What Would Cause A Pick Line Not Being Able To Draw Blood

Getting Off: The Basics of Safer Injection

This affiliate covers:

Taking Control
Mainlining (Intravenous Injection)
Bureaucracy of Rubber for Choosing Intravenous Injection Sites
Veins vs. Arteries
Veins vs. Fretfulness
Exercises for Improving Vein Visibility
Some Tips for "Getting Veins Up"
Muscle-Popping (Intramuscular Injection)
Skin-Popping (Subcutaneous Injection)

This section of the manual presents information on proper injection technique (intravenous, intramuscular, and subcutaneous injection).

Every bit of import equally preparing your drugs as cleanly as possible is injecting them equally safely and as carefully equally possible.

This department of the manual presents information on proper injection technique (intravenous, intramuscular, and subcutaneous injection). In addition to mastering proper injection technique, folks who inject intravenously regularly must also be sure to practice good vein care, and everyone who injects should be enlightened of the diverse things they tin do—similar rotating injection sites—that will help them avert infection and maintain expert health.

TAKING CONTROL

Information technology is extremely important for people who inject regularly —peculiarly those who are physically dependent—to exist able to gear up and safely inject drugs on their own. People may accept reward of you when they know that you rely on them for getting off. You lot deserve to have control over your body and what y'all demand to practice for yourself! Learn how to safely and properly inject yourself!

Learning how to inject properly, like mastering any other complicated action, takes practice. Afterwards a while, yous will no doubt be able to hitting veins you've never used earlier on the first try, causing minimal trauma to the injection site and leaving a tiny puncture wound that barely bleeds. Yous will develop 'a feel' for where your veins are and how you need to position and insert your needle in order to get a adept striking.

Perhaps the safest manner to learn how to inject is to accept someone who knows what they're doing teach you lot. An experienced injector can walk you through the process of injecting, or mayhap even demonstrate it, and forbid y'all from making any dangerous mistakes. If possible, find someone who you trust to mentor you lot through this process. And talk with other injectors well-nigh the various tips and wisdom about injecting they've picked up over the years.

Hopefully, there are things in this transmission that volition exist new and helpful even to those of u.s.a. who have been injecting for a long time. However, reading most how to inject and actually doing information technology are 2 different things. If you are new to injecting, we can only circumspection you lot to read this manual thoroughly before you brainstorm and to become slow and be aware of everything you're doing. If the risk of injecting drugs seems too dangerous afterward you've read this booklet, deciding not to administer drugs via injection is a harm reduction response that nosotros whole-heartedly support.

Chiliad A I N L I N I Northward G ( INTRAVENOUS INJECTION )

Intravenous injection (mainlining), or injecting a substance directly into the bloodstream through a vein, is one of the fastest ways to deliver a drug into your organisation. It is also the riskiest method to use in terms of overdose (as compared to sniffing, smoking, or oral administration) because the entire dose enters the torso all at once and very quickly. Injecting intravenously normally gives the user a "rush" that many people report to be extremely pleasurable, a sensation that does non occur with intramuscular or subcutaneous injection. While each injection method carries its ain risks, mainlining is arguably the riskiest since it creates a directly opening betwixt the bloodstream and the outside globe. Heroin, cocaine, and amphetamine are three drugs that are commonly administered intravenously.

CHOOSING AN INJECTION SITE

People who inject drugs ofttimes have ane or two favorite places to inject—sites that experience the most comfy, are easy to admission, and where you most e'er get a clean hit on your first try. While it may seem awkward at beginning, it is of import to learn how to inject in other places that may not seem every bit comfortable or attainable on your first couple of tries. If yous keep injecting in your favorite spots over and over without letting the veins repair themselves they will become leaky, making your shot less satisfying and harder to hit; could become seriously infected; and will eventually collapse or scar so badly that they become altogether unusable and interfere with circulation. And then, it is very of import to rotate the sites y'all use to inject. Endeavor to employ a new site for each new injection and go back to sites you've already used only after they've had time to rest and repair themselves.

In addition to learning to inject in new places, it is also important to larn how to inject with either hand so that if the veins on one side of your body need a remainder or are otherwise unusable, you're able to inject into the veins on the other side of your trunk—fifty-fifty if yous need to use your non-dominant paw to practice it. The adjacent time y'all're in withdrawal and really need to get off but tin can't observe a vein in your usual spot, you lot'll exist thankful you taught yourself how to inject into the other arm!

