Re: Injection Technique --> RE: Bionix Products -- interesting devices

[Guest guest]

I give great shots too. My patients will tell me they didn’t

feel a thing. I use a fresh needle (that hasn’t penetrated the

rubber stopped) , quick through the skin straight in, and straight out is very

important. I inject slowly most vaccines to avoid the uncomfortable

pressure sensation. Stinging vaccines I give fast otherwise it will just

sting longer. These are the sub q’s (MMR, Varicella,

Zostavax). If some people feel I sting (some do), I just inject quick and

get out.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Jean

Antonucci

Sent: Tuesday, November 25, 2008 7:55 AM

To:

Subject: Re: Injection Technique --> RE:

Bionix Products -- interesting devices

I give great shots:)

It is the injecting quickly that works becasue it is the skin that

has the nerve endings It looks bad jabbing someone but to get

past the skin quickly is the part that dimisnhes pain

Obviously injecting a 1cc vaccine hurts more than a 1/2 cc dose yes

becasue of volume but the biggest casue of pain is the needle

piercing the skin.

JEan

Thanks for the offer .

I'll get in touch if I decide to

get them.

I did buy the Elephant washer --

I'll see what my Med Tech thinks of it.

I find the idea of injecting

quickly causing less pain counterintuitive to past recommendations to lessen

lidocaine pain on injection.

I have heard some sources say to

inject the lidocaine slowly to cause less pain -- in addition to all the other

things -- buffer it, etc.

Wouldn't injecting 0.5-1cc of

fluid quickly into the muscle cause the tissue to expand rapidly and therefore

more pain?

Perhaps it's the difference

between injecting for a laceration or skin biopsy (more intradermal and subQ)

vs vaccination (typically IM).

Locke, MD

From:

[mailto: ]

On Behalf Of Seto

Sent: Monday, November 24, 2008 8:58 AM

To:

Subject: Re: Bionix Products -- interesting

devices

,

I have a bag of these things in my

office and I'd be happy to send them to you if you want them. I bought them

when I first opened my practice and unfortunately, did not find them as

effective as simply stretching the skin to reduce the pain of injection.

Perhaps that is why they are no longer being sold?

In looking up vaccine injection

technique, I found this article which states that a " pragmatic "

approach (no aspiration, rapid injection and rapid withdrawal) was less painful

than the currently recommended method. Makes sense:

http://www.medscape.com/viewarticle/561956

Seto

South Pasadena, CA

On Nov 22, 2008, at 9:10 AM,

Locke wrote:

I have no financial connection to

Bionix.

I was looking for hte Shot

Blocker and someone pointed me to Bionix.

Interestingly, they don't carry

the shot blocker anymore, but do have these interesting tidbits.

--

If you are a patient please allow up to 12 hours for a reply by

email/

please note the new email address.

Remember that e-mail may not be entirely secure/

MD

ph fax

[Guest guest]

I find the larger the volume, the more painful the shot. No matter what it is, no matter what the med. When I give 1 gram of ceftriaxone I always mix it with half lidocaine. Doesn't help immediately, but 10 seconds later it does.

To: Sent: Tuesday, November 25, 2008 12:48:48 AMSubject: Injection Technique --> RE: Bionix Products -- interesting devices

Thanks for the offer .

I'll get in touch if I decide to get them.

I did buy the Elephant washer -- I'll see what my Med Tech thinks of it.

I find the idea of injecting quickly causing less pain counterintuitive to past recommendations to lessen lidocaine pain on injection.

I have heard some sources say to inject the lidocaine slowly to cause less pain -- in addition to all the other things -- buffer it, etc.

Wouldn't injecting 0.5-1cc of fluid quickly into the muscle cause the tissue to expand rapidly and therefore more pain?

Perhaps it's the difference between injecting for a laceration or skin biopsy (more intradermal and subQ) vs vaccination (typically IM).

