Airbubbles and Injections

[anonymous21]

A few friends and I are interested in steroids yet are concerned about possible risks involving death. I've read multiple sources on side effects, and newbie stacks to run, but nobody comes straight out with needle information. They say how to inject, they tell you what to do, but it seems they stay away from injection problems. I've always been under the impression of big risks involved with needles can you confirm my suspicions?
1.) Airbubbles accidentally injected in the muscle will kill you?
2.) Airbubbles accidentally injected in a vein or artery will kill you?
3.) Pure juice(airbubble free)accidentally injected in vein or artery will kill you?
4.) All air bubbles must be removed? Are bubbles the size of a grain of sand considerably dangerous.
If this is all true, then everytime you take a needle you have a chance of dieing, if you know what you are doing, is it worth the risk?
Also What Are The Consequences Involved In Vein or Artery Injections?

[Da Bull]

A few friends and I are interested in steroids yet are concerned about possible risks involving death. I've read multiple sources on side effects, and newbie stacks to run, but nobody comes straight out with needle information. They say how to inject, they tell you what to do, but it seems they stay away from injection problems. I've always been under the impression of big risks involved with needles can you confirm my suspicions?
1.) Airbubbles accidentally injected in the muscle will kill you?
2.) Airbubbles accidentally injected in a vein or artery will kill you?
3.) Pure juice(airbubble free)accidentally injected in vein or artery will kill you?
4.) All air bubbles must be removed? Are bubbles the size of a grain of sand considerably dangerous.
If this is all true, then everytime you take a needle you have a chance of dieing, if you know what you are doing, is it worth the risk?
Also What Are The Consequences Involved In Vein or Artery Injections?

1)NO
2)NO
3)In a vein no,possibly in an artery if you dump a large amount,but still not likely.
4)NO

[NewBreed]

in a vein it may kill you,in an artery it will stuck in the artery and that´s it,that´s what I think about it.
Airbubbles aren´t that dangerous,you need large amounts of air,injected directly into a vein to kill you.(I think at least 3cc of air)

The problem about oil in a vein is,that you may collapse.

[sepjuice]

u need alot of air to kill you bro.

[map200uk]

hmm how much air is it, everyone seems to say different things someone said 30cc (which sounds way tooo much) 6 * the max my syringe holds..so if thats the case its fine:P

[fabry]

there was a disccussion with link ref few days ago about air bubble in syringe (coz i was askin something about aspirating).
at the end of the story, if i remember well, the real risk is with 3cc of air in a vein, that is a lot more than just air bubbles!!!

[simplyjakked]

you need 3cc or more of air injected to do any damage such as death, if you inject that much air you shouldnt be injecting anything anyway!

[powerlifter]

Takes 20 cc of air injected into vein to kill you - that's a ****load - if I had a dollar for everytime someone went mental over the champagne bubbles in their IV line - I would be retired living in the Tropics - IM no problem - in fact there is an injection technique that uses a small air bubble

[RJM03]

Just be careful when doing an inject and you will be fine.

[Tygh]

As someone who injected some air into a muscle accidentally, I can say it did nothing but make me a bit more sore than normal.

I pushed a cc of air into my delt along with a cc of test prop. Dumbass mistake on my part, but the muscle tissue can absorb a hell of a lot.

[-The_Bouncer-]

Just aspirate and you should be fine. Hold your needle upright with the pin upwards and flick it until u can push the bubbles out. 3cc are needed to kill yourself.
Just giver bro.

[edmen2]

in nursing school they teach to use at least .1cc of air in a syringe to help disperse the medication and to keep it from coming back out. now on the other hand 3cc of air injected into an artery can cause an air bubble in ur heart. the doc will make u lay on ur side for a couple of hours to see if the body will absorb it and if not they will have to remove the air manually. just as long as u aspirate and use correct injection spots u will be fine.

[anonymous21]

Thank you so so much, I can't believe how worried I was over nothing, again thank you all so much for being so helpful.

[SV-1]

1)NO
2)NO
3)In a vein no,possibly in an artery if you dump a large amount,but still not likely.
4)NO

Yep.

Takes 20 cc of air injected into vein to kill you - that's a ****load - if I had a dollar for everytime someone went mental over the champagne bubbles in their IV line - I would be retired living in the Tropics - IM no problem - in fact there is an injection technique that uses a small air bubble

Yep.


Originally posted on MuscleSci by 956Vette:

Introduction

Intramuscular (IM) injections, as the name implies, administer drugs directly into the muscle beneath the subcutaneous tissue. This route allows quicker absorption than subcutaneous injections.

In the UK the Z-track method is widely used, advocated by Beyea and Nicoll (1996) as it controls leakage into the surrounding tissues and is generally more comfortable for the patient.

However, a comparative study of depot intramuscular injection techniques has revealed that the air-bubble method widely used in Canada and USA is significantly more effective at controlling seepage than the Z-track (Quartermaine, 1995).


