|
|
Injecting
Procedures
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.
THREE
ACCEPTABLE SITES FOR INTRAMUSCULAR INJECTIONS ARE
SHOWN BELOW
|
|
| A)
BUTTOCK |
 |
| B)
LATERAL SURFACE OF THIGH |
 |
| C)
DELTOID REGION |
 |
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. |
|
|
|
|
