Selecting syringes

Scrubmouse RN · Jun 6, 2011

IMs generally use a 1-1.5 inch needle with a larger gauge something like 22-23

SQ is 5/8ths of an inch and around a 25-27 gauge

However, these can vary depending on how big your patient is and whether you are giving injections to a peds patient.

My nursing instructor gave us a great handout regarding choosing needles. It's at http://www.immunize.org/handouts/needle-safety.asp.

SpEdtacular, MSN, RN, EMT-P · Jun 6, 2011

I think you're asking about needle size and not syringe size am I right? Syringe size depends on what volume of medication you're giving 1cc, 3cc, 5cc, 10cc, etc., As for needle size you can always ask a coworker but sometimes they may not know the "official" answer so it's always a good idea to check the policy and procedure manual for little technical things like this. Most places I've been haven't had a really wide assortment. For example where I work as a paramedic has 19g and 25g needles both of which are 1 1/2" long (we also have tuberculin syringes with needles on them). I usually end up using the 19g because the 25g seem too small and flimsy for anything but a small child.

Rob72, ASN, RN · Jun 6, 2011

IMs generally use a 1-1.5 inch needle with a larger gauge something like 22-23
SQ is 5/8ths of an inch and around a 25-27 gauge
However, these can vary depending on how big your patient is and whether you are giving injections to a peds patient.
My nursing instructor gave us a great handout regarding choosing needles. It's at http://www.immunize.org/handouts/needle-safety.asp.

^^ This. Larger needles cause more displacement(hurts). They allow more rapid infusion of the solution (hurts).

For something thick, like Rocehpin, a larger needle is appropriate, however, simply to get then injection done in a timely manner. Trying to push it through a 23g is like pulling your sock through an eylet in your shoe.

Thick or large volume= larger needle, otherwise, 22-23 is generally fine.

netglow, ASN, RN · Jun 6, 2011

OP, you will find a syringe to accommodate the amount of fluid medication you need to inject. Keep in mind some meds must be diluted first, which adds to the total volume and would make you select a higher volume capacity syringe than you had first thought. In hospital you won't need to deal with needles to directly inject the patient too much excepting insulin and that one you might have an insulin pen or vaccinations, etc. When you do get something that you need to inject direct into the patient, you will need to select that needle and screw it on to your selected syringe.

There should be some reference for you in one of your books? If not google or youtube can bring up some charts and how tos. Relax, you can just glance at an arm for IM and get an idea of what is too short and what is too long of a needle after a while. Just grab the injection area with your hand to feel how much "meat" is there. You dont' want to hit bone, that hurts.

queenjulie, RN · Jun 6, 2011

I think you're asking about needle size and not syringe size am I right?

Yes, I do mean needle size, not syringe size! (See, I'm hopeless! ) I feel pretty secure in selecting syringe sizes, even though I haven't had to do it yet, because I will know how much medication I'm giving. I'm glad to hear the policy and procedure manual will have information like this--for some reason, I thought it was left up to the nurse.

queenjulie, RN · Jun 6, 2011

IMs generally use a 1-1.5 inch needle with a larger gauge something like 22-23
SQ is 5/8ths of an inch and around a 25-27 gauge
However, these can vary depending on how big your patient is and whether you are giving injections to a peds patient.
My nursing instructor gave us a great handout regarding choosing needles. It's at http://www.immunize.org/handouts/needle-safety.asp.

Thank you! That is really helpful, and that website is great! I bookmarked it. :)

360jRN · Jun 7, 2011

I think you're asking about needle size and not syringe size am I right? Syringe size depends on what volume of medication you're giving 1cc, 3cc, 5cc, 10cc, etc., As for needle size you can always ask a coworker but sometimes they may not know the "official" answer so it's always a good idea to check the policy and procedure manual for little technical things like this. Most places I've been haven't had a really wide assortment. For example where I work as a paramedic has 19g and 25g needles both of which are 1 1/2" long (we also have tuberculin syringes with needles on them). I usually end up using the 19g because the 25g seem too small and flimsy for anything but a small child.

I just want to say...OUCH! LOL!

makes needs known · Jun 7, 2011

Skinny people get the shorter needles.

Altra, BSN, RN · Jun 7, 2011

The size of the syringe you use also depends on what is stocked in the med room at the precise moment that you need it ...

While it seems most efficient to use the smallest syringe which will hold the volume of medication being given ... there's nothing inherently wrong about grabbing a 10mL syringe to give 1mL of med.

Needle sizes ... the length is determined by the type of injection (IM or SQ) and the size of the patient. The guage ... depends on the med being given. Generally the smallest needle (highest guage) which will accomodate the med.

queenjulie, RN · Jun 7, 2011

Generally the smallest needle (highest guage) which will accomodate the med.

And how do you know which will accomodate the med? I saw the other responder who noted that Rocephin is thick, and thus needs a bigger needle, but how do you know that? Just years of experience? I've never seen a drug book that mentions "This medication is gluey and will make your patient cry--use a big needle!" :) I think I need a list of which meds are thick and sticky to carry around with me. :lol2:

noahsmama · Jun 7, 2011

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. You've already had practice with the two exceptions, namely insulin and lovenox.

When I worked in a peds hospital, I very occasionally gave flu vaccines, especially during the height of the H1N1 epidemic. I also very occasionally gave antibiotics IM, but only if the kid had lost their IV, multiple unsuccessful attempts had been made to place a new one, they only needed another dose or two or three of an IV antibiotic that could also be given IM, and the doctor felt that there weren't any PO antibiotics that could be used as an alternative (this may have happened a total of 3 or 4 times in the 1.5 years I worked there).

For kids, the largest volume injection we ever gave IM or SC was 1 ml. If they needed a volume larger than 1 ml, we would divide the dose and give multiple injections.

Good luck with your studies!