Air-lock injecting technique safe?

[Grand_Cannons]

Hello everyone I'm currently on my 6th shot but I have a question for all of you. I'm currently using the air-lock method where you have a bubble at the end to push out most of the juice that is left behind in the syringe head. The question is this, everyone at the gym is telling me I'm going to keep it up until I die. Actually how many cc's of air would actually kill you if you injected into a vein and how many of you use this air-lock method also I read some where about a z-track method what is this and is it safe. Anyhow I'm signing off please let me know about the way I'm injecting because everyone at the gym are killing me they said just 1 extremely tiny bubble could kill you i've heard it would take some cc of air and is there any hard proof out there not just opinions I'd really like to be informed about this because I don't want to end up dead with my family left behind. thanks.

[Reality]

i wouldnt call myself and expert but people on this forum have told me that its ok to inject with bubbles still in the syringe...aslong as ur not inject a whole bunch of air like a cc or something ull be fine
and as far as the ztrack method - i believe it is used to prevent gear leakage after injecting...i probably dont do it exactly right but i simply stretch the skin over the injection spot with my thumb and pointer finger
-i think it makes for easier penetration for the needle but the idea behind it is to either make the injection hole smaller than it would be using regular injection tech. or have the hole move after injecting so juice wont leak

i hope i was clear enough-reality

[Grand_Cannons]

Thanks I get you on the z-track. Yes i've heard about injecting bubbles to I just want to get everyones opinion or atleast find hard medical facts. When you have youngin running around you don't want to take any more risk then you have to. Peace

[abstrack]

I think your playing a game a russian roulette. why would you be so concerned with sucha small amount of gear??? If you cant grow off the whole cycle, then something else is wrong!! The culprit is not the small amount of gear. I am not saing your not growing, but use your head when doing this shit. A few bubbles but to leave air in the chamber to get a few drops of test, OMG!

[abstrack]

Do you eat the very last piece of rice thinking if you dont finish it you will not get the full macros for the meal???

[goldenear]

I've been using the air-lock injection technique for every inject I've ever done (several years worth). It is a universally accepted medical procedure followed throughout the world. I prefer it over z-track because there is less surrounding tissue disruption (= less overall discomfort). Z-track is probably better for larger volumes, though (>3 cc's).

Regarding injecting air into a vein and dying...I remember researching this subject and found a brief write-up from a coroner specializing in forensics who helps law enforcement solve difficult homocide cases. He said it would take 100's of cc's of air injected directly into a large vein to be lethal. He actually detailed a case where a medical doctor murdered his wife this way. I found it particularly interesting when he remarked how difficult it would be for a non-medical professional to kill someone this way because the victim would have to permit the killer to continue emptying 10cc syringes full of air into the same injection point (meaning there would have to be some form of trust involved).

[animal-inside]

I wouidln't use the air lock method and have never.. I agree with abstract.. the little bit of gear u lose is not worth tryin to get out.. your trainign and diet are more important and no one has perfect diet or trianign.. so worry abotu that first..

the z track method..
pulling the skin one way abotu half a inch ..then insterting the needle all the way in.. the idea is that when you remove the needle the skin slides back to its original position leaving the needle track into the muscle covered up.. the hole in the skin where the needle went in is no longer over the needle track,,, thus when u take the needle out no gear can leak out... or blood.. I use it when i can .. but when you do ur own shots its hard too use becaus eu need 2 hands soemtimes..

[abstrack]

I've been using the air-lock injection technique for every inject I've ever done (several years worth). It is a universally accepted medical procedure followed throughout the world. I prefer it over z-track because there is less surrounding tissue disruption (= less overall discomfort). Z-track is probably better for larger volumes, though (>3 cc's).

Regarding injecting air into a vein and dying...I remember researching this subject and found a brief write-up from a coroner specializing in forensics who helps law enforcement solve difficult homocide cases. He said it would take 100's of cc's of air injected directly into a large vein to be lethal. He actually detailed a case where a medical doctor murdered his wife this way. I found it particularly interesting when he remarked how difficult it would be for a non-medical professional to kill someone this way because the victim would have to permit the killer to continue emptying 10cc syringes full of air into the same injection point (meaning there would have to be some form of trust involved).

and how is it that a single blood clot in a vien, can errupt and rush straight to the heart killing one person??? One case can not be the basis for all, so it is better safe than sorry---would be the motto!!