Locke, MD

From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp rovement1@ yahoogroups. com] On Behalf Of SetoSent: Monday, November 24, 2008 8:58 AMTo: Practiceimprovement 1yahoogroups (DOT) comSubject: Re: [Practiceimprovemen t1] Bionix Products -- interesting devices

, I have a bag of these things in my office and I'd be happy to send them to you if you want them. I bought them when I first opened my practice and unfortunately, did not find them as effective as simply stretching the skin to reduce the pain of injection. Perhaps that is why they are no longer being sold?

In looking up vaccine injection technique, I found this article which states that a "pragmatic" approach (no aspiration, rapid injection and rapid withdrawal) was less painful than the currently recommended method. Makes sense:

http://www.medscape .com/viewarticle /561956

Seto

South Pasadena, CA

I have no financial connection to Bionix.

I was looking for hte Shot Blocker and someone pointed me to Bionix.

Interestingly, they don't carry the shot blocker anymore, but do have these interesting tidbits.

[Guest guest]

I find the larger the volume, the more painful the shot. No matter what it is, no matter what the med. When I give 1 gram of ceftriaxone I always mix it with half lidocaine. Doesn't help immediately, but 10 seconds later it does.

To: Sent: Tuesday, November 25, 2008 12:48:48 AMSubject: Injection Technique --> RE: Bionix Products -- interesting devices

Thanks for the offer .

I'll get in touch if I decide to get them.

I did buy the Elephant washer -- I'll see what my Med Tech thinks of it.

I find the idea of injecting quickly causing less pain counterintuitive to past recommendations to lessen lidocaine pain on injection.

I have heard some sources say to inject the lidocaine slowly to cause less pain -- in addition to all the other things -- buffer it, etc.

Wouldn't injecting 0.5-1cc of fluid quickly into the muscle cause the tissue to expand rapidly and therefore more pain?

Perhaps it's the difference between injecting for a laceration or skin biopsy (more intradermal and subQ) vs vaccination (typically IM).

Locke, MD

From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp rovement1@ yahoogroups. com] On Behalf Of SetoSent: Monday, November 24, 2008 8:58 AMTo: Practiceimprovement 1yahoogroups (DOT) comSubject: Re: [Practiceimprovemen t1] Bionix Products -- interesting devices

, I have a bag of these things in my office and I'd be happy to send them to you if you want them. I bought them when I first opened my practice and unfortunately, did not find them as effective as simply stretching the skin to reduce the pain of injection. Perhaps that is why they are no longer being sold?

In looking up vaccine injection technique, I found this article which states that a "pragmatic" approach (no aspiration, rapid injection and rapid withdrawal) was less painful than the currently recommended method. Makes sense:

http://www.medscape .com/viewarticle /561956

Seto

South Pasadena, CA

I have no financial connection to Bionix.

I was looking for hte Shot Blocker and someone pointed me to Bionix.

Interestingly, they don't carry the shot blocker anymore, but do have these interesting tidbits.

[Guest guest]

I find the larger the volume, the more painful the shot. No matter what it is, no matter what the med. When I give 1 gram of ceftriaxone I always mix it with half lidocaine. Doesn't help immediately, but 10 seconds later it does.

To: Sent: Tuesday, November 25, 2008 12:48:48 AMSubject: Injection Technique --> RE: Bionix Products -- interesting devices

Thanks for the offer .

I'll get in touch if I decide to get them.

I did buy the Elephant washer -- I'll see what my Med Tech thinks of it.

I find the idea of injecting quickly causing less pain counterintuitive to past recommendations to lessen lidocaine pain on injection.

I have heard some sources say to inject the lidocaine slowly to cause less pain -- in addition to all the other things -- buffer it, etc.

Wouldn't injecting 0.5-1cc of fluid quickly into the muscle cause the tissue to expand rapidly and therefore more pain?

Perhaps it's the difference between injecting for a laceration or skin biopsy (more intradermal and subQ) vs vaccination (typically IM).

