![HypodermicBronami](https://upload.wikimedia.org/wikipedia/commons/a/a5/HypodermicBronami.svg)
A hypodermic needle (from
Greek
Greek may refer to:
Greece
Anything of, from, or related to Greece, a country in Southern Europe:
*Greeks, an ethnic group.
*Greek language, a branch of the Indo-European language family.
**Proto-Greek language, the assumed last common ancestor ...
ὑπο- (''hypo-'' = under), and δέρμα (''derma'' = skin)), one of a category of medical tools which enter the skin, called sharps, is a very thin, hollow tube with one sharp tip. It is commonly used with a
syringe
A syringe is a simple reciprocating pump consisting of a plunger (though in modern syringes, it is actually a piston) that fits tightly within a cylindrical tube called a barrel. The plunger can be linearly pulled and pushed along the inside ...
, a hand-operated device with a plunger, to
inject substances into the body (e.g.,
saline solution
Saline (also known as saline solution) is a mixture of sodium chloride (salt) and water. It has a number of uses in medicine including cleaning wounds, removal and storage of contact lenses, and help with dry eyes. By injection into a vein it ...
, solutions containing various drugs or liquid medicines) or extract fluids from the body (e.g., blood). Large-bore hypodermic intervention is especially useful in catastrophic blood loss or treating
shock
Shock may refer to:
Common uses Collective noun
*Shock, a historic commercial term for a group of 60, see English numerals#Special names
* Stook, or shock of grain, stacked sheaves
Healthcare
* Shock (circulatory), circulatory medical emerge ...
.
A hypodermic needle is used for rapid delivery of liquids, or when the injected substance cannot be ingested, either because it would not be
absorbed (as with
insulin
Insulin (, from Latin ''insula'', 'island') is a peptide hormone produced by beta cells of the pancreatic islets encoded in humans by the ''INS'' gene. It is considered to be the main anabolic hormone of the body. It regulates the metabolism o ...
), or because it would harm the
liver
The liver is a major Organ (anatomy), organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of proteins and biochemicals necessary for ...
. It is also useful to deliver certain medications that cannot be delivered orally due to vomiting. There are many possible
routes
Route or routes may refer to:
* Route (gridiron football), a path run by a wide receiver
* route (command), a program used to configure the routing table
* Route, County Antrim, an area in Northern Ireland
* ''The Route'', a 2013 Ugandan film
* Ro ...
for an injection, with
intramuscular
Intramuscular injection, often abbreviated IM, is the injection of a substance into a muscle. In medicine, it is one of several methods for parenteral administration of medications. Intramuscular injection may be preferred because muscles have l ...
(into a
muscle
Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of muscl ...
) and
intravenous
Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutrie ...
(into a
vein
Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated b ...
) being the most common. A hypodermic syringe has the ability to retain liquid and blood in it up to years after the last use and a great deal of caution should be taken to use a new syringe every time.
The hypodermic needle also serves an important role in research environments where sterile conditions are required. The hypodermic needle significantly reduces contamination during
inoculation
Inoculation is the act of implanting a pathogen or other microorganism. It may refer to methods of artificially inducing immunity against various infectious diseases, or it may be used to describe the spreading of disease, as in "self-inoculati ...
of a sterile
substrate. The hypodermic needle reduces contamination for two reasons: First, its surface is extremely smooth, which prevents airborne
pathogens
In biology, a pathogen ( el, πάθος, "suffering", "passion" and , "producer of") in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ ...
from becoming trapped between irregularities on the needle's surface, which would subsequently be transferred into the media (e.g.
agar
Agar ( or ), or agar-agar, is a jelly-like substance consisting of polysaccharides obtained from the cell walls of some species of red algae, primarily from ogonori (''Gracilaria'') and "tengusa" (''Gelidiaceae''). As found in nature, agar is ...
) as contaminants; second, the needle's surface is extremely sharp, which significantly reduces the diameter of the hole remaining after puncturing the membrane and consequently prevents microbes larger than this hole from contaminating the substrate.
History
Early use and experimentation
The ancient Greeks and Romans knew injection as a method of medicinal delivery from observations of snakebites and poisoned weapons.
There are also references to "anointing" and "inunction" in the Old Testament as well as the works of Homer, but injection as a legitimate medical tool was not truly explored until the 17th century.
