Opioids How do you stop a vein from rolling also... Flagging/registering issue?

[Zonxx]

title says it all, my lower veins whenever i do use them tend to.... idk, roll? sometimes i'll actually have an issue puncturing them but this could be due to not using a tourniquet because ain't nobody got time fro dat
The registering is a pain in the ass sometimes, WHY. i mean... i used to be able to pin, pull a liiiitle back, tada good to go, buuuuut the last go i had, i mean, i knew i was in but why not flag to make sure right, nothing except for a sting, went for it because confident, not a problem at all... the area i use


k my arm is NOT this bad anymore lol. this was a stupid day, where i went to check if my vein still worked because i missed a few weeks ago and i didn't even see my main veins for about 5 days

any tips on registering and keeping from rolling?

 

[Jabberwocky]

I know some people who use a tourniquet that crosses the arm in two places - effectively pinning the vein. It’s fiddle and tricky though and easy to blow a vein.

 

[Nicomorphinist]

Using a butterfly needle, like they use when getting blood samples, can help, and the 25 gauge ones I have used for medications are self-registering even with my low blood pressure, in other words blood will flow into the proximal half cm or more of the tubing connected to the needle, and I think one can get butterfly needles with translucent butterflies (the pieces of plastic right by the needle which are held with the finger and thumb to direct the needle) which show blood even further down.

What I do is prepare the syringe with the nicomorphine, hydromorphone, morphine, Scophedal, or whatever, get another syringe and draw saline into it, maybe 1-2 cc of saline in a 3 cc syringe or so and screw that into the butterfly and use that to flush the air from the needle and syringe . . . then I apply the tourniquet and sterilise the injection site -- actually since I sometimes have to poke more than one location just because I have tiny blood vessels, I will do the entire region like the inside of the forearm and spray the whole region with an atomiser of alcohol even before the tourniquet . . . then I put some tape on the tubing maybe 4-6 cm from the butterfly,

Then it is time to grasp the butterfly, get the needle in, and when it self-registers (in ambiguous cases I do pull back with the 3 cc with saline in it or the drug syringe after screwing it into the butterfly needle apparatus) push the tape down onto the skin with my nose or other hand or a pencil held in my teeth, then unscrew the saline syringe, screw in the drug syringe, and push the plunger, and do it at a moderate speed, then unscrew the drug syringe, screw in the 3 cc saline syringe and use 1 cc or so to push the rest of the drug in the tube into my vein, and take care of the tourniquet afterwards.

The butterfly needle can be used very easily with wheel filters and I have used inline IV filters and other things with extra pieces of tubing in some cases, like when I was using a syringe driver for a shot that had to be diluted to more than 5 cc or could make one pass out during the injection, and things like iron and Procrit and so forth and amounts of saline and glucose up the size of the largest syringe, 60 cc in my experience . . . one can use a syringe driver for that, or of course an IV setup with a stand and bags and tubes and inline filters and so forth can be used as well; I have both and especially used the syringe driver to push in 10 or more cc of dextromoramide diluted with 9‰ saline so I wouldn't faint from the blood pressure drop. That was when they started scripting Scophedal and then it was no longer available and I started getting it compounded . . . I still got the dextromoramide from time to time and would turn the syringe driver all the way up to maximum speed, so even if I did nod or pass out the shot would finish itself because it was not an overdose, it was orthostatic hypotension from when I would shoot the undiluted Palf into the main line with a single wham that took four seconds at most. The bang, which was necessary for tackling severe breakthrough pain, was even more than nicomorphine and comparable to phenadoxone plus hydroxyzine, both of which came in ampoules and I mixed in a 5 cc syringe and used with the syringe driver also and were even a hair better than Diconal and one didn't have to grind up pills with sand in them . . .

