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Devices · Syringes & needles · continued

A ten-fold dose error caught before injection posts 31–60

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

NV
n.villalobosTL28 May 2025 · edited#31
e.roos, post #26: Post #23 answers the question as asked. The question underneath it is different. Syringe barrel size: common sizes are 0.3 mL, 0.5 mL, and 1.0 mL. Smaller barrels are more legible for small doses. Larger barrels hold larger volumes. Choose based on your dose. Go to post

Post #30 answers the question as asked. The question underneath it is different.

Reusing a needle blunts it and there is no benefit to offset that. The second injection with the same needle is the one people describe as painful.

9 likes in reply to #26 15mo
FP
forest_plotTL3Evidence synthesis10 May 2025#32

Marking my uncertainty on ten-fold dose error caught explicitly. I am confident about the direction, much less confident about the size, and not confident at all that it generalises past the case in the first post.

20 likes 15mo
SA
s.antonsenTL212 May 2025#33

If someone has run ten-fold dose error caught properly I would rather read that than my own reconstruction of it. Posting mine only because the thread has gone quiet.

0 likes 15mo
QZ
q.zhao_qaTL3Quality assurance14 May 2025#34

Worth separating two things that post #32 runs together.

Needle length for subcutaneous delivery is a question about tissue depth and injection angle together. Short needles at ninety degrees and longer ones at an angle reach comparable depths.

Posting it because the silence on this was starting to look like agreement.

2 likes 14mo
CO
c.ostergaardTL216 May 2025#35
e.roos, post #26: Post #23 answers the question as asked. The question underneath it is different. Syringe barrel size: common sizes are 0.3 mL, 0.5 mL, and 1.0 mL. Smaller barrels are more legible for small doses. Larger barrels hold larger volumes. Choose based on your dose. Go to post

Narrowing post #34, because the general version has more than one answer.

Buying a box of the wrong barrel size is the most common regret described in this subcategory, and the reason is nearly always that the dose was decided after the syringes.

Happy to expand any of that if it is the useful part.

14 likes in reply to #26 14mo
PI
p.iyer_pharmdTL318 May 2025#36
HI
h.iyerTL221 May 2025#37

Ten-fold dose error caught is well covered in the tag pages, and the older discussions are better than the recent ones because they were argued out properly. Worth twenty minutes before adding to this one.

0 likes 14mo
BI
blank_injectionTL2Analytical chemist23 May 2025#38

The reason ten-fold dose error caught keeps being re-asked is that the answer is conditional and people quote it without the condition. It is not that the answer is unknown.

5 likes 14mo
BD
b.dumitruTL225 May 2025#39

Sharps containers are a legal requirement for disposal in several jurisdictions and a sensible precaution everywhere. A rigid sealed container is the minimum.

Not disagreeing with anyone above, just adding the bit I keep having to look up.

20 likes 14mo
NT
nl_translatorTL2Translator · NL27 May 2025#40

I had written a reply contradicting post #37 and deleted it. Here is what survived.

Reading units correctly: look at the marking from the side, not from above or below. The bottom of the plunger tip is the reading. Parallax error (wrong angle) is a source of dosing error.

Adding a source would improve this post and I do not have one to hand.

0 likes 14mo
MS
m.stephanopoulosTL3Regular29 May 2025#41
Lundqvist, post #19: Marking my place. If it changes for me I will come back and say so. Go to post

I have three months of notes on ten-fold dose error caught and the honest summary is that the trend is real and the week-to-week numbers are noise. I nearly drew the opposite conclusion from the first fortnight.

15 likes in reply to #19 14mo
BN
b.nwosuTL231 May 2025#42

The bit of ten-fold dose error caught that nobody enjoys is that the answer changes depending on what you are trying to decide with it. Say what the decision is and the thread will converge.

5 likes 14mo
RG
r.girardTL22 Jun 2025#43

I had written a reply contradicting post #41 and deleted it. Here is what survived.

Reusing a needle blunts it and there is no benefit to offset that. The second injection with the same needle is the one people describe as painful.

1 like 14mo
ZI
z.iyerTL24 Jun 2025#44

Confirming post #41 from a second method, which matters more than confirming it from a second person.

Graduation spacing is worth checking before you buy rather than after. Some 1 mL barrels are marked every two units and some every one, and that changes what doses you can read.

Correct me on the arithmetic if it is wrong; I would rather know.

0 likes 14mo
AZ
a.zamoraTL26 Jun 2025 · edited#45
t.pereira, post #17: The number people quote for ten-fold dose error caught is a central estimate presented without its interval, and the interval is wide enough that the estimate is nearly uninformative on its own. Go to post

I had read the opposite somewhere and cannot now find where, which tells me something.

10 likes in reply to #17 14mo
CS
c.silvaTL28 Jun 2025#46
h.jansen, post #7: Coming back to post #3, because the follow-up matters more than the original answer. The most useful thing anyone has posted about ten-fold dose error caught in this category was a table of what had been measured and by whom. That is what I would want again. Go to post

The documentation on ten-fold dose error caught is better than this thread and I say that as someone who has posted in the thread.

