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Patients Against Lymphoma

 

Treatments > Biologics > Subcutaneous Injections

Tips & Resources

Last update: 08/29/2012

Overview
 
  1. Read and reread the directions provided by your doctor, which might be different from this text. 

    Also see Practice tip below.

  2. Select an uncluttered work area.

  3. Remove medication from  refrigeration ~ 30 minutes before injecting, and prepare medication if necessary.

  4. Clean the work area and wash your hands thoroughly.

  5. Choose an area of the body to inject the medication as directed or recommended, typically the back of arm, or front of thigh, or abdomen.
     

    Injection sites 2a.jpg (21541 bytes)
    Click image to enlarge

  6. Clean area to inject with alcohol swab. Clean in a circular motion; work from center out.

  7. Hold needle as you would a dart or pencil. 

  8. Fold skin with free hand.

  9. Insert needle quickly and firmly at a 90 or 45 degree 
     
    TIP: Go all the way into the fold of skin. Subcutaneous means *under* the skin. 

  10. Release skin, and hold base of syringe with free hand. 

  11. Avoid injecting medication into blood vessel: 

    a) Pull back slightly on plunger to check for blood in syringe.  
     
    TIP: If in a blood vessel the plunger will pull back more easily, otherwise there will be resistance.

    b) IF blood appears in the syringe, withdraw needle, discard it. Then go to step 3 above.

  12. Slowly and steadily inject medication.  

  13. Withdraw needle quickly and apply direct pressure using a sterile gauze or alcohol swab held in the free hand.

  14. Safely dispose of needle.

 

 

Subcutaneous Injections ~ Tips & Resources

Patients and caregivers often need to inject biologics, such as Neupogen and Interferon. Here we provide resources, and overview of the procedure, and tips from patients, caregivers and advisors. 

As with most procedures, it's not difficult to do when you do it correctly, and you've given yourself adequate time to practice.  Most importantly, do not hesitate to ask questions of your health care providers.

Please consult with your healthcare provider before trying these tips. 
The information presented on Lymphomation.org is not intended to be a substitute for professional medical advice or to replace your relationship with a physician. 

For all medical concerns,  you should always consult your doctor. 


Graphic location: http://www.medaille.edu/ ~ Click image to enlarge.

How to give subcutaneous injections:

bullet
NIH - Detailed instructions - http://www.cc.nih.gov - PDF 

TIPS from patients and advisors:

Apprehension: The other thing to suggest is that Joanne is probably a little apprehensive now as its been painful the last few times. Distraction helps. So while you are in the process of giving the injection talk to her about something unrelated to take her focus off the subject. I'd suggest alternating injection sites from one side of the abdomen to the other. ~ Andy (advisor)

Practice: I'd suggest getting one of the used syringes and practicing with it on an orange. It takes a while to get used to manipulating syringes. Practice inserting the needle through the skin of the orange, a brief pull back on the plunger and then steadily inject some water. Also you could get a nurse or doctor to watch you administer the injection to make sure its not intradermal. Another thing you could try is to practice injecting a normal sterile syringe full of normal saline into yourself to make sure you have the technique right. Then you'll be able to feel whats painful and whats not. ~ Andy (advisor)

Avoiding blood vessels: You don't need to do a major draw back as if you are in a vein blood will flow into the syringe. Just a small brief amount of backward pressure on the plunger and you'll know if your in a vein or not. Then steadily inject the Neupogen. 

Avoiding blood vessels: in general if you can draw back [on the plunger] about a centimeter your not in a vessel.  Hitting a vessel means that the blood will flow easily. It takes a lot more effort than when your not in there. ~ Susan (advisor)

Avoiding blood vessels: Generally if an individual is adequately hydrated, when one injects a medication and pulls back on the syringe to determine if placement has inadvertently occurred within an intravascular space, it is very easy to see the extravasation of blood backing up into the syringe. If you pull back and you do not see this blood back up - you are likely not in the vein. ~ Lynda (advisor)

Inserting needle: With your non-dominant hand (left hand for right handed people) pinch a fold of skin and hold it up. Then using your dominant hand pick up the syringe. Holding it like a pencil you want to QUICKLY dart it in to the skin fold. Insert the entire needle perpendicular to the skin and keep it there.- About.com

Reducing pain: Make sure the injections aren't intradermal as these can be painful. Subcutaneous means injected below the skin. Some people are worried they will inject too deeply and so end up giving an intradermal injection which is painful and not absorbed as well. If you try and inject it too rapidly it increases the pressure and the pain of the injection. A slow and steady injection is usually the least painful.  ~ Andy (advisor)

Does the Neupogen come as an already packaged syringe? Or do you have to attach a needle to the Neupogen? If you have to attach a needle yourself I'd recommend using a 23 gauge the slightly wider diameter reduces the resistance to the flow of the Neupogen. If its prepackaged that is also fine the gauge on the prepackaged Neupogen I used was fine and allowed delivery of a reasonably pain free injection. ~ Andy (advisor)

Location and pain: I did them in my spare tire (which has grown in passing years)
just above my hip.  ~ Marc (nhl-follic) 

Location and pain:  I recently gave myself Neupogen for a stem cell harvest. I experienced little pain when injecting subcutaneously into either of the lower quadrants of the abdomen. I'd suggest bunching up a small handful of abdominal fat and inserting the needle (not injecting) reasonably quickly. ~ Andy (advisor)

Reducing pain: Before giving my wife her Neupogen shots they apply ice to the area and she finds that it cuts down on the pain. ~ Jerry (nhl-follic)

Resistance: I self injected Neupogen in my thighs. As I recall, it was merely a sub-dermal shot. (I didn't have to find a vein or draw blood first). I remember having less resistance when I injected at a 45 degree angle. Also, I pinched my skin b/w my thumb and fore finger before injecting which seemed to help. ~ Frank (nhl-follic)

Reducing pain: The key to a comfortable injection is swift needle entry followed by slow injection of fluid. Therefore, slowly push the plunger down then quickly withdraw the needle. You may use a clean alcohol sponge to hold pressure on the injection site for a moment or two. - About.com

Reducing pain: I had my Neupogen shots in the stomach area - self given. I had to pinch a bit of flesh first before putting the needle in and then let it go - draw back a little to see if any blood (usually just a bit of white fat appeared - never struck a blood vessel) and then delivered the dose. I never experienced any burning but believed some people do. I needed to vary the site each time I had the injection. The only problem I experienced was blunt needles sometimes - made it difficult to push in. Bear in mind the I am a rather large size (6'3" - 250lbs) so maybe this is why I had no problems. I had around 60 or so during the stem cell harvest etc exercise. ~ Barry (nhl-MALT)

 
Disclaimer:  The information on Lymphomation.org is not intended to be a substitute for 
professional medical advice or to replace your relationship with a physician.
For all medical concerns,  you should always consult your doctor. 
Patients Against Lymphoma, Copyright 2004,  All Rights Reserved.