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Steroid Injections Part I

There are a number of steps that should be understood in order to complete a safe and proper intramuscular injection.  

First off, before handling any needles or vials, the user should take a thorough shower. Next, an alcohol swab should be used to clean the injection site and another alcohol swab should be used to clean the rubber stopper on top of the vial which will be drawn from. Then, take a brand new Syringe out of its wrapper, remove its plastic top, draw about 2 ccs of air into it and insert it into the vial. Inject this air into the vial; this creates pressure within the vial and makes it easier to draw out oil based preparations. Then, turn the vial upside-down and slowly draw out the oil until you\rquote ve overdrawn at least 1/4 cc.

For example, if someone was going to take a shot of 1 cc, they should pull out approximately 1 1/4 to 1 1/2 ccs of liquid, then tap the side of the case to help get the air bubbles that were drawn into the Syringe to come to the top. At that point, the excess 1/4 to 1/2 cc could be injected back into the vial and the needle removed. Then, hold the Syringe needle-side-up and continue to tap it to encourage all the air bubbles to come to the top of the Syringe. Now, take another clean Syringe, remove it from its sterile package and unscrew the needle from the Syringe. Exchange the brand new needle for the one that has just been injected into the stopper. By using two needles for every injection, you can take advantage of using the full sharpness of the pin. The needle does suffer some dulling when it is pushed through the firm rubber stopper on a vial. It is important not to touch this needle before the injection. It should not come into contact with a counter top, your fingers, nor should it be cleaned with alcohol. This needle is sterile and should not be touched. At this point, once again swab the injection site with alcohol, then press the stopper of the Syringe holding it needle-side-up, until the slight air bubbles that are at the top are pressed out. Once a bead of oil has appeared at the top of the needle, allow it run down the surface of the needle which provides lubrication. At this time, take the Syringe and hold it like a dart.

Use the other hand to stretch the skin at the injection site and simply push the sharp clean needle in. After inserting it deep into the muscle, pull back on the stopper for a few seconds to make sure it does not fill up with blood which would indicate that the needle had been injected into a blood vessel.

Providing there is no blood present in the Syringe, slowly press the stopper down until all the oil is injected. Then, quickly pull the needle out and take another alcohol swab and press firmly on the injection site. This will minimize bleeding, if there is any, and by firmly pressing on the injection site and slightly massaging it, some of the soreness may be eliminated. It is important that the liquid is not injected too quickly as this causes more pain at the site during the injection and in the proceeding days. After this procedure has been completed, return the plastic caps to shield the needles and make sure they are discarded properly. To avoid discomfort and excessive scar tissue at the injection site, it is not wise to inject more than 2 ccs of solution per shot. It is also not prudent to use the same injection site more than twice a week (once a week is preferred) .