[Kotwal, Atul. "Innovation, diffusion and safety of a medical technology: a review of the literature on injection practice". ''Social Science & Medicine'' Volume 60, Issue 5, March 2005, pp. 1133–1147]
Christopher Wren
Sir Christopher Wren PRS FRS (; – ) was one of the most highly acclaimed English architects in history, as well as an anatomist, astronomer, geometer, and mathematician-physicist. He was accorded responsibility for rebuilding 52 churches ...
performed the earliest confirmed experiments with crude hypodermic needles, performing intravenous injection into dogs in 1656.
These experiments consisted of using animal bladders (as the syringe) and goose quills (as the needle) to administer drugs such as opium intravenously to dogs. Wren and others' main interest was to learn if medicines traditionally administered orally would be effective intravenously. In the 1660s, J. D. Major of Kiel and J. S. Elsholtz of Berlin were the first to experiment with injections in humans.
These early experiments were generally ineffective and in some cases fatal. Injection fell out of favor for two centuries.
19th-century development
![SyringeAllGlass](https://upload.wikimedia.org/wikipedia/commons/3/3f/SyringeAllGlass.jpg)
The 19th century saw the development of medicines that were effective in small doses, such as opiates and strychnine. This spurred a renewed interest in direct, controlled application of medicine. "Some controversy surrounds the question of priority in hypodermic medication." Irish physician
Francis Rynd
Francis Rynd AM, MRCS, MRIA (1801–1861) was an Irish physician, known for inventing the hollow needle used in hypodermic syringes.
Background
Rynd was born in Dublin, Ireland, in 1801 to James Rynd and his third wife Hester Fleetwood, of Rynd ...
is generally credited with the first successful injection in 1844, in the
Meath Hospital
The Meath Hospital ( ga, Ospidéal na Mí) was a general hospital in the Earl of Meath's Liberty in Dublin, Ireland. It was absorbed into the Tallaght Hospital in June 1998.
History
The hospital was opened to serve the sick and poor in the crow ...
in
Dublin
Dublin (; , or ) is the capital and largest city of Republic of Ireland, Ireland. On a bay at the mouth of the River Liffey, it is in the Provinces of Ireland, province of Leinster, bordered on the south by the Dublin Mountains, a part of th ...
,
Ireland
Ireland ( ; ga, Éire ; Ulster Scots dialect, Ulster-Scots: ) is an island in the Atlantic Ocean, North Atlantic Ocean, in Northwestern Europe, north-western Europe. It is separated from Great Britain to its east by the North Channel (Grea ...
.
Alexander Wood’s main contribution was the all-glass syringe in 1851, which allowed the user to estimate dosage based on the levels of liquid observed through the glass. Wood used hypodermic needles and syringes primarily for the application of localized, subcutaneous injection (localized anesthesia) and therefore was not as interested in precise dosages.
Simultaneous to Wood's work in Edinburgh,
Charles Pravaz
Charles Gabriel Pravaz (24 March 1791 – 24 June 1853), a French orthopedic surgeon, pioneered the hypodermic syringe.
While the concept dated to Galen, the modern syringe is thought to have originated in 15th-century Italy, although it took ...
of Lyon also experimented with sub-dermal injections in sheep using a syringe of his own design. Pravaz designed a hypodermic needle measuring 3 cm (1.18 in) long and 5 mm (0.2 in) in diameter; it was made entirely of silver.
Charles Hunter, a London surgeon, is credited with the coining of the term "hypodermic" to describe subcutaneous injection in 1858. The name originates from two Greek words: ''hypo'', "under", and ''derma'', "skin". Furthermore, Hunter is credited with acknowledging the systemic effects of injection after noticing that a patient's pain was alleviated regardless of the injection’s proximity to the pained area.
Hunter and Wood were involved in a lengthy dispute over not only the origin of the modern hypodermic needle, but also because of their disagreement as to the medicine's effect once administered.
Modern improvements
Dr. Francis Rynd (1801–1861) used the first "Hollow Needle" as a hypodermic syringe on Ms. Margaret Cox 6/3/1844 in Ireland.
Dr. Wood can be largely credited with the popularization and acceptance of injection as a medical technique, as well as the widespread use and acceptance of the hypodermic needle. The basic technology of the hypodermic needle has stayed largely unchanged since the 19th century, but as the years progressed and medical and chemical knowledge improved, small refinements have been made to increase safety and efficacy, with needles being designed and tailored for very particular uses. Hypodermic needles remain essential to large volume administration or exchange in settings of trauma or dialysis. The trend of needle specification for use began in the 1920s, particularly for the administration of insulin to diabetics.