 

[KS78]

You sure have a lot of puncture marks for a guy who doesn't favor IV use

 

[Soso78]

You answered ur own question. Use a tourniquet

 

[Zonxx]

You sure have a lot of puncture marks for a guy who doesn't favor IV use

yeah admittedly i was testing my vein the night i did that, i mean, i got fixated on the rush / lack of pain and slammed the dilaudid a couple times over the night, i can't tell you how many times i went at it, but i firmly think i should have just done a few large doses instead of 6mg slams at a time buuut then again it wasn't primarily to get high

 

[Painful One]

OMG SON!!!!

Look at your arm!

This makes your adopted mom @Painful One VERY sad!
*tears streaming down face.

 

[Nicomorphinist]

yeah admittedly i was testing my vein the night i did that, i mean, i got fixated on the rush / lack of pain and slammed the dilaudid a couple times over the night, i can't tell you how many times i went at it, but i firmly think i should have just done a few large doses instead of 6mg slams at a time buuut then again it wasn't primarily to get high

The idea was to get the bang, rush, and overall come-up with the Dilaudid more than anything else? I understand completely -- the intensity of the bang has a clinical use for breakthrough pain which also happens with IV morphine, nicomorphine, oxymorphone, dextromoramide . . . so, for example, with Dilaudid HP, either that or some morphine goes in the leg every 3-4 hours steadily through the day to maintain pain relief, and if one has breakthrough pain poking through, then load up the syringe with D or Vilan or Scophedal or morphine mixed with tripelennamine (Blue Velvet), or the others work too, and find the main line and wham! It does make a difference, though it doesn't appear to be an official tenet of nursing training these days, but nurses, doctors, and patients, and pharmacologists writing monographs and inserts, should know this technique because it really helps, and it makes the case for medicinal diamorphine (smack) too which hits slightly harder than nicomorphine and in the same high-impact fashion . . .

 

[Nicomorphinist]

As far as finding blood without have to poke around under the skin and try multiple sites, something I noticed is that is helps to get away from a rigid figure like 30° or 45° from the horizontal . . . each location works best with anything from 10° to 60° in my experience and it take some trial and error, the depth of the vein and the length of the straight-away of the vein visible are the biggest determiners of this. Becoming familiar with the veins, arteries, nerves, tendons, muscles and everything else in the area through Topographische Anatomie des Menschen, Gray's Anatomy, and the like is also essential in my opinion. The basilic vein in a lot of people is actually pretty wide, more so than one may expect for one aside from the main line, and works quite well, especially with the butterfly needle.

The pain of probing around under the skin and other unpleasantness also relays a great deal of information at a rather fine level of granularity as they say and it is all important, so if one must use local anaesthetic creams on the area or numb injection sites with lignocaine from a 30 gauge needle I would propose waiting to add this to the routine until one can do the whole thing with their eyes closed -- so to speak, that is -- and I have heard both sides of the debate of using antibiotic cream on the injection site after it is all done. I suppose if one is injecting multiple times a day, one could put a catheter in there and multi-use access apparatus, which pretty much requires numbing with local anaesthetic, that someone else with nursing training should be putting it in.

I propose washing the area and hands well with anti-bacterial soap and warm water before the whole operation if at all possible, and the temperature of the water may help with warmer water bringing the veins closer to the surface and a hot towel over the area being very helpful, a moist one even more so.

Also, the tourniquet is critically important in the case of the arm and other such cases where there is a vein one is trying to get -- it reduces the chances of putting a needle into a valve in the vein, which doesn't really help shooting to put it mildly, and damaging them leads to lots of problems, and a lot of people have some potential of hitting tendons down near the wrist, which don't swell up with the tourniquet and can be spotted as such.

I tried using two tourniquets on either side of the target today and it worked well for me, and there are people whose veins are more apt to roll it seems, and it seems like they can retreat from the surface almost like hiding from the needle over time; this technique will be helpful in at least the former case.

 

[Zonxx]

nd I have heard both sides of the debate of using antibiotic cream on the injection site after it is all done.

i do this, Betaderm + polysporin multi biotic - tends to heal up the arms very quickly ~ 2-4 days to be 110% however, NEVER right after injection, i wait a good hour before application, and always disinfect the applicator be it my finger or a q-tip