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Where to inject
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All oil based and water based anabolic steroids should be taken
intramuscularly. This means the shot must penetrate the skin and
subcutaneous tissue to enter the muscle itself. Intramuscular
injections are used when prompt absorption is desired, when larger
doses are needed than can be given cutaneously or when a drug is too
irritating to be given subcutaneously. The common sites for in
tramuscular injectons include the buttock, lateral side of the
thigh, and the deltoid region of the arm. Muscles in these areas,
especially the gluteal muscles in the buttock, are fairly thick.
Because of the large number of muscle fibers and extensive fascia,
(fascia is a type of connective tissue that surrounds and separates
muscles) the drug has a large surface area for absorption.
Absorption is further promoted by the extensive blood supply to
muscles. Ideally, intramuscular injections should be given deep
within the muscle and away from major nerves and blood vessels. The
best site for steroid injections is in the gluteus medius muscle
which is located in the upper outer quadrant of the buttock. The
iliac crest serves as a landmark for this quadrant. The spot for an
injection in an adult is usually to 7 1/2 centimeters (2 to 3
inches) below the iliac crest. The iliac crest is the top of the
pelvic girdle on the posterior (back) side. You can find the iliac
crest by feeling the uppermost bony area above each gluteal muscle.
The upper outer quadrant is chosen because the muscle in this area
is quite thick and has few nerves. The probability of injecting the
drug into a blood vessel is remote in this area. Injecting here
reduces the chance of injury to the sciatic nerve which runs through
the lower and middle area of the buttock. It controls the posterior
of each thigh and the entire leg from the knee down. If an
injection is too close to this nerve or actually hits it, extreme
pain and temporary paralysis can be felt in these areas. This is
especially undesirable and warrants staying as far away from this
area as possible.
If the gluteal region cannot be injected for some reason, the second
choice would be the lateral portion of the thigh. Usually,
intramuscular injections in the thigh are only indicated for infants
and children. The vastus lateralis muscle is the only area of the
thigh that should be injected intramuscularly. This site is
determined by using the knee and the greater trochanter of the femur
as landmarks. The greater trochanter is the bony area that you can
feel where the femur joins the pelvic girdle. The mid portion of the
muscle is located by measuring the handbreadth above the knee and
the handbreadth below the greater trochanter. Injecting into the
front of the thigh or inside of the thigh is extremely unwise. These
areas contain nerves as well as a number of blood vessels.
WHAT TO USE FOR INJECTIONS
It is important to choose the proper syringe for the administration
of injectable anabolic steroids. The principle components of a
syringe include a cylindrical barrel to one end of which a hollow
needle is attached, and a close fitting plunger. The most acceptable
syringe for injecting anabolic steroids is a 22 gauge 1 1/2" or
23 gauge 1" apparatus with a 3 cc case. This length allows for
penetration to reach deep inside the muscle tissue. Shorter needles,
5/8" or 1/2" are usually not sufficient for intramuscular
injections and occasionally leave a portion of the Injection in a
subcutaneous area which will cause a swell between the skin and
muscle as well as impaired absorption. The gauge size of a syringe
represents the needle\rquote s diameter. The lower the gauge number,
the wider it is. A 27 gauge needle is very thin. An 18 gauge is
quite wide; it is often referred to as a cannon. The 22 and 23 gauge
needles are not so large that they are difficult to insert, yet are
large enough for solutions to easily be propelled through them. The
use of insulin needles is not acceptable; they are simply too small.
Usually, insulin pins are 25 to 27 gauge and only a 1/2" long
with a 1 cc case.
INJECTION PROCEDURES
There are a number of steps that should be understood in order to
complete a safe and proper intramuscular injection. First off,
before handling any needles or vials, the user should take a
thorough shower. Next, an alcohol swab should be used to clean the
injection site and another alcohol swab should be used to clean the
rubber stopper on top of the vial which will be drawn from. Then,
take a brand new syringe out of its wrapper, remove its plastic top,
draw about 2 ccs of air into it and insert it into the vial. Inject
this air into the vial; this creates pressure within the vial and
makes it easier to draw out oil based preparations. Then, turn the
vial upside-down and slowly draw out the oil until you\rquote ve
overdrawn at least 1/4 cc. For example, if someone was going to take
a shot of 1 cc, they should pull out approximately 1 1/4 to 1 1/2
ccs of liquid, then tap the side of the case to help get the air
bubbles that were drawn into the syringe to come to the top. At that
point, the excess 1/4 to 1/2 cc could be injected back into the vial
and the needle removed. Then, hold the syringe needle-side-up and
continue to tap it to encourage all the air bubbles to come to the
top of the syringe. Now, take another clean syringe, remove it from
its sterile package and unscrew the needle from the syringe.
Exchange the brand new needle for the one that has just been
injected into the stopper. By using two needles for every injection,
you can take advantage of using the full sharpness of the pin. The
needle does suffer some dulling when it is pushed through the firm
rubber stopper on a vial. It is important not to touch this needle
before the injection. It should not come into contact with a counter
top, your fingers, nor should it be cleaned with alcohol. This
needle is sterile and should not be touched. At this point, once
again swab the injection site with alcohol, then press the stopper
of the syringe holding it needle-side-up, until the slight air
bubbles that are at the top are pressed out. Once a bead of oil has
appeared at the top of the needle, allow it run down the surface of
the needle which provides lubrication. At this time, take the
syringe and hold it like a dart. Use the other hand to stretch the
skin at the injection site and simply push the sharp clean needle
in. After inserting it deep into the muscle, pull back on the
stopper for a few seconds to make sure it does not fill up with
blood which would indicate that the needle had been injected into a
blood vessel. Providing there is no blood present in the syringe,
slowly press the stopper down until all the oil is injected. Then,
quickly pull the needle out and take another alcohol swab and press
firmly on the injection site. This will minimize bleeding, if there
is any, and by firmly pressing on the injection site and slightly
massaging it, some of the soreness may be eliminated. It is
important that the liquid is not injected too quickly as this causes
more pain at the site during the injection and in the proceeding
days. After this procedure has been completed, return the plastic
caps to shield the needles and make sure they are discarded
properly. To avoid discomfort and excessive scar tissue at the
injection site, it is not wise to inject more than 2 ccs of solution
per shot. It is also not prudent to use the same injection site more
than twice a week (once a week is preferred) .
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