CLEANING THE INJECTION SITE

Any fourth dimension you inject intravenously, you take a chance pushing bacteria, fungi, and any other infection-causing microbes that are on your skin directly into your bloodstream. It is therefore extremely of import to thoroughly make clean your injection site prior to getting off. Alcohol pads work well for this purpose, only be sure to wipe in only i direction and not in a round motion which will cause the clay and germs to stay on your peel. Rubbing alcohol, hydrogen peroxide, or evidently old soap and h2o or any other blazon of cleaning amanuensis or disinfectant also work fine. Be sure not to touch the injection site with your fingers later on you lot've cleaned it. Routinely cleaning the skin prior to injection is i of the most important things you tin do to reduce your risk of endocarditis, blood poisoning, and similar infections (discussed in chapter 3).

TYING UP

Use gravity to bring blood to the limb yous're going to use to inject earlier applying your tourniquet (tie): swing or hang your arms, make a fist, etc. Necktie your tourniquet in such a way that it can exist easily removed if necessary. Try to secure 'rolling' veins like those in your forearms before you lot inject into them. Finally, be sure not to leave the tourniquet on for too long. If you experience your limb becoming numb or observe it turning blue, undo your tourniquet and don't retie it until y'all're ready to inject.

INSERTING YOUR NEEDLE

Insert the needle into your vein with the needle bevel (opening) facing upwards, at a 15 to 35 caste angle, and always in the direction of the eye. The more perpendicular the needle is to the injection site, the greater chance you have of sticking the needle through the vein instead of into it. (Encounter analogy on following page.)

REGISTERING

Once you lot recollect you're in a vein, pull the plunger back to see if claret comes into the syringe. If so, and the claret is night red and deadening moving, you know that yous've hit a vein. You can now untie your tourniquet and proceed to inject your drugs. If no blood or simply a very tiny amount of blood comes into the syringe when yous pull back, you lot're not in a vein and will have to untie your tourniquet, pull your needle out, and try again. If you lot proceed to inject without being properly positioned in a vein, yous'll be putting your drugs into the tissue surrounding the vein, under the skin, or some other place. It will probably be painful and become swollen, and the furnishings of your drugs will come on much more slowly. Yous also chance abscess germination and other possible bug.

If there's too much claret in your shot to tell if y'all're properly registering, split the shot into two and dilute each half with water. If the plunger of your syringe is forced back by the pressure of the claret and information technology is bright carmine, frothy, and 'gushing,' you may have hit an artery. Stay calm and slowly draw the syringe out and elevate the limb.

Some people similar to 'boot' their syringe after they've injected their drugs—that is, pull dorsum the plunger, draw blood into the syringe, and re-inject it. Some injectors similar to do this several times, ostensibly to rinse out any drug solution that remains in the syringe. Because of all the blood involved, you might want to refrain from booting if you know y'all're going to exist cleaning your needle and syringe and allowing someone else to use it. Be certain to thoroughly flush your needle and syringe with water afterward booting if you lot program to re-utilize information technology at a subsequently time, and so that blood doesn't clog the needle.

PULLING OUT

After you've successfully injected your drugs, advisedly pull the needle out of the injection site at the same bending at which it went in. (To minimize bruising, you should take untied your tourniquet before you injected your shot.) Apply pressure level to the injection site to end any haemorrhage. If y'all're getting off in a public place, it is a good idea to have some tissue, gauze, or Band-Aids around so yous don't get blood all over your clothes. Don't use alcohol pads on a fresh injection wound: alcohol will crusade it to drain more, not less.

MISSED SHOTS & AFTERCARE

Don't utilize creams, salves or oils yous use to treat your runway marks or bruising until the injection wound has begun to close (a couple of hours subsequently injecting) otherwise you might cause an infection. Treat missed shots (those that ended upwards somewhere other than in your vein) immediately with a warm water soak or shrink to reduce the likelihood of irritation and abscess formation. Warmth will open the capillaries and bring disease-fighting white blood cells to the affected area.

MAINLINING COCAINE

Cocaine has a numbing outcome on the veins and causes them to constrict (shrink), so if you're shooting coke, you should be extra careful to register properly and make sure you're in a vein before you inject your drugs. Also, chances are that if you're shooting coke, you'll exist injecting many times in a short menses of time with peradventure only several minutes between each injection. This can be traumatic on the veins and the surrounding tissues, and result in a lot of bleeding.

Endeavor to use a sterile, sharp needle for each injection;
make sure you go on your injection equipment separate from anyone else's you're getting off with;
and effort to give the area a good residual for a few days.

