Hi folks. I've just been prescribed 10 ml of Bicillin to be injected every two weeks in the upper gluteal. My mother is the one injecting me, and because it's a large dose we've split the injection up into three syringes. The problem is, once the needle is inserted into my muscle, the plunger on the syringe just won't go down! We can't inject any of the medicine.
We're certain its the right injection site, the medicine is brought to room temp beforehand, aspiration is clear- essentially, we've checked and double checked everything and still can't identify the problem. We're using reconstituted bicillin, not premixed, and a 21 gauge needle...could the fluid be precipitating and then clogging the needle? What on earth is going on?
Thanks. PH
Posted by susank (Member # 22150) on :
I'll try to help. You mixed Bicillin powder with a solution? I've read that way/kind is prone to clogging. Like the powder does not dissolve well enough. I've never used the kind that has to be mixed - not sure what to do to make sure it dissolves as much as possible. IIRC folks have had to use larger gauge needles for the reconstitued Bicillin. You can search around to check that out. I used 21g for the premixed. I would guess the mixture is clogging the needle - would perhaps pass through a larger bore needle. Maybe it's not mixed well enough? Also I've dealt with "sticky" syringes before for other drugs. So I had to "prime" the syringes - ie w/o the needle on - obviously - move the plunger up and down the syringe a few times. I think this is OK to do? Then draw up the drug.
Are you bringing the mixture to room temp in the syringe with the needle on? I would assume so. Perhaps change the needle just before injecting in case a wee bit "dried" got sticky while waiting. Hope this helps/makes sense. Tired........
Posted by SickSam (Member # 45330) on :
I'd bet the needle is getting clogged too. Even the premixed stuff says clogged needles can be an issue. Wish I had a solution to share with you! I haven't had that problem with my premixed Bicillin yet.
Posted by gz (Member # 43818) on :
I've used both the premixed and reconstituted. I've injected the reconstituted powder through a thin walled 21 before, but clogging was a definite issue. The powder doesn't dissolve, it just floats around in suspension until it settles. You would have a much easier time increasing the gauge size.
Never try to force the med through. To get the mixed powder solution to move through without clogging, I had keep the needle totally clear until injecting, which meant holding the shot needle end up to prevent it from running in or settling around the top.
I continued swirling the mix. In a series of quick motions, I then had to stab, aspirate, and inject. If the needle doesn't clog the solution injects much easier than the premixed because it is much thinner.
I take less than 30 seconds to inject 5 mL of reconstituted compared to 2-3 minutes for the thicker premixed. You could probably inject slower with a bigger needle. Using lidocaine in place of some of the sterile water can make the injection more comfortable, just have to be very careful with aspirating and not being in a blood vessel.
Posted by Paige EH (Member # 50593) on :
Hi All, thanks for your suggestions,
I think that the problem was that the needle was clogging. I tried reconstituting the powder immediately before injection, as well as holding the needle upright at all times and I had much more success.
The needle still sometimes clogs, but my solution in those cases has been to remove the needle, change it to a new sterile one, and try again.
It's not perfect, but it's better than nothing!
Posted by TF (Member # 14183) on :