Locke, MD

From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp rovement1@ yahoogroups. com] On Behalf Of SetoSent: Monday, November 24, 2008 8:58 AMTo: Practiceimprovement 1yahoogroups (DOT) comSubject: Re: [Practiceimprovemen t1] Bionix Products -- interesting devices

, I have a bag of these things in my office and I'd be happy to send them to you if you want them. I bought them when I first opened my practice and unfortunately, did not find them as effective as simply stretching the skin to reduce the pain of injection. Perhaps that is why they are no longer being sold?

In looking up vaccine injection technique, I found this article which states that a "pragmatic" approach (no aspiration, rapid injection and rapid withdrawal) was less painful than the currently recommended method. Makes sense:

http://www.medscape .com/viewarticle /561956

Seto

South Pasadena, CA

I have no financial connection to Bionix.

I was looking for hte Shot Blocker and someone pointed me to Bionix.

Interestingly, they don't carry the shot blocker anymore, but do have these interesting tidbits.

[Guest guest]

Interesting. I'm great at giving shots! ;-)But I have a different

method.First, I use a reasonably fine gauge needle (27G).Second, I touch

the needle to the skin and ask how sharp it feels. If they say, " not bad, "

I inject there. If they say, " sharp, " I move the needle about 1/2 cm in

any direction and ask again. If that is better, I inject there. If it's worse, I go

back to first spot and inject there.Why? Because the sensory nerves are not

exactly evenly spread around the skin. One spot can be more tender than another with

a needle on the skin. Consider how often patients say, " gee, I don't know

why but that was a lot (better/worse) than last year. " I think that's the

reason.Third, I actually think the volume into the muscle is the more painful

part, so I inject relatively slowly once the needle is in. (exept kids... 4-5

yr old can fight back, so once they are held steady, I jab-and-inject in one swift

motion ... so they'll cry... they'll get over it!... I know, heartless!)TimOn Tue, November 25, 2008 7:54 am

EST, wrote:

I give great shots:) It is the

injecting quickly that works becasue it is the skin that has the nerve endings It

looks bad jabbing someone but to get past the skin quickly is the part that

dimisnhes pain Obviously injecting a 1cc vaccine hurts more than a 1/2

cc dose yes becasue of volume but the biggest casue of pain is the needle piercing

the skin.JEan

Thanks

for the offer .

I'll

get in touch if I decide to get them.

I did

buy the Elephant washer -- I'll see what my Med Tech thinks of

it.

I find

the idea of injecting quickly causing less pain counterintuitive to past

recommendations to lessen lidocaine pain on injection.

I have

heard some sources say to inject the lidocaine slowly to cause less pain -- in

addition to all the other things -- buffer it, etc.

Wouldn't injecting 0.5-1cc of fluid quickly into the muscle cause the

tissue to expand rapidly and therefore more pain?

Perhaps it's the difference between injecting for a laceration or

skin biopsy (more intradermal and subQ) vs vaccination (typically IM).

Locke, MD

From:

[mailto: ]

On Behalf Of SetoSent: Monday,

November 24, 2008 8:58 AMTo: Subject: Re: Bionix Products --

interesting devices

,

I have a bag of these things in my office and I'd be happy to send them to you if you want them. I bought them when I first opened my practice and unfortunately, did not find them as effective as simply stretching the skin to reduce the pain of injection. Perhaps that is why they are no longer being sold?

In looking up vaccine injection technique, I found this article which states that a " pragmatic " approach (no aspiration, rapid injection and

rapid withdrawal) was less painful than the currently recommended method.

Makes sense:

http://www.medscape.com/viewarticle/561956

Seto

South Pasadena, CA

I have no financial connection to

Bionix.

I was looking for hte Shot Blocker

and someone pointed me to Bionix.

Interestingly, they don't carry the

shot blocker anymore, but do have these interesting tidbits.