A further study compiled at the Bracton Centre, Specialist Mental Health Service, could provide no advantages to choosing either the air-bubble method or the Z-track method over each other.

Complications of IM injections

Complications can occur at the site of the injection following IM drug administration, such as seepage of the injection solution and/or bleeding from the injection site onto the skin, pain, irritation and even skin lesions. Such complications are widely recognised and have been investigated (Hay 1995, Murphy 1991). One cause of complications noted in these investigations is some degree of fault in the IM injection administration technique itself.

Injection sites

Taylor et al (1993) recommend the rotation of sites if a series of injections is to be administered, in order to reduce the risk of local reaction.

IM injections should be given into the upper outer quadrant of either the thigh or buttock, into the gluteal muscles.

Correctly identify the site

Place patient on their side with their top leg flexed to relax the muscle.
Mark out an imaginary cross thus dividing the area into four quarters.
By injecting into the upper outer quadrant of the buttock, the sciatic nerve will be missed.
Z-track technique

Place the ulnar side of your non-dominant hand on the chosen injection site and stretch the skin taut.
Hold the needle at 90 degrees to the skin.
Plunge the needle in quickly, penetrating the muscle and leaving about a third of the needle exposed.
Pull back on the plunger to observe for blood aspiration. If blood is aspirated the procedure should be discontinued.
If no blood is aspirated, slowly and continuously inject the drug.
After a couple of seconds withdraw the needle at the same angle at which it went in.
Release the skin. This has the effect of breaking the needle track as the skin and subcutaneous layers move back over the muscle. The drug is therefore locked within the muscle. (Belanger, 1985)
Air bubble technique

The procedure for the air bubble technique differs from the Z-track in only one way. When drawing up the medication, a small bubble of air is also drawn up. This is injected into the muscle with the drug, thus forming an air lock in the muscle depot preventing the medication from seeping out along the needle track into other subcutaneous tissue or onto the skin. (Pritchard and Mallett 1992, Taylor et al 1993)

Keen, (1986) suggests that the Z-track technique produces more pain at the injection site and this is further supported by MacGabhann (1996).

Does experience improve IM technique?

MacGabhann goes on to suggest that "The period of training for staff during the study highlighted disparate knowledge and practice of injection techniques. There was no working policy or procedure on administering injections to which staff could refer". This implies a potential discrepancy between ongoing training and improving techniques.

Katsma and Smith (1997) suggest that the potential for pain experience in IM injections is due to the kinematics of injections, ie. the movement of the needle through muscle and tissue. He goes on to say "Minimizing of this effect is accomplished by controlling the needle trajectory during penetration along a linear path from point of contact to end point."

The study invloved 35 RGNs and 21 3rd year student nurses. Student nurse characteristics differed from experienced nurses primarily in syringe angular positioning. They tended to be closer to the "textbook" style (which they had been recently taught) with angle at contact closer to vertical. However, kinematic characteristics describing the non-linear characteristics during needle penetration were not significantly different from those of experienced nurses.


While it is fair to assume that the more experience a nurse has the more likely she will be to optimize a technique for IM administration, this study suggests the wide variability of the nurse kinematic characteristics argues against this optimization occurrence.

Conclusion

There are arguments for and against both the Z-track method and the air bubble method of IM injection techniques and currently in the UK the most commonly used is different variants of the Z-track method (MacGabhann, 1996). This said, nurses should not become complacent in their abilities to administer injections. As the study by Katsma and Smith showed, some experienced nurses have a much poorer technique than those less experienced than them. To understand the rationale, supported by effective research, behind good injection technique can only serve as a benefit to the profession as a whole, our patients and the nurses of the future.



References

Belanger MC (1985) Long acting neuroleptics: technique for intramuscular injection. Canadian Nurse. 81, 8, 41-44.

Beyea, S., Nicoll, L.M. (1996) Back to basics. Administering Intramuscular Injections the right way. American Journal of Nursing 96:1, 34-35

Hay J (1995) Complications at site of injection of depot neuroleptics. British Medical Journal. 311, 421.

Katsma, D., Smith, G. Intramuscular injection mechanics: Does experience improve technique?Nursing Research, 46, 288-292, 1997.


Mac Gabhann L (1996) A comparison of two depot injection techniques. Nursing Standard. 12, 37, 39-41

Murphy JI (1991) Reducing the pain of intramuscular (IM) injections. Clinical Care. July/August, 35.

Quartermaine S (1995) A comparative study of depot injection techniques. Nursing Times. 91, 30, 36-39.

Pritchard AP, Mallett J (1992) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. Third edition. London, Blackwell Scientific.


Taylor C, Lillis C, Le Mone P (1993) Fundamentals of Nursing: The Art and Science of Nursing Care. Second edition. Philadelphia PA, JB Lippincott.