You may experience some pain and swelling afterwards such intense activity.

MAINLINING Crack

Considering crack comes in a solid class (rock), it is necessary to dissolve it offset. The safest way to do this is with powdered citric or ascorbic acid–ask your local syring service program or health nutrient store where to find information technology. Avoid lemon juice or vinegar, equally these can atomic number 82 to serious infections.

To dissolve scissure: put crack and citric or ascorbic acid (about a pinch to a slab) in the cooker; add together plenty of water; mash and mix well. Try to only utilize as much acid as you need, since extra volition dissolve your drugs, and acid tin can be very difficult on your veins.

SHOOTING SPEED

Because speed is often cut with such dangerous chemicals, information technology is very important non to miss your shot. Skin-popping speed can be very painful, may cause an abscess, and will take a long time for the trunk to blot. If you get the shakes afterward doing a few shots, it may exist helpful to have a friend inject yous if you are not using alone. Considering the quality of speed varies so dramatically, a tester shot is a good idea.

HIERARCHY OF Rubber

for Choosing Intravenous Injection Sites

The post-obit is a breakdown of possible intravenous injection sites, beginning with the safest options and moving toward the least safety ones.

ARMS: Arms, first upper then lower, are the safest sites for injecting. You should be careful to secure the 'rolling' veins in the forearms earlier you lot inject into them. Arms are also good if you're concerned about hiding your injection or track marks (although wearing long sleeves in the summer can be a drag!).

HANDS: Hands are somewhat less safe than artillery because the veins are significantly smaller and more fragile and therefore more probable to trample or become damaged. Circulation is also slower in the hands, causing healing to take longer. If you're getting off in your hands, exist sure to use the thinnest needle possible (highest gauge) or, if you tin discover one, a butterfly needle. Be vigilant well-nigh rotating the sites, and proceed in heed that information technology is difficult to conceal injection marks and bruises on the easily.

LEGS: Apportionment in the legs may be poor, particularly in people who don't use theirs a lot. Veins in the legs are more likely than those in the arms to develop clots that can obstruct circulation and eventually break off and lodge in the lungs or heart. Also, damaging the valves in the leg veins is more serious than damaging those in the arms since they play a greater function in getting blood back to the heart.

FEET: As with the easily, the veins in the feet are more often than not smaller than in other parts of the torso, and close to nerves, cartilage, and tendons which yous want to avoid hit when you inject. Considering they are farther from the heart than the veins in the hands, artillery, and legs, blood circulates more slowly in the foot veins and they therefore require more fourth dimension for healing and repair. In addition, foot sweat and dingy socks human activity to prevent wounds from healing and increment the run a risk of infection from bacteria.

GROIN: The femoral vein in the groin area is a large and fairly like shooting fish in a barrel vein to access, merely its location almost the femoral nerve and the femoral avenue make it quite a risky place to inject. Among the three, the femoral vein is located closest to the groin, with the artery and so the nerve located as you move outward. If you lot're going to inject into the femoral vein, first locate your femoral artery— where yous practise not desire to inject—by finding the pulse. So motility a curt distance toward the inside of your leg to find the femoral vein. Because information technology lies fairly deep, you will probably not be able to see it simply will have to inject into it without seeing where the vein is.

Neck : The jugular vein in the neck is the riskiest place to inject considering it lies very close to the carotid artery, a major blood vessel that brings blood straight to the brain. Accidentally hitting the carotid artery could be fatal, and damaging the jugular vein in any way can interfere with claret apportionment to the encephalon.

SAFEST INJECTING LOCATION: THE ARM

(Numbered in order of safety)

LOCATION OF VEINS IN Hand:

Know Where You're Hitting

MORE TIPS FOR CHOOSING AN Advisable INJECTION SITE

Taking proper care of the veins in your arms and other safer locations will forestall y'all from having to shoot upwardly in more unsafe ones.
Y'all should avoid using veins that are tender, hardened, or inflamed until (and if) they heal. Warm compresses and the use of appropriate creams can help speed the healing process.
The larger and more visible the vein, the easier and safer it usually is to hit. Deep veins are harder to hit, and trying to admission them increases your adventure of hitting a nerve or artery in the procedure. On the other manus, it may be hard to keep a needle properly positioned in a very shallow vein, causing you lot to accidentally skin-pop your striking.
Areas that are farthest from the heart, like the hands and feet, heal the slowest and have the poorest circulation. Areas nearest to the heart (like the groin and the neck) have veins that are located nigh major arteries and nerves which, if accidentally hit, tin cause serious, life-threatening harm.
Injecting about a bone increases the chances that swelling and pain will occur.

