There is one main question i have above all and this is something i am wondering, i notice a lot of people are using a tube to feed the globulins through but i have not seen anyone injecting it directly without a tube.
Is there any danger or problem to inject myself directly through a syringe and needle subcutaneously without the tube? What is the difference there?
Yes, a tube is absolutely necessary. I haven't seen the exact reason mentioned, but I assume that it's related to the high viscosity of the immune globulin, the necessity of injecting it slowly, and the necessity of keeping the injection site stable.. The fastest injection speed recommended is 2 ml/minute, and that's as fast as I'm physically capable of injecting using the proper equipment.
I haven't looked at the videos above, but I learned how to do SCIG injection mostly through the following video:
The tubing is actually something called an "SCIG needle set." Such a needle set requires a prescription, which you can obtain from your doctor. However, I found that the site that had the needle sets I wanted (DiabeticsTreatment.com
) did not ask for a prescription. It is important to note that there are many types of needle sets used in SCIG, and it is essential that you purchase the correct one for your needs.
For best results, most people are going to want a 27G x 9mm needle. A larger needle width (24G or 25G) may be used for a somewhat faster infusion, but you want to make sure not to exceed the 2 ml/minute speed, as you don't want to damage the tissue at the injection site. A larger needle width also makes use with a pump potentially easier.
The 9 mm needle length is for adults of average build. Children need to use a shorter needle, often 6 mm, while adults with a lot of extra fat at the injection site will often find that a 12 mm needle or larger works best.
The needle set that I have been using for months, which has worked perfectly for me with zero problems, is the Emed Technology - SUB-109-G24 - SUB-112-G24 - SCIg Set, Single Needle with One Site Dressing
. (Note that this link is for a pack of 50 sets; a smaller pack is available.) This set is ideal for doing small-scale injections without a pump - the "rapid push" method that is illustrated in the above video. This needle set also comes with full instructions for doing the complete SCIG infusion, from start to finish.
Depending on the brand of immune globulin you're using, the amount that can be injected per site varies slightly. (I found all this information on the Internet when I was first researching this topic.) However, you should be able to inject at least 20 ml/site. If you are using Gamunex-C, for example, this comes out to two grams. Much higher doses per site are possible, but they have to be injected over a period of time long enough not to stress the injection site. Google "SCIG maximum per site" or the name of your immune globulin for more information on this topic.
Note that the first link in this post shows many different types of needle sets; in addition to single needle sets, there are sets that range from bifurcated all the way up to hexa-furcated. These needle sets are used with pumps, and are generally necessary when you have a very large amount of immune globulin to infuse.
As I said, I have had no problems doing this completely on my own, under the supervision of my doctor. But it is essential that you know what you are doing here, and that you follow the proper instructions exactly. If you are unsure about something, either do the research necessary to find out the exact answer, or consult with your doctor if you are unable to do so. Never guess about any part of this procedure. SCIG injections are extremely safe if done properly, but if not done properly, they can be quite dangerous. For this reason, you should not do this procedure if you are not completely clear on how it is to be done.
You should also always have an EpiPen (or equivalent) by your side any time you do one of these injections, and you should be well acquainted with its use beforehand.