is right about the mechanism and I think understates the practical bit.

A genuinely late dose: the labelling generally says that if the next dose is more than a couple of days away, take it as soon as you notice. If the next dose is close, skip it and resume the schedule. The reasoning follows from the long half-life; you are perturbing a slowly moving average.

19 likes in reply to #8 3mo
BS
b.solbergTL228 Apr 2026#33
MC
m.coelhoTL2 Moderator30 Apr 2026#34

Air bubbles in a subcutaneous injection: the honest risk assessment is low. Tiny air bubbles in subcutaneous tissue do not behave like an air embolism in a blood vessel. A few air bubbles are not a reason to restart the entire injection.

0 likes 3mo
SV
sa.vogelTL2 Moderator3 May 2026#35

Bleeding at the injection site: normal and usually minimal. A little blood at the needle site after withdrawal is not a reason to assume you lost a significant dose. The needle passed through tissue and there is a small amount of bleeding in the tract.

27 likes 3mo
BR
buffer_reviewTL3Regular5 May 2026#36
m.ramos, post #5: Bleeding at the injection site: normal and usually minimal. A little blood at the needle site after withdrawal is not a reason to assume you lost a significant dose. The needle passed through tissue and there is a small amount of bleeding in the tract. Go to post

post #35 answers the question as asked. The question underneath it is different.

Injecting into an area that has become firm: lipohypertrophy — thickened fatty tissue from repeated injection in one area — changes local tissue absorption. Avoid injecting into areas that are noticeably firm or lumpy and allow those areas to recover for at least a few months.

13 likes in reply to #5 3mo
AM
a.mwangiTL2 Moderator7 May 2026#37

Coming back to post #35, because the follow-up matters more than the original answer.

Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A shorter needle (4-6 mm) is safer with a gentle pinch. The pinch size matters less than people think; the injection angle matters more.

2 likes 3mo
CD
cannula_driftTL3Regular9 May 2026#38

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.

0 likes 3mo
RN
r.novakTL2 Moderator11 May 2026#39

Injection discomfort: comes from needle gauge (finer = less discomfort), volume (smaller = less discomfort), temperature (room temperature or warmed is less uncomfortable than cold), and technique (smooth, purposeful injection is less uncomfortable than hesitant). All four are under your control.

0 likes 3mo
OA
o.abrahamsenTL3Regular14 May 2026#40

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.

0 likes 2mo
DB
d.bramleyTL3Regular16 May 2026#41

A site rotation scheme that actually works: abdomen, outer thigh, back of arm, outer hip. Rotate through them in order, move a minimum 2 cm between consecutive sites, note the site with each dose. If a local reaction appears you have the history. If you rotate properly you will not get lipohypertrophy from overuse of one area.

16 likes 2mo
VK
v.kjaerTL2 Moderator18 May 2026#42
m.eriksen, post #25: Picking up post #22: that is the part I would want checked first. Leak-back after withdrawal: a small amount of liquid on the skin after withdrawal is ordinary. Whether you lost a "meaningful" dose depends on concentration and your target dose, but some leak-back is universal and does not need to be treated as an error. Go to post

Worth separating two things that post #38 runs together.

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.

32 likes in reply to #25 2mo
G
GEldridgeTL3Regular20 May 2026 · edited#43

Angle of injection: 90 degrees into pinched tissue ensures subcutaneous placement. It is not always necessary and shallower angles can work, but 90 degrees into a small pinch is the safest technique to learn first.

0 likes 2mo
HJ
h.jansenTL2 Moderator22 May 2026#44

Angle of injection: 90 degrees into pinched tissue ensures subcutaneous placement. It is not always necessary and shallower angles can work, but 90 degrees into a small pinch is the safest technique to learn first.

3 likes 2mo
EF
erratum_fileTL3Regular24 May 2026#45

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.

11 likes 2mo
IG
i.grimaldiTL2 Moderator26 May 2026#46
f.chowdhury, post #22: I read post #20 twice before replying, because I had assumed the opposite. Injection discomfort: comes from needle gauge (finer = less discomfort), volume (smaller = less discomfort), temperature (room temperature or warmed is less uncomfortable than cold), and technique (smooth, purposeful injection is less uncomfortable than… Go to post

Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A shorter needle (4-6 mm) is safer with a gentle pinch. The pinch size matters less than people think; the injection angle matters more.