VEINS VS. ARTERIES

You always want to inject into a vein and never into an avenue. Veins are claret vessels that carry blood from the extremities of the trunk back to the center and lungs where it becomes re-oxygenated. Veins take no pulse, and the blood they carry is a deep, dark carmine because it is low in oxygen. Arteries carry blood rich in oxygen from the lungs and eye to all the other parts of the body. Arteries take a pulse, and the blood in them is bright red and frothy. Arteries are located deeper in the body than veins and then are non visible equally many of your veins are.

Y'all'll know you lot striking an avenue if:

The plunger of your syringe is forced back by the force per unit area of the blood.
When you register, the blood in your syringe is brilliant red and 'gushing.' Blood in veins is dark red, slow-moving, and "lazy."
Information technology hurts differently from your usual injections

You can avoid striking an avenue by:

Never injecting where you feel a pulse.
Injecting only into surface veins and not trying to hit those that lie deeper.

What to practice if you hit an artery:

Untie your tourniquet and pull your needle out immediately.
Raise the limb above your head to stop the bleeding, if possible.
Apply firm pressure to the wound for at least 10 minutes.
If bleeding continues, use a bandage or fabric wrapped very tightly around the wound and seek medical attention immediately. The loss of blood from hit an artery can be life-threatening if it'southward not stopped.

Veins vs. Nerves

Unlike some veins, nerves are non visible from outside the torso, although you volition definitely know if you've striking 1 while injecting because you'll experience extreme pain and no claret will enter the syringe when you pull back to register. You may feel an electric "burn down" forth your limb.

Striking a nerve can be very dangerous and effect in paralysis or the loss of a limb. Information technology'southward a good idea to know where your major nerves are so that you can avoid them when getting off.

Exercises for Improving Vein Visibility

If you're the athletic blazon, engaging in the following activities can help make your veins more visible from outside the body.

Button-ups, pull-ups, and other exercises that strengthen the arms
Weight-lifting, peculiarly bicep exercises
Squeezing tennis balls
Wrist curls

Some tips for "Getting Veins Up"

If you're having difficulty locating a vein to inject into, you might want try one of the post-obit:

Put a warm compress on your injection site for v or ten minutes to help bring a vein to the surface. When you're cold, it tin be very difficult to access a vein. (If you're getting off in a bathroom or somewhere else where there'southward not a lot of heat, don't unroll your sleeve or uncover your injection site until yous're ready to inject.)
Lower your arms below your heart or swing them in a circle.
Lightly slap the injection site.
Wrap your limb in Saran Wrap for a few minutes. This traps the estrus and causes veins to rising to the surface.
Caffeine and nicotine can both constrict veins. Try injecting before you've had your first cup of coffee and/or cigarette. If you lot accept had a cup of coffee or a cigarette, expect about 30 minutes to try injecting once more.
Remain calm. It can be extremely frustrating to be unable to become a hit, particularly if you're in withdrawal. Chances are getting upset will only increment your difficulty, so take a few deep breaths and first once more in a calmer state of heed.

MUSCLE – POPPING ( INTRAMUSCULAR I Due north J EC T IO Northward )

Some drugs, including injectable steroids and hormones, must be injected into a muscle instead of a vein, just heroin and other opiates tin also be administered using this method. The physical and psychoactive effects that upshot from an intramuscular injection of a drug come on much more slowly than those of an intravenous injection (half an hr to 40-five minutes versus almost immediately), although the overall, cumulative intensity of the effects and the experience are virtually identical. Too, the "rush" that is produced when drugs similar heroin are administered intravenously is not experienced by individuals who inject intramuscularly.

Most if not all of the infection control and other safety precautions intravenous drug injectors should follow too employ to individuals who inject drugs intramuscularly. Muscle-popping produces much less bleeding than intravenous injection, if any at all, but the risk of transmitting viruses and other blood-borne leaner as a result of needle-sharing is as serious as it is with intravenous injection. In addition, muscle-poppers are at high run a risk for abscess formation, specially if what they inject has any particles in information technology whatsoever. When musculus-popping, it is extremely important to inject simply a solution that is every bit particle-free every bit possible.