3 likes in reply to #7 14mo
BF
b.fonsecaTL210 Jun 2025#47

Insulin syringe graduations: U-100 syringes are marked in units where 100 units = 1 mL. Always confirm your syringe is U-100. Confusion between insulin units and milligrams is the most common syringe error.

0 likes 14mo
DT
d.tammTL212 Jun 2025#48

Post #46 is right about the mechanism and I think understates the practical bit.

U-100 means the barrel is graduated for a solution containing one hundred units of insulin per millilitre. For anything that is not insulin, the units are simply hundredths of a millilitre.

30 likes 14mo
AN
a.novakTL214 Jun 2025#49
s.antonsen, post #33: If someone has run ten-fold dose error caught properly I would rather read that than my own reconstruction of it. Posting mine only because the thread has gone quiet. Go to post

Answering the question post #46 raises rather than the one it answers.

Aspirating before injection: for subcutaneous injection, aspirating (pulling back on the plunger to check for blood) is not necessary and is sometimes discouraged because it is associated with more discomfort. Subcutaneous injection without aspiration is standard practice.

Two sources, same conclusion, and I could not rule out that one copied the other.

29 likes in reply to #33 13mo
AA
a.adebayoTL216 Jun 2025#50
e.dalgleish, post #23: Reading units correctly: look at the marking from the side, not from above or below. The bottom of the plunger tip is the reading. Parallax error (wrong angle) is a source of dosing error. The part I am sure of is shorter than the part I have written. Go to post

The arithmetic in post #49 is right; the assumption feeding it is the part to check.

A detachable luer needle plus hub can retain enough volume to matter. Whether it matters to you depends on your dose, and the arithmetic is worth doing once.

I would hold that lightly until someone with a larger sample weighs in.

14 likes in reply to #23 13mo
MS
m.steinerTL218 Jun 2025 · edited#51
il.dumitru, post #30: What would change my mind on ten-fold dose error caught is a second dataset collected by someone with no stake in the first. Until then I hold it loosely and I would rather say so than pretend to more. Go to post

Second-hand on ten-fold dose error caught, so weight it accordingly — someone whose method I trust told me this and I have not verified it myself.

23 likes in reply to #30 13mo
FD
f.demirTL2Regular20 Jun 2025#52

Silicone coating on the barrel affects how smoothly the plunger moves and how a very slow injection feels. It is one reason two syringes at the same specification are not identical to use.

That distinction has done more work for me than anything else in this category.

0 likes 13mo
JM
j.moreauTL222 Jun 2025#53

If you are new and reading this thread for the answer to ten-fold dose error caught: the answer is conditional, the conditions are in the third reply, and the rest of the thread is worth skipping.

1 like 13mo
BV
bias_varianceTL4Biostatistician24 Jun 2025#54
f.laurent, post #20: Post #18 describes the usual case. This is about the unusual one. U-100 means the barrel is graduated for a solution containing one hundred units of insulin per millilitre. For anything that is not insulin, the units are simply hundredths of a millilitre. Go to post

Where I part company with post #50, and it is a narrow parting.

Offering a way to settle ten-fold dose error caught rather than another opinion about it. Two measurements, taken the same way, a fortnight apart. If the difference is within the noise, the question was not answerable at this precision.

6 likes in reply to #20 13mo
HD
h.delgadoTL226 Jun 2025#55
blank_injection, post #38: The reason ten-fold dose error caught keeps being re-asked is that the answer is conditional and people quote it without the condition. It is not that the answer is unknown. Go to post

Reading rather than answering, but this is the post I would point somebody at.

16 likes in reply to #38 13mo
IT
impurity_tableTL3Analytical chemist28 Jun 2025#56

Drawing air into the vial before withdrawing liquid equalises the pressure and makes the draw easier. It is not required and it is why some people find a full vial harder to draw from than a half-empty one.

The strength of my opinion here exceeds the strength of my evidence.

32 likes 13mo
NL
n.laurentTL230 Jun 2025#57

Confirming post #56 from a second method, which matters more than confirming it from a second person.

Worth stating the null on ten-fold dose error caught before we explain it: the observation may be nothing. That possibility deserves a sentence and usually does not get one.

0 likes 13mo
CR
compounding_ruthTL4Pharmacist2 Jul 2025#58

I had written a reply contradicting post #54 and deleted it. Here is what survived.

My position on ten-fold dose error caught is current rather than settled. I have revised it once already and I expect to again, so treat it accordingly.

3 likes 13mo
VB
va.baptistaTL23 Jul 2025#59

Post #56 answers the question as asked. The question underneath it is different.

Syringe barrel size: common sizes are 0.3 mL, 0.5 mL, and 1.0 mL. Smaller barrels are more legible for small doses. Larger barrels hold larger volumes. Choose based on your dose.

Genuinely open to being wrong about this one.

0 likes 13mo
TV
t.vasquezTL4 Moderator5 Jul 2025#60

I read post #58 twice before replying, because I had assumed the opposite.

A note on how ten-fold dose error caught gets discussed rather than on ten-fold dose error caught itself: the confident posts get the replies and the careful ones get ignored, and the careful ones have been right more often.

1 like 13mo