-- If you are a patient please allow up to 12

hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD 115 Mt

Blue Circle ph fax 207 778

3544

---------------------------------------- Malia, MDMalia

Family Medicine & Skin Sense Laser6720 Pittsford-Palmyra Rd.Perinton

Square MallFairport, NY 14450 (phone / fax)www.relayhealth.com/doc/DrMaliawww.SkinSenseLaser.com--

Confidentiality Notice --This email message, including all the attachments, is

for the sole use of the intended recipient(s) and contains confidential information.

Unauthorized use or disclosure is prohibited. If you are not the intended recipient,

you may not use, disclose, copy or disseminate this information. If you are not the

intended recipient, please contact the sender immediately by reply email and destroy

all copies of the original message, including attachments.----------------------------------------

[Guest guest]

Interesting. I'm great at giving shots! ;-)But I have a different

method.First, I use a reasonably fine gauge needle (27G).Second, I touch

the needle to the skin and ask how sharp it feels. If they say, " not bad, "

I inject there. If they say, " sharp, " I move the needle about 1/2 cm in

any direction and ask again. If that is better, I inject there. If it's worse, I go

back to first spot and inject there.Why? Because the sensory nerves are not

exactly evenly spread around the skin. One spot can be more tender than another with

a needle on the skin. Consider how often patients say, " gee, I don't know

why but that was a lot (better/worse) than last year. " I think that's the

reason.Third, I actually think the volume into the muscle is the more painful

part, so I inject relatively slowly once the needle is in. (exept kids... 4-5

yr old can fight back, so once they are held steady, I jab-and-inject in one swift

motion ... so they'll cry... they'll get over it!... I know, heartless!)TimOn Tue, November 25, 2008 7:54 am

EST, wrote:

I give great shots:) It is the

injecting quickly that works becasue it is the skin that has the nerve endings It

looks bad jabbing someone but to get past the skin quickly is the part that

dimisnhes pain Obviously injecting a 1cc vaccine hurts more than a 1/2

cc dose yes becasue of volume but the biggest casue of pain is the needle piercing

the skin.JEan

Thanks

for the offer .

I'll

get in touch if I decide to get them.

I did

buy the Elephant washer -- I'll see what my Med Tech thinks of

it.

I find

the idea of injecting quickly causing less pain counterintuitive to past

recommendations to lessen lidocaine pain on injection.

I have

heard some sources say to inject the lidocaine slowly to cause less pain -- in

addition to all the other things -- buffer it, etc.

Wouldn't injecting 0.5-1cc of fluid quickly into the muscle cause the

tissue to expand rapidly and therefore more pain?

Perhaps it's the difference between injecting for a laceration or

skin biopsy (more intradermal and subQ) vs vaccination (typically IM).

Locke, MD

From:

[mailto: ]

On Behalf Of SetoSent: Monday,

November 24, 2008 8:58 AMTo: Subject: Re: Bionix Products --

interesting devices

,

I have a bag of these things in my office and I'd be happy to send them to you if you want them. I bought them when I first opened my practice and unfortunately, did not find them as effective as simply stretching the skin to reduce the pain of injection. Perhaps that is why they are no longer being sold?

In looking up vaccine injection technique, I found this article which states that a " pragmatic " approach (no aspiration, rapid injection and

rapid withdrawal) was less painful than the currently recommended method.

Makes sense:

http://www.medscape.com/viewarticle/561956

Seto

South Pasadena, CA

I have no financial connection to

Bionix.

I was looking for hte Shot Blocker

and someone pointed me to Bionix.

Interestingly, they don't carry the

shot blocker anymore, but do have these interesting tidbits.

-- If you are a patient please allow up to 12

hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD 115 Mt

Blue Circle ph fax 207 778

3544

---------------------------------------- Malia, MDMalia

Family Medicine & Skin Sense Laser6720 Pittsford-Palmyra Rd.Perinton

Square MallFairport, NY 14450 (phone / fax)www.relayhealth.com/doc/DrMaliawww.SkinSenseLaser.com--

Confidentiality Notice --This email message, including all the attachments, is

for the sole use of the intended recipient(s) and contains confidential information.