Many of the substances that require intramuscular injection come pre-prepared in liquid grade. To forestall contaminating your entire supply (especially if you're sharing it with someone else), be sure to utilize only a sterile needle and syringe when cartoon the liquid up from the bottle in which it's stored. Muscling speed or cocaine is very painful and unsafe, and is probable to crusade an abscess.

CHOOSING AN INJECTION SITE

The buttocks, thighs, and upper arms are the three best sites, respectively, for intramuscular injection. The best is in the deltoid, the muscle on your upper, outer arm where your shoulder and your arm meet. If injecting into the butt, mentally carve up each cheek into 4 equal sections and inject into the top right or meridian left outer section of each cheek. You tin besides use the front surface of your thighs about six inches above your knee to about six inches beneath your hip, or the outer surfaces of your upper arms between your shoulder and your elbow. Always be conscientious to avoid nerves, blood vessels, or bones, and rotate injection sites to avoid bruising, abscess formation, and the like. Information technology is not uncommon for your muscle to be sore for a few days afterwards an injection.

CLEANING THE INJECTION SITE

Be sure to advisedly clean the injection site prior to injecting (meet 'Mainlining' section above for more item).

INSERTING THE NEEDLE

Try to relax the muscle prior to injection. This will upshot in a less painful injection and may forestall the soreness you commonly feel the following day or 2. When injecting into a muscle, insert the needle in one quick stab direct into the injection site at a 90° angle to the body. Nearly the entire needle should enter the muscle. You definitely desire to draw your plunger dorsum slightly to make sure no blood comes into the syringe. If claret does appear, you've hit a blood vessel and demand to pull out and try again. Inject your substance slowly.

PULLING OUT

Pull your needle out in the same direction and angle at which you inserted information technology. Because yous injected into a musculus, there should be little if any bleeding. You might want to apply a Band-Assistance in whatsoever case to forbid infection. Massaging the surface area lightly for a few minutes will help the drug blot and reduce the hurting.

MUSCLING HORMONES

Hormones are to be injected merely into the thigh or buttock musculus. When injecting, exist careful of fretfulness, veins, and bones. The buttock is the most common place people inject. You can switch buttock cheeks to avoid bruises and sores. Later you inject into these muscles, you might be sore for a day or two.

Practice not inject more than the prescribed corporeality; information technology will not speed up your treatment process. You can cause serious liver damage and increment the risk of claret clots. Claret clots can appear in the veins of the legs and can travel to the lungs; this is called Pulmonary Embolism, which can exist fatal. People who smoke cigarettes and inject hormones are more likely to develop Pulmonary Embolism. (This section taken from Positive Health Project'due south "Safety Guidelines for Injecting Hormones.")

S K I North – P O P P I N G ( S U B C U T A N E O U S I N J E C T I O N )

Skin-popping is the injection of drugs betwixt the trunk's skin and fat layers. Similar muscle-popping, the effects of your drug volition come on much more than slowly than if y'all'd injected information technology intravenously, and you will not experience a "rush."

Skin-poppers should follow all of the infection control and other rubber precautions that intravenous and intramuscular injectors should follow. Although like with muscle-popping, skin-popping results in little or no haemorrhage at the site of the injection, the take chances for bacterial or viral infection is real if injection equipment is shared or drugs are not prepared and injected hygienically. Also, peel-poppers are at greatly increased risk for abscesses, especially if injecting crushed pills or some other solution with particles in it. When peel-popping, it is critical to use only a solution that is as particle-free as possible.

CHOOSING AN INJECTION SITE

The upper and lower arms and legs are probably the best locations for skin-popping.

CLEANING THE INJECTION SITE

Equally ever, thoroughly make clean the injection site with booze, soap and water, or other disinfectant prior to injection.

INSERTING THE NEEDLE

Slide the needle under your skin at a shallow bending, xv° to 45° at the most. Inject no more than ane⁄two cc of liquid (one-half of the volume of a 1 cc syringe) to course a niggling bubble under the skin. If your hitting is more than i⁄2 cc, inject into ii or more than sites. The crash-land from the solution you injected will slowly decrease as the liquid is captivated into the body, and should disappear completely within a few hours. Skin-popping tin exist uncomfortable, and the crash-land you create may hurt a bit. If you skin pop where the pare is loose, pinch the peel between your thumb and forefinger and put the needle into the pare you lot've pulled up.

PULLING OUT

Pull your needle out in the aforementioned management every bit it went in. There should not be much bleeding at the injection site when pare-popping, but you might want to apply a Band-aid to forbid infection.