Selecting syringes

[queenjulie]

How do you experienced nurses select a syringe for injections that aren't pre-filled? I'm halfway through nursing school, and as yet have only given insulin and Lovenox injections, which either have their own syringes or come pre-filled. Although we got a lecture in class about the sizes of syringes, I've never had to actually choose my own, and I'm afraid I have no idea which to pick! I think a 1 to 1 1/2-inch is probably right for an IM, in general, right? But what gauge? The higher the gauge number, the skinnier the needle, correct? Does anyone have a good site that has a "how to select the correct syringe" tutorial? Thanks!

[netglow, ASN, RN]

OP, you can usually tip the vial or what ever, to judge the viscosity of the med. Think of a skinny coffee stir type straw (those little red or brown ones), how it'd be if you tried to use one to suck up a milkshake.

[TinyRNgrl]

Ativan is another medication that is "thick" and needs a smaller gauge needle. I work in the ED and we give a lot of IM injections. Although most meds are the IV, PO route, we give our fair share of IM. I think tonight alone I gave 4 IM injections, and epi SC twice. We also give a lot of torodol IM because 30mg is max IV, so higher dose (60mg) we just give IM. Plus Bentayl is NEVER to be given IV so another IM we give a good bit.

Don't ever be afraid to ask your coworkers or others if your unsure, but a little experience and you can eyeball your pt and know what to use. Some of our immunizations are prefilled but 90% of our meds we draw up.

Good luck.

[redmondson]

The needle gauge you pick also depends on the amount of fluid you need to draw/inject. If the physician wants you to draw up 30 cc of Lidocaine you don't want to choose a 25 gauge needle because it will take forever to draw. I would choose a needle that makes the process quick, like a 16 gauge, then you can change the needle before administration if needed.

[peripateticRN, BSN, RN]

Just thought I'd add that, if you end up working in a hospital after nursing school, you may not have to give injections all that often -- in hospital settings, most meds are given IV or PO, not that many are given IM or SC.

I think this must be very hospital dependent - on our med units I give at least 2-3 SubQ Dilaudid or morphine injections a shift, and we often give haldol IM (and periodically Gravol).

Also I'm not sure if it's been mentioned but there is often some finesse involved with picking syringe size! For example, while you can give your 0.5ml of heparin with a 1ml syringe its better to use a 3ml as there is less pressure exerted with the larger syringe which causes less pain and tissue damage (or so I'm told). It's one of those things you'll pick up as you go - not something to cause much stress about!