Unauthorized use or disclosure is prohibited. If you are not the intended recipient,

you may not use, disclose, copy or disseminate this information. If you are not the

intended recipient, please contact the sender immediately by reply email and destroy

all copies of the original message, including attachments.----------------------------------------

[Guest guest]

Interesting. I'm great at giving shots! ;-)But I have a different

method.First, I use a reasonably fine gauge needle (27G).Second, I touch

the needle to the skin and ask how sharp it feels. If they say, " not bad, "

I inject there. If they say, " sharp, " I move the needle about 1/2 cm in

any direction and ask again. If that is better, I inject there. If it's worse, I go

back to first spot and inject there.Why? Because the sensory nerves are not

exactly evenly spread around the skin. One spot can be more tender than another with

a needle on the skin. Consider how often patients say, " gee, I don't know

why but that was a lot (better/worse) than last year. " I think that's the

reason.Third, I actually think the volume into the muscle is the more painful

part, so I inject relatively slowly once the needle is in. (exept kids... 4-5

yr old can fight back, so once they are held steady, I jab-and-inject in one swift

motion ... so they'll cry... they'll get over it!... I know, heartless!)TimOn Tue, November 25, 2008 7:54 am

EST, wrote:

I give great shots:) It is the

injecting quickly that works becasue it is the skin that has the nerve endings It

looks bad jabbing someone but to get past the skin quickly is the part that

dimisnhes pain Obviously injecting a 1cc vaccine hurts more than a 1/2

cc dose yes becasue of volume but the biggest casue of pain is the needle piercing

the skin.JEan

Thanks

for the offer .

I'll

get in touch if I decide to get them.

I did

buy the Elephant washer -- I'll see what my Med Tech thinks of

it.

I find

the idea of injecting quickly causing less pain counterintuitive to past

recommendations to lessen lidocaine pain on injection.

I have

heard some sources say to inject the lidocaine slowly to cause less pain -- in

addition to all the other things -- buffer it, etc.

Wouldn't injecting 0.5-1cc of fluid quickly into the muscle cause the

tissue to expand rapidly and therefore more pain?

Perhaps it's the difference between injecting for a laceration or

skin biopsy (more intradermal and subQ) vs vaccination (typically IM).

Locke, MD

From:

[mailto: ]

On Behalf Of SetoSent: Monday,

November 24, 2008 8:58 AMTo: Subject: Re: Bionix Products --

interesting devices

,

I have a bag of these things in my office and I'd be happy to send them to you if you want them. I bought them when I first opened my practice and unfortunately, did not find them as effective as simply stretching the skin to reduce the pain of injection. Perhaps that is why they are no longer being sold?

In looking up vaccine injection technique, I found this article which states that a " pragmatic " approach (no aspiration, rapid injection and

rapid withdrawal) was less painful than the currently recommended method.

Makes sense:

http://www.medscape.com/viewarticle/561956

Seto

South Pasadena, CA

I have no financial connection to

Bionix.

I was looking for hte Shot Blocker

and someone pointed me to Bionix.

Interestingly, they don't carry the

shot blocker anymore, but do have these interesting tidbits.

-- If you are a patient please allow up to 12

hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD 115 Mt

Blue Circle ph fax 207 778

3544

---------------------------------------- Malia, MDMalia

Family Medicine & Skin Sense Laser6720 Pittsford-Palmyra Rd.Perinton

Square MallFairport, NY 14450 (phone / fax)www.relayhealth.com/doc/DrMaliawww.SkinSenseLaser.com--

Confidentiality Notice --This email message, including all the attachments, is

for the sole use of the intended recipient(s) and contains confidential information.

Unauthorized use or disclosure is prohibited. If you are not the intended recipient,

you may not use, disclose, copy or disseminate this information. If you are not the

intended recipient, please contact the sender immediately by reply email and destroy

all copies of the original message, including attachments.----------------------------------------