24 likes in reply to #22 2mo
R
RidgewayTL329 May 2026#47
ZA
z.adeyemiTL2 Moderator31 May 2026#48

Drawing up with one needle and injecting with another: a reasonable practice if you have extra needles. Fresh needle for injection reduces tissue drag and can decrease discomfort. Not necessary, but not harmful either.

1 like 2mo
OL
o.lindgrenTL2Regular2 Jun 2026#49
h.amankwah, post #28: 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. Go to post

post #48 is right about the mechanism and I think understates the practical bit.

Injection discomfort: comes from needle gauge (finer = less discomfort), volume (smaller = less discomfort), temperature (room temperature or warmed is less uncomfortable than cold), and technique (smooth, purposeful injection is less uncomfortable than hesitant). All four are under your control.

7 likes in reply to #28 2mo
RL
r.lundgrenTL2 Moderator4 Jun 2026#50

Injecting into an area that has become firm: lipohypertrophy — thickened fatty tissue from repeated injection in one area — changes local tissue absorption. Avoid injecting into areas that are noticeably firm or lumpy and allow those areas to recover for at least a few months.

17 likes 2mo
O
OkaforTL3Regular6 Jun 2026#51

Coming back to post #49, because the follow-up matters more than the original answer.

A site rotation scheme that actually works: abdomen, outer thigh, back of arm, outer hip. Rotate through them in order, move a minimum 2 cm between consecutive sites, note the site with each dose. If a local reaction appears you have the history. If you rotate properly you will not get lipohypertrophy from overuse of one area.

10 likes 2mo
FI
f.ibarraTL28 Jun 2026#52
SC
septum_checkTL1Member10 Jun 2026#53
CSagredo, post #23: 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 #23 2mo
DN
d.nilsenTL2 Moderator12 Jun 2026#54
y.eriksen, post #12: Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A shorter needle (4-6 mm) is safer with a gentle pinch. The pinch size matters less than people think; the injection angle matters more. Go to post

post #53 answers the question as asked. The question underneath it is different.

Leak-back after withdrawal: a small amount of liquid on the skin after withdrawal is ordinary. Whether you lost a "meaningful" dose depends on concentration and your target dose, but some leak-back is universal and does not need to be treated as an error.

30 likes in reply to #12 2mo
VK
v.klausenTL3Regular14 Jun 2026#55

I read post #53 twice before replying, because I had assumed the opposite.

Cold solution and stinging: warming the vial in your hands for a minute before injection reduces the stinging sensation substantially. This is the simplest thing to try if injections are uncomfortable.

6 likes 1mo
EC
e.coelhoTL2 Moderator16 Jun 2026#56

This follows post #53 rather than contradicting it.

Air bubbles in a subcutaneous injection: the honest risk assessment is low. Tiny air bubbles in subcutaneous tissue do not behave like an air embolism in a blood vessel. A few air bubbles are not a reason to restart the entire injection.

1 like 1mo
ID
integrator_draftTL3Regular18 Jun 2026 · edited#57

Angle of injection: 90 degrees into pinched tissue ensures subcutaneous placement. It is not always necessary and shallower angles can work, but 90 degrees into a small pinch is the safest technique to learn first.

0 likes 1mo
NS
n.szaboTL2 Moderator20 Jun 2026#58
y.eriksen, post #7: Picking up post #4: that is the part I would want checked first. Injecting into an area that has become firm: lipohypertrophy — thickened fatty tissue from repeated injection in one area — changes local tissue absorption. Avoid injecting into areas that are noticeably firm or lumpy and allow those areas to recover for at least a few… Go to post

Injection discomfort: comes from needle gauge (finer = less discomfort), volume (smaller = less discomfort), temperature (room temperature or warmed is less uncomfortable than cold), and technique (smooth, purposeful injection is less uncomfortable than hesitant). All four are under your control.

22 likes in reply to #7 1mo
ED
e.dalgleishTL3Regular22 Jun 2026#59
sterile_table, post #6: 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. Go to post

Cold solution and stinging: warming the vial in your hands for a minute before injection reduces the stinging sensation substantially. This is the simplest thing to try if injections are uncomfortable.

3 likes in reply to #6 1mo
RI
r.ilungaTL2 Moderator24 Jun 2026#60

Picking up post #57: that is the part I would want checked first.

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.

0 likes 1mo