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» LymeNet Flash » Questions and Discussion » Medical Questions » Tips on injecting Bicillin that has to be mixed?

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Author Topic: Tips on injecting Bicillin that has to be mixed?
skrwolf
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I did my first injection yesterday of Bicillin that has to be mixed (the powder and the water). I mixed 3 cc's of injectable water with the powder (1.2 mil units). This is the amount of water that came with the Bicillin.

I used a 3 cc syringe with a 21 gauge needle. Needless to say, after poking myself 6 times and wasting about half the medication, I was really frustrated!!

The medication kept getting clogged in the needle... Is it better to mix it more? Let it sit longer? Use a bigger needle? I had to pull out the needle and push the clog through and then inject again.

Any tips would be appreciated!!

Shelly

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sammy
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Each dose of the powdered Bicillin comes in individual vials right? If so you probably injected the sterile normal saline into the vial and mixed it in there.

You probably just need to mix it better, make sure all the little chunks and particles of abx are dissolved in there. It might help to hold it up to a light so that you can see it better.

I've never mixed bicillin but i've had to mix other opaque meds for injection before. It is more of a challenge but you can do it. Sometimes it has taken 10-15min to fully mix. So keep shaking/ rolling it in your hands until you are sure it is ready to draw up.

A 21guage 1 1/2in needle is what usually comes with the Bicillin LA prefilled syringes so it should work for you too.

And don't pull the needle out and reinject with the same one. If it is that clogged shouldn't use it.

Good luck!

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David95928
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As sammy said, be sure to shake it long and vigorously. Using a 20 gauge needlemay also help.

--------------------
Dave

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Lymeorsomething
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For you self-injectors out there, can one use other locations besides the buttocks? Maybe the thigh?

--------------------
"Whatever can go wrong will go wrong."

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Rianna
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[QUOTE]Originally posted by skrwolf:
[QB] after poking myself 6 times and wasting about half the medication, I was really frustrated!!
________________________________________________

I did a youtube video on Youtube as so many people get stuck on this so watch that

http://uk.youtube.com/watch?v=U3KCMSayBaA

Written instructions are as follows

Protocol For the Preparation of Benzathine Penicillin 1.2 MU

This medication is a Suspension and not a solution. Therefore there is no complete dissolution possible with Benzathine Penicillin power.

Suggested materials for injection: A needle (large Calibre) 19G

Apply Emla cream to the injection site 50 minutes prior to injection, it is an OTC cream

Reconstitute Benzathine Penicillin 1,2 MU with 3ml of water or injection

Reconstitute:

*Inject the 3ml of water slowly in to the vial of powder, along the rim to avoid foaming of the water

*Hold the vial vertically and shake until all of the powder has been dissolved

*Draw up in to the syringe

*As soon as the suspension is drawn in to the syringe keep rotating the syringe as the product will fall out of suspension rapidly

*The preparation should only be done only immediately prior to administration of the product

*Attach a new needle to the syringe ready to purge only at the moment of injection, Not beforehand - you must use a different needle as the draw up needle could be blocked

*Before injecting the solution you need to ensure you draw back (aspirate) the syringe to check for blood in the syringe, if any blood is present you MUST NOT inject the solution - remove the needle from the injection site and replace the needle and inject in a different area
Injection:

*The injection should be performed immediately after the syringe has been purged

*Any delay in performing the injection will cause the suspension to precipitate and therefore will block/obstruct the needle

Troubleshooting Guide:Needle Obstruction

*The Benzathine Penicillin is a powder for dilution. When reconstituted it forms a suspension, not a solution.

*The product Benzathine Penicillin will fall out of suspension rapidly which can block the needle and retard the progression of the liquid

*To prevent this problem the injection should be performed immediately after the syringe has been purged. Any delay in performing the injection will cause the suspension to precipitate and therefore will block/obstruct the needle

Where to inject - You get someone else to do your injection for you and inject in to the upper outside quadrant of the buttock

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skrwolf
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Awesome video Rianna!!! THANK YOU SO MUCH!!! Great tips that I didn't know (especially about the suspension vs. solution. I do the injections myself. I had my husband do the first one but found that it was so much easier to do them myself. I'm an RN, so I've given lots of injections.

I must say, however, a 19 gauge needle - yuck! That's a big needle! I didn't know that the Emla cream was OTC. Where can I find it?

Thanks so much again!

Shelly :-)

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Rianna
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[QUOTE]Originally posted by skrwolf:
I must say, however, a 19 gauge needle - yuck! _______________________________________

Honestly the 19G does not hurt a bit, its no different than any other IM especially if you use Emla - Its the product that gives the sting!!!!!

Emla here is OTC unsure in other countries.

Good luck
Rianna

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