1. Clean the surface of your work area.
2. Have an alcohol swabs, bandage, a needle, your sharps container and your instructions handy.
3. Take one syringe or vial to where you inject, leaving the rest in the refrigerator.
4. Warm the syringe or vial by rolling it between your hands for approximately one minute.
5. Wash your hands with soap and water.
6. Attach the needle to the syringe (if it isn’t, already) and twist it to lock it. Set it down on your work area.
7. Choose an injection site; clean it with an alcohol wipe, starting at the spot where you are going to inject and using a circular motion clean from that point out a few inches.
8. Wipe the vial top with an alcohol wipe also.
9. When you’re ready to inject, pull the safety cover off the needle.
10. PRE-MIXED SYRINGES: (Skip to the next paragraph if you have a mix-it-yourself kit)
Point the needle up towards the ceiling and flick the syringe near the vial with your finger to get the air bubbles to the top. Push them out with the plunger.
10. Powdered Mix-It-Yourself Kit
Fill the syringe: Pull the top off the syringe. Holding the vial in one hand, have the syringe in the other and brace both hands together so you can pierce the center of the vial without blunting the needle. Turn the vial upside down and draw in the IFN. Push out the air (vial and syringe still upside down). Then draw to the full dose, occasionally pushing out air bubbles. I draw a little more past the fill level, so if its a 3mil dose instead of the .5cc I go to a couple of small marks beyond 0.5cc. Take the needle out of the vial. Holding the syringe needle up, push the plunger to the correct level (e.g., .5cc). This gets rid of any air in the needle.
11. Hold the syringe like you hold a pencil, with the opening of the needle facing up.
12. With one hand pinch the skin/fat layer at the injection site. As fast as possible push the needle into the layer with the syringe at a 45 degree angle to the skin. The faster the needle goes in, the less pain there is. (Another way is to pretend the needle is a thumb tack. Place the needle against your skin, and then tell yourself that the nerves are on the surface of the skin, and the needle is already there. Pushing it in won’t make it hurt anymore than what you feel with the needle against your skin. Push. It works for me. I don’t worry about “missing”. --Joan)
Pull the syringe straight back. You get less bleeding if you don’t play twister. Drop the syringe in the sharps container. Cover the area with a bandage.
Things that happen after injection:
Sometimes there will be a tiny bit of blood after an injection. This just means you’ve probably popped some capillaries or punctured a small vein. It’s nothing to worry about; just cover it up with a bandage and let it clot.
Bruising is also very common after shots. You may be able to avoid bruising and bleeding if you choose a spot with no visible red or blue veins.
The day after a shot, a red area is quite normal. They can range from dime size to silver dollar size and may feel hot and tender. A small area is fine, but if it gets much bigger and hotter, or you see something that looks infected, contact your doctor.
Sites: Most people use their thighs for injections. Some people find the lower abdominal area (*not* around the belly button) to be the least painful spot for injections.
Sharps containers: You should be provided with one, either from where you get your interferon (pharmacy or home delivery) or your doctor’s office. If you have a problem getting one, puncture-proof soda bottles can be used to temporarily hold the used syringes until you can take them to your doctor’s office and ask them what to do with them. If you do this enough times, eventually, someone might get the idea you need a real sharps container. If you have children and/or cats, keep your sharps container locked up. The hole is inviting to small hands and paws.
Some find it helpful to numb the injection site beforehand. An icepack (or a bag of frozen peas) placed on the injection site a few minutes ahead of time will make the shot relatively painless.
To help prevent bruising, some people recommend using only half of the diluent provided (This does not apply to the pre-mixed syringes).
If you are having a problem giving yourself a shot, ask your pharmacist for a B-D Automatic Injector, Inject-Ease. They cost about $25.00, and are well worth every penny. You simply load the syringe into the automatic injector, place it on the injection site, and push a button. It is virtually painless, and also makes it much easier to choose a site to inject, thereby giving you more sites per thigh or tummy.
It’s almost a sure thing that at least once you will pull the needle out and find blood and bruises. Unless you are injecting into your neck and hit the jugular you have no problem! And even then, with the size of needles we use, it would be real hard to have a bleeding problem. The skin is “rich” with blood supply, so it’s just a matter of time before you “nail” something that bleeds or shows up as a bruise (not just the normal interferon reaction).
Normally, if you hit an actual vein, there will be no doubt in your mind, as the blood tends to come up into the needle very quickly. If you only see bruising or a small drop or two of blood, chances are that you only went through some capillaries and it’s nothing to worry about.
The only important thing to do if you are bleeding after an injection is to cover it with a band-aid. Even for long-term interferon users there is enough clotting factor to stop the bleeding in a few minutes. The band-aid is to stop making a mess. Interferon is given intramuscularly and intravenously for other conditions, so even if you are “lucky” enough to find a real vein or vessel the interferon won’t hurt you.
The caution against injecting the interferon intravenously is because interferon is very irritating and can cause a slight phlebitis (inflammation of the vein). Also it will be painful once the reaction starts, with swelling and redness. If that ever happens to you first apply cold compresses to keep the swelling down and take your favorite painkiller. If after 24 hours the swelling becomes worse, along with increased pain and redness, apply warm compresses and call your doctor or go to the emergency room.
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