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Discussion

When selecting needle size, is there a standard?

I am getting confused as to what needle to choose and for what. Every text that I have shows something different and so do all the web sites I have researched. Is there a standard size (guage) that a person follows? or standard range? Do hospitals have their own protocols when it comes to this? And goodness the larger the guage the smaller the needle? how confusing is that??

Help me clear up the confusion..(or will all the posters have different answers?)

Thanks.

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The most common needle I use is a 25G 1inch (1 1/2 for very large patients and it is in the Glut)...if it is more than one CC and it is an IM it can not go it the deltoid. We use a lot of TB syringes w/needles also. If I am drawing up somthing thick like gold injections and some pych meds I will use a 18G and then change it...Kenalog is milky and I have found a larger needle easier to work with when drawing up also. I generally use a 27G 1/2inch for childrens immunizations, depending on what I am giving. If it is somthing like epi on the face or a biopsy I will use a 30G 1/2inch. Make sure you use a filter needle when using a glass ampule, at least it is a law in my state, and I would advise using a 4by4 when breaking it open to avoid any cuts (also tap the top because medication can get stuck in the upper part) And yes, the smaller the number on the gauge the larger the needle, its the same as peircings if that helps.

Are you referring to injections, blood draws, IV's, or something else?

  • Experts

standard needle to use for im injections is a 19 or 21 gauge needle. the choice is usually dependant on what the facility has available for you to use. use 1-inch for a very, very thin person, but usually a 1 and 1/2-inch long needle for an im injection into any of the gluts. i will use a 2-inch needle for a heavy person if i can find one. for a thick solution like pcn injection, use an 18 gauge 1 and 1/2 needle. the pcn needs to go deep and you need the larger gauge in order to draw up the pcn because it is so thick. you're going to want to use a 1-inch needle for a deltoid injection, especially if the person is thin. insulin and tb syringes come manufactured with standard needles and needle lengths on them. pick up the wrappers of them when you are in your clinical sites to get all the info about them.

here's a website that may be a little help for you. it shows pictures of the wrappers the syringes come in:

http://flightline.highline.edu/drydberg/balckboard/injection%20equipment.htm - injection equipment and techniques: im injections. includes short discussion on needles, gauge, length and bevel, syringes and sizes (shows pictures of difference between regular and leur lock tips), what a carpuject and tubex cartridge looks like, how to draw up solutions from an ampoule or a vial, im, subq, intradermal and z-track injection techniques as well as the im injection sites.

The needle size I use is dependant upon how much trouble the patient has given me in the past:chuckle (just kidding ) My favorite is the 25g 1.5 in. The smaller the needle the smoother the insertion.Personally, I feel that anything bigger than a 20 (unless it could compromise the stability of the med) is a little too big. Use the size of your patient and muscle mass as your guide. You'll get it, and don't freak out if you hit a bone. In geriatric pt's, I have been known to use an insulin or tb syringe to give deltoids, they have very little muscle to work with. to make things worse, NG's and Foley are opposite; the bigger the #, the larger the French or circumference, for lack of a better term.

Everything you learned in school, you'll soon forget. You don't necessarily have to know what it's called, just what to do about it.In nursing, nothing is set in stone. You'll find that everything is dependent on something else and the only true "given" is that there is no "normal". What's normal for some is not for others. Define normal anyway. It's scary, confusing, frustrating, but O, SO MUCH FUN. Don't get so hung up on details you read in books (once you're out of school, that is) and use common sense. You'll do fine.

  • Author

I was referring to just simple injections as I have yet to give one. IM's SQ's, Intradermal ....so I haven't even begun to question needle size for blood products (yikes lol).....or IV's...

But I do have a question and that is ......you mentioned glut? What is a glut? Are you referring to a gluteal muscle????

In our doseage calc book it briefly mentions needles but does not give specific sizes to use for specific things in fact the book focused way more on syringe size than the needle itself.

I take it that I will just have to judge the needle size once I see each patient. I worry more that if I am asked what size I am about to choose, I won't be able to answer...and just wondered if there was a set standard for each procedure. Guess not!!

Thanks for the help.

  • Experts

Yes, glut is just short for gluteal. I was referring to any one of the gluteal muscles. You know, I think you are getting ahead of your studies. I was wondering why you were asking a question about needle sizes and why your instructor hadn't given you a lecture on it. Now I think I got it. You are trying to get ahead of the game here. It's not a good idea to get responses from those of us who have been practicing for years. I understand your curiosity to know these things. However, your instructors are eventually going to give you lectures and sound reasons for picking the desired needles and syringes to use. You are only going to become confused by hearing what us old timers have to add to that information. You need to listen to what your instructors are going to tell you and go by what they say. When you get your license you can pick and chose needle sizes and lengths as you like, just like we do. I commend you for your enthusiasm, but don't get too far ahead of the teacher, OK?

  • Author

I have messaged you privately to respond. Thanks.

Yes, glut is just short for gluteal. I was referring to any one of the gluteal muscles. You know, I think you are getting ahead of your studies. I was wondering why you were asking a question about needle sizes and why your instructor hadn't given you a lecture on it. Now I think I got it. You are trying to get ahead of the game here. It's not a good idea to get responses from those of us who have been practicing for years. I understand your curiosity to know these things. However, your instructors are eventually going to give you lectures and sound reasons for picking the desired needles and syringes to use. You are only going to become confused by hearing what us old timers have to add to that information. You need to listen to what your instructors are going to tell you and go by what they say. When you get your license you can pick and chose needle sizes and lengths as you like, just like we do. I commend you for your enthusiasm, but don't get too far ahead of the teacher, OK?
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