[Beckton Dickinson and Company, "Four Major Phases of Injection Device Development"]
Syringe and Needle History
/ref>
The onset of World War II spurred the early development of partially disposable syringes for the administration of morphine and penicillin on the battlefield. Development of the fully disposable hypodermic needle was spurred on in the 1950s for several reasons. The Korean War created blood shortages and in response disposable, sterile syringes were developed for collecting blood. The widespread immunization against polio during the period required the development of a fully disposable syringe system.
The 1950s also saw the rise and recognition of cross-contamination from used needles. This led to the development of the first fully disposable plastic syringe by New Zealand pharmacist Colin Murdoch in 1956. This period also marked a shift in interest from needle specifications to general sterility and safety.
The 1980s saw the rise of the HIV epidemic and with it renewed concern over the safety of cross-contamination from used needles. New safety controls were designed on disposable needles to ensure the safety of medical workers in particular. These controls were implemented on the needles themselves, such as retractable needles, but also in the handling of used needles, particularly in the use of hard-surface disposal receptacles found in every medical office today.
By 2008, all-plastic needles were in production and in limited use. One version was made of Vectra (plastic) Vectra is a brand of liquid crystal polymer (LCP) manufactured by Ticona (a subsidiary of Celanese
Celanese Corporation, formerly known as Hoechst Celanese, is an American technology and specialty materials company headquartered in Irving, Tex ...
aromatic
In chemistry, aromaticity is a chemical property of cyclic ( ring-shaped), ''typically'' planar (flat) molecular structures with pi bonds in resonance (those containing delocalized electrons) that gives increased stability compared to satur ...
liquid crystal polymer
Liquid crystal polymers (LCPs) are polymers with the property of liquid crystal, usually containing aromatic rings as mesogens. Despite uncrosslinked LCPs, polymeric materials like liquid crystal Elastomer, elastomers (LCEs) and liquid crystal n ...
tapered from 1.2 mm at the hub to 0.72 mm at the tip (equivalent to 22 gauge metal needle), with an ID/OD ratio of 70%.
Manufacture
Hypodermic needles are normally made from a stainless-steel
Stainless steel is an alloy of iron that is resistant to rusting and corrosion. It contains at least 11% chromium and may contain elements such as carbon, other nonmetals and metals to obtain other desired properties. Stainless steel's resis ...
or Niobium
Niobium is a chemical element with chemical symbol Nb (formerly columbium, Cb) and atomic number 41. It is a light grey, crystalline, and ductile transition metal. Pure niobium has a Mohs hardness rating similar to pure titanium, and it has sim ...
tube through a process known as tube drawing Tube drawing is a process to size a tube by shrinking a large diameter tube into a smaller one, by drawing the tube through a die. This process produces high-quality tubing with precise dimensions, good surface finish, and the added strength of cold ...
where the tube is drawn through progressively smaller die
Die, as a verb, refers to death, the cessation of life.
Die may also refer to:
Games
* Die, singular of dice, small throwable objects used for producing random numbers
Manufacturing
* Die (integrated circuit), a rectangular piece of a semicondu ...
s to make the needle. The end of the needle is bevel
A bevelled edge (UK) or beveled edge (US) is an edge of a structure that is not perpendicular to the faces of the piece. The words bevel and chamfer overlap in usage; in general usage they are often interchanged, while in technical usage they ...
led to create a sharp pointed tip, letting the needle easily penetrate the skin.
Gauge
The main system for measuring the diameter of a hypodermic needle is the Birmingham gauge
The Birmingham gauge is a wire gauge system, and is also used to specify thickness or diameter of hypodermic needles and tube products.
Terminology
Birmingham gauge is also known as the Stubs Iron Wire Gauge or Birmingham Wire Gauge. It is not t ...
(also known as the Stubs Iron Wire Gauge); the French gauge
The French scale, French gauge or Charrière system is commonly used to measure the size of a catheter. It is most often abbreviated as Fr, but can often be seen abbreviated as Fg, FR or F. It may also be abbreviated as CH or Ch (for Charrière, i ...
is used mainly for catheters. Various needle lengths are available for any given gauge. Needles in common medical use range from 7 gauge (the largest) to 33 (the smallest). 21-gauge needles are most commonly used for drawing blood for testing purposes, and 16- or 17-gauge needles are most commonly used for blood donation, as the resulting lower pressure is less harmful to red blood cells (it also allows more blood to be collected in a shorter time).
