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Practice · Administration · continued

Pinch or no pinch, and how needle length changes the answer — the long version posts 31–60

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

AP
au.pereiraTL215 Mar 2026 · edited#31
e.lokken, post #21: Leaving the needle in for a couple of seconds after depressing the plunger reduces leakage at the site. It costs nothing and it is the fix for the "some came back out" question. That is a description of practice, not a recommendation of it. Go to post

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

5 likes in reply to #21 4mo
LE
logbook_erinTL3Regular17 Mar 2026#32

A new needle for each injection is not fussiness. A needle blunts on first use and a blunted needle is the reason the second injection hurts more than the first.

Two people can read the same figure differently here and both be reasonable.

0 likes 4mo
AI
a.ilungaTL219 Mar 2026#33

Pinch was covered in the wiki last year and the page has a review date on it, which is a better starting point than my memory of a thread.

0 likes 4mo
CL
coldchain_liuTL3Regular22 Mar 2026#34

This follows post #33 rather than contradicting it.

Filing a mild objection to the consensus on Pinch. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit.

19 likes 4mo
PK
p.krastevTL224 Mar 2026#35
e.lokken, post #21: Leaving the needle in for a couple of seconds after depressing the plunger reduces leakage at the site. It costs nothing and it is the fix for the "some came back out" question. That is a description of practice, not a recommendation of it. Go to post

I had written a reply contradicting post #33 and deleted it. Here is what survived.

If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life.

8 likes in reply to #21 4mo
RV
r.venkatesanTL326 Mar 2026#36
FD
f.danquahTL229 Mar 2026#37

Leaving the needle in for a couple of seconds after depressing the plunger reduces leakage at the site. It costs nothing and it is the fix for the "some came back out" question.

Filing this under things that are true until someone shows me otherwise.

0 likes 4mo
MM
maintenance_modeTL3Regular31 Mar 2026#38

A new needle for each injection is not fussiness. A needle blunts on first use and a blunted needle is the reason the second injection hurts more than the first.

27 likes 4mo
HV
h.vargaTL22 Apr 2026#39

My understanding of Pinch is a few years old and may have been superseded. If it has been, I would genuinely like to know rather than keep repeating it.

13 likes 4mo
DO
d.oyelaranTL3Pharmacist4 Apr 2026 · edited#40
a.wikstrom, post #27: Adding the measurement that post #24 says would settle it. A note on scope: what I am saying about Pinch applies to the case in the first post and I would not extend it further without checking. Go to post

Understood, and I withdraw the assumption I opened with.

4 likes in reply to #27 4mo
PP
peak_purityTL3Analytical chemist7 Apr 2026#41
j.nascimento, post #23: Pinch would be much easier to settle if anyone reported the denominator. Almost nobody reports the denominator. Go to post

Appreciated. The plain phrasing does more work here than a longer post would.

8 likes in reply to #23 4mo
NS
no.silvaTL29 Apr 2026#42

I read post #39 twice before replying, because I had assumed the opposite.

Drawing up with one needle and injecting with another: a reasonable practice if you have extra needles. Fresh needle for injection reduces tissue drag and can decrease discomfort. Not necessary, but not harmful either.

I would want the raw data before agreeing with my own summary of it.

18 likes 4mo
OB
owen.bradyTL4 Moderator11 Apr 2026#43

The failure mode on Pinch is boring rather than dramatic. It is almost always the step everyone assumes was done correctly because it is too simple to get wrong.

0 likes 4mo
SD
s.dialloTL213 Apr 2026#44

Pinch is a question about a distribution, not about a value, and treating it as a value is what produces the confident wrong answers.

1 like 3mo
MD
m.dalgaardTL3Regular15 Apr 2026 · edited#45
h.fonseca, post #30: If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life. Go to post

Narrowing post #42, because the general version has more than one answer.

If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life.

One case, stated as one case.

4 likes in reply to #30 3mo
FR
f.rasmussenTL218 Apr 2026#46

Bleeding at the injection site: normal and usually minimal. A little blood at the needle site after withdrawal is not a reason to assume you lost a significant dose. The needle passed through tissue and there is a small amount of bleeding in the tract.

13 likes 3mo
NG
np_gilmoreTL3Nurse practitioner20 Apr 2026#47

Summarising the Pinch thread so far, since it is long and the answer is buried: the first reply has the method, the fourth has the correction to it, and the rest is people agreeing at length.

0 likes 3mo
MV
m.vukovicTL222 Apr 2026#48

What I can speak to on Pinch is narrow, so I will keep it narrow rather than generalising from it. Beyond that boundary I do not know.

0 likes 3mo
HM
h.mensahTL224 Apr 2026#49

If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life.

18 likes 3mo
LS
l.solbergTL226 Apr 2026#50

Agreed, and I will stop repeating the version of this I had been repeating.

0 likes 3mo
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NHuddlestonTL1Member28 Apr 2026#51
au.pereira, post #31: I had read the opposite somewhere and cannot now find where, which tells me something. Go to post

Answering the question post #47 raises rather than the one it answers.

Injection discomfort: comes from needle gauge (finer = less discomfort), volume (smaller = less discomfort), temperature (room temperature or warmed is less uncomfortable than cold), and technique (smooth, purposeful injection is less uncomfortable than hesitant). All four are under your control.

Marking that as an opinion rather than a finding.

17 likes in reply to #31 3mo
FY
f.yildizTL230 Apr 2026#52

The arithmetic in post #51 is right; the assumption feeding it is the part to check.

A genuinely late dose: the labelling generally says that if the next dose is more than a couple of days away, take it as soon as you notice. If the next dose is close, skip it and resume the schedule. The reasoning follows from the long half-life; you are perturbing a slowly moving average.

I would put the burden of proof on the interesting explanation, not the dull one.

6 likes 3mo
ST
stopper_traceTL2Member2 May 2026#53

If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life.

0 likes 3mo
MG
m.guerreroTL25 May 2026#54

Leave real distance between consecutive sites rather than moving a centimetre. Repeatedly injecting one area changes the local tissue over time and eventually changes absorption there.

32 likes 3mo
GP
g.pemberton_ukTL37 May 2026#55
RS
r.szaboTL29 May 2026#56

Adding the measurement that post #54 says would settle it.

Pinching a fold is useful for lean tissue and unnecessary elsewhere. The point is to keep the needle out of muscle, and whether you need to depends on the site and on you.

Worth reading the earlier posts in this thread before acting on mine.

11 likes 3mo
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WendelboeTL2Member11 May 2026#57

Noted, and thank you for writing it out rather than summarising it.

1 like 3mo
AV
ai.vukovicTL213 May 2026#58

If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life.

0 likes 3mo
UC
unit_conversionTL3Regular15 May 2026#59

I have three months of notes on Pinch 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.

31 likes 2mo
RV
r.vukovicTL217 May 2026#60
IHollingworth, post #10: Pinch is worth one more sentence than it usually gets, and the sentence is the one about how the number was arrived at. Go to post

The bit of Pinch 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.

16 likes in reply to #10 2mo