[Money Boss Hustla]

IMHO a little air in the muscle won't affect you.

I like the rice analogy though.

[Grand_Cannons]

Well Billy_Bathgate is the one that prefers the air-lock method and referred it to me and personally I think he knows what he's talking about. And I don't even think you get that full bubble in you anyways because as I watch in the injections once I get to end and airbubble next to go I see it go to head of syringe and I can't push no more so Im not sure if that airbubble is even going in me just helping push that extra oil out. But I'd like more opinions please especially by vets or mods.
Bump

[Billy_Bathgate]

From every bit of literature Ive read, it would take about 30cc in a muscle or about 5cc in a vein to cause any damage.

I use it everytime with no worries.

[goldenear]

and how is it that a single blood clot in a vien, can errupt and rush straight to the heart killing one person???

A blood clot is not the same thing as an air embolism. I've personally watched air bubbles move through an IV feed into my vein and asked the attending medical personnel what was up. They just replied there's nothing to worry about. Maybe they're careless or maybe we're paranoid.

[Grand_Cannons]

Bump

[Cycleon]

Something I found by a forensic pathologist that might be helpful:

Murder by air embolism is quite rare, despite the strong chances of a murderer escaping scot free in such cases. This is because such a technique requires great skill. Not everyone can handle a syringe, let alone puncture a vein successfully with it. I have a nagging fear that such type of murder might be very common among the drug addicts of our country. They are quite suited for committing such types of murder. They can handle syringes very deftly (almost as deftly as doctors, as they have to inject the drugs through the syringe all the time), and they need to do away with people fairly commonly.

In my whole life, I have encountered just one case of murder by air embolism and that too when I was in Edinburgh. The case was of a doctor husband who had got tired of his nagging wife. The husband was carrying on an affair with one of his female patients and his wife had got hint of that. She was having fits of faintness for quite sometime. So one day the doctor filled up a large syringe with air and injected air into her veins under the pretext that he was giving her some drug. About 200 c.c. of air is required to kill a person by air embolism. I do not know how he managed to inject that much amount through a syringe. Even a commonly used large syringe takes in about 20 c.c. of air only. He might have used a bigger syringe or may be he repeatedly pushed the air inside by removing the piston from the syringe again and again. Well, the important thing is that he did use the air for committing the murder. He would have gone scot free, but when I asked one of the witnesses as to what were the symptoms of the lady when she was dying, I was told that she was gasping for air. This immediately alerted me. This is a symptom of air embolism as we have already seen. Coupled with this was the fact that her husband was a doctor. He was ideally suited for committing such a type of act. So before opening the body, I decided to take a radiograph (X-ray) of the body. Sure enough the bubbles of air could be seen in the deceased woman's pulmonary arteries. Then I looked at the dead woman's forearms. They showed marks of injection. Immediately I alerted the Lothian and Borders Police (the police force that mans the city of Edinburgh). A detailed interrogation was done and sure enough the doctor admitted his guilt. This was yet another victory of Forensic Medicine.

I do z track myself usually but sometimes, like last night, it can be a pain if your fingers slip and the needle is still in ouch, today I have a bit of a limp

[Cycleon]

And something even better


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.

[Grand_Cannons]

Thx man good read

[Austex]

Nice read. It takes 3 cc's of air injected directly into a vein to affect the body. Although it is not likely death will occur, it will most certainly be an experience one wouldn't soon forget.

[popa]

air lock method sounds alittle too crazy to me, I'll just stick to the old fashion way

[Austex]

I have a fix for the problem...one that I personally use. Example: you need to inject 250 mg of test enan. Step One: you simply draw 1 and 1/4 cc from the vial. Step Two: Inject the solution (equal to about 1 1/8 cc). So I only get about 8 cc's per 10 cc vial...I'm happy knowing I'm getting my required nutrients and besides, it's just a little more money.

[goldenear]

Cycleon, thanks for doing the legwork for me, bro. Those two excerpts are exactly the ones I was referring to in my posts above.

Too bad there will be still be paranoia on these boards surrounding the practice of injecting air.

[Cycleon]

NOTICE - 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."

[Grand_Cannons]

well I've been doing it so far and no worries besides its alittle bubble it's prob not 1/8th of a cc big.