Although reusable needles remain useful for some scientific applications, disposable needles are far more common in medicine. Disposable needles are embedded in a plastic or aluminium hub that attaches to the syringe barrel by means of a press-fit or twist-on fitting. These are sometimes referred to as "Luer Lock" connections, referring to the trademark Luer-Lok
The Luer taper is a standardized system of small-scale fluid fittings used for making leak-free connections between a male-taper fitting and its mating female part on medical and laboratory instruments, including hypodermic syringe tips and nee ...
. The male and female luer lock and hub—produced by pharmaceutical equipment manufacturers—are two of the most critical parts of disposable hypodermic needles.
Use by non-specialists
Hypodermic needles are usually used by medical professionals (dentist
A dentist, also known as a dental surgeon, is a health care professional who specializes in dentistry (the diagnosis, prevention, management, and treatment of diseases and conditions of the mouth, oral cavity and other aspects of the craniofaci ...
s, phlebotomist
Phlebotomy is the process of making a puncture in a vein, usually in the arm, with a cannula for the purpose of drawing blood. The procedure itself is known as a venipuncture, which is also used for intravenous therapy. A person who performs a ph ...
s, physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
s, pharmacist
A pharmacist, also known as a chemist (Commonwealth English) or a druggist (North American and, archaically, Commonwealth English), is a healthcare professional who prepares, controls and distributes medicines and provides advice and instructi ...
s, nurse
Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health c ...
s, paramedic
A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research.
Not all ambulance personnel are p ...
s), but they are sometimes used by patients themselves. This is most common with type one diabetics, who may require several insulin
Insulin (, from Latin ''insula'', 'island') is a peptide hormone produced by beta cells of the pancreatic islets encoded in humans by the ''INS'' gene. It is considered to be the main anabolic hormone of the body. It regulates the metabolism o ...
injections a day. It also occurs with patients who have asthma
Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, cou ...
or other severe allergies
Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic derma ...
. Such patients may need to take desensitization injections or they may need to carry injectable medicines to use for first aid in case of a severe allergic reaction. In the latter case, such patients often carry a syringe loaded with epinephrine
Adrenaline, also known as epinephrine, is a hormone and medication which is involved in regulating visceral functions (e.g., respiration). It appears as a white microcrystalline granule. Adrenaline is normally produced by the adrenal glands and ...
(e.g. EpiPen
An epinephrine autoinjector (or adrenaline autoinjector, also known by the trademark EpiPen) is a medical device for injecting a measured dose or doses of epinephrine (adrenaline) by means of autoinjector technology. It is most often used for t ...
), diphenhydramine
Diphenhydramine (DPH) is an antihistamine and sedative mainly used to treat allergies, insomnia, and symptoms of the common cold. It is also less commonly used for tremor in parkinsonism, and nausea. It is taken by mouth, injected into a vein ...
(e.g. Benadryl
Benadryl is a brand of various antihistamine medications used to stop allergies, whose content varies in different countries, but which includes some combination of diphenhydramine, acrivastine, and/or cetirizine.
It is sold by Johnson & Johnso ...
), or dexamethasone
Dexamethasone is a glucocorticoid medication used to treat rheumatic problems, a number of skin diseases, severe allergies, asthma, chronic obstructive lung disease, croup, brain swelling, eye pain following eye surgery, superior vena cav ...
. Rapid injection of one of these drugs may stop a severe allergic reaction.
Multiple sclerosis
Multiple (cerebral) sclerosis (MS), also known as encephalomyelitis disseminata or disseminated sclerosis, is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This d ...
patients may also treat themselves by injection; several MS therapies, including various interferon
Interferons (IFNs, ) are a group of signaling proteins made and released by host cells in response to the presence of several viruses. In a typical scenario, a virus-infected cell will release interferons causing nearby cells to heighten the ...
preparations, are designed to be self-administered by subcutaneous or intramuscular injection. In some countries, erectile dysfunction
Erectile dysfunction (ED), also called impotence, is the type of sexual dysfunction in which the penis fails to become or stay erect during sexual activity. It is the most common sexual problem in men.Cunningham GR, Rosen RC. Overview of male ...
patients may be prescribed Alprostadil
Prostaglandin E1 (PGE1), also known as alprostadil, is a naturally occurring prostaglandin which is used as a medication. In infants with congenital heart defects, it is delivered by slow injection into a vein to open the ductus arteriosus unti ...
in injectable form, which is self-injected directly into the base or side of the penis with a very fine hypodermic needle.
Hypodermic needles are also used by untrained users in recreational intravenous drug use (e.g., injecting solutions of heroin
Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and brow ...
and water). Before governments attained current levels of awareness about the spread of disease through shared needles, hypodermic syringes in many countries were available only by prescription. Thus, in order to limit the spread of blood-borne disease
A blood-borne disease is a disease that can be spread through contamination by blood and other body fluids. Blood can contain pathogens of various types, chief among which are microorganisms, like bacteria and parasites, and non-living infectious ...
s such as hepatitis
Hepatitis is inflammation of the liver tissue. Some people or animals with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes (jaundice), poor appetite, vomiting, tiredness, abdominal pa ...
and HIV
The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...
through shared injection equipment, many countries have needle exchange programs
A needle and syringe programme (NSP), also known as needle exchange program (NEP), is a social service that allows injecting drug users (IDUs) to obtain clean and unused hypodermic needles and associated paraphernalia at little or no cost. It ...
in most larger cities. In some countries, such programs are wholly or partially subsidized by the government.
Blunt needles, manufactured without a sharp bevel and usually non-sterile, are used industrially for filling small containers or accurately applying small amounts of solvent or glue.
Phobia
It is estimated that anywhere from nearly 3.5 to 10% of the world’s population may have a phobia
A phobia is an anxiety disorder defined by a persistent and excessive fear of an object or situation. Phobias typically result in a rapid onset of fear and are usually present for more than six months. Those affected go to great lengths to avo ...
of needles (trypanophobia), and it is much more common in children, ages 5–17. Topical anesthetics can be used to desensitize the area where the injection will take place to reduce pain and discomfort. For children various techniques may be effective at reducing distress or pain related to needles. Techniques include: distraction, hypnosis
Hypnosis is a human condition involving focused attention (the selective attention/selective inattention hypothesis, SASI), reduced peripheral awareness, and an enhanced capacity to respond to suggestion.In 2015, the American Psychologica ...
, combined cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (suc ...
, and breathing techniques.
See also
* Cannula
A cannula (; Latin meaning 'little reed'; plural or ) is a tube that can be inserted into the body, often for the delivery or removal of fluid or for the gathering of samples. In simple terms, a cannula can surround the inner or outer surfaces ...
* Catheter
In medicine, a catheter (/ˈkæθətər/) is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Cath ...
* Intravenous therapy
Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutri ...
* Nanoneedle Nanoneedles may be conical or tubular needles in the nanometre size range, made from silicon or boron-nitride with a central bore of sufficient size to allow the passage of large molecules, or solid needles useful in Raman spectroscopy, light emit ...
* Needle and syringe programmes
A needle and syringe programme (NSP), also known as needle exchange program (NEP), is a social service that allows injecting drug users (IDUs) to obtain clean and unused hypodermic needles and associated paraphernalia at little or no cost. It ...
* Needle biopsy
Fine-needle aspiration (FNA) is a diagnostic procedure used to investigate lumps or masses. In this technique, a thin (23–25 gauge (0.52 to 0.64 mm outer diameter)), hollow needle is inserted into the mass for sampling of cells that, aft ...
* Needle gauge comparison chart
The Birmingham gauge is a wire gauge system, and is also used to specify thickness or diameter of hypodermic needles and tube products.
Terminology
Birmingham gauge is also known as the Stubs Iron Wire Gauge or Birmingham Wire Gauge. It is not t ...
* Needle remover
A needle remover is a device used to physically remove a Hypodermic needle, needle from a syringe. In developing countries, there is still a need for improvements in needle safety in hospital settings as most of the needle removal processes are do ...
* Needlestick injury
A needlestick injury is the penetration of the skin by a hypodermic needle or other sharp object that has been in contact with blood, tissue or other body fluids before the exposure. Even though the acute physiological effects of a needlestick i ...
* Pin prick attack A pin prick attack is an assault on another person with a needle or syringe tainted with the blood of somebody carrying a blood-borne disease, such as HIV. Although there have been numerous cases of people being attacked with needles and syringes, ...
* Supervised injection site
Supervised injection sites (SIS) are medically supervised facilities designed to provide a hygienic environment in which people are able to consume illicit recreational drugs intravenously and prevent deaths due to drug overdoses. The legality ...
* Tuohy needle
A Tuohy (/tOO-ee/) needle is a hollow hypodermic needle, very slightly curved at the end, suitable for inserting epidural catheters.
Epidural needle
Literally, an epidural needle is simply a needle that is placed into the epidural space. To ...
References
External links
The Needle Phobia Page
Needle Phobia and Dental Injections
{{DEFAULTSORT:Hypodermic Needle
Drug delivery devices
Drug paraphernalia