as a care giver who might be administering it to patient. First of all I'm going to go

through the supplies that you need. You need an alcohol swab or if you're at home and you

don't have any alcohol swabs you can use your bottle of alcohol with a cotton ball. You

will need the syringe and you will of course need your Vitamin B12 that the physician called

in for you. The physician will probably have called in your syringe with your needles also.

With my patient population I do prefer the smaller needle which is a 25 gauge, one inch

needle. And actually that is the size of the needle that they use to give you your seasonal

flu shot. So for all of you that have needle phobia it is OK to use a smaller needle. At

home I'm going to use my little skin pad but you can also practice on an orange or any

kind of fruit. A lemon would work or even an apple. I like to use the orange and the

lemons only because they are softer and it has more of a skin like feeling. So what you'll

do is go ahead and just open your alcohol swab and get it ready or get your cotton ball

ready. I'm going to go ahead and take out the syringe and all of the syringes that you

use will always have numbers on it and the most common doses of Vitamin B12 are what

we call 1cc or 1ml. Now according to your physician he may choose to give you a different

dose. On the 3cc syringe it is numbered from a half cc to 3ml or 3cc. You will always focus

on the 1. And then you will have of course your vial of Vitamin B12 and on your bottle

it will probably not say Vitamin B12 it will say a long difficult name and it's called

Cyanocobalamin. So what we'll do is go ahead and prep the skin. So you can practice this

with your orange. And you go ahead and take your alcohol and you will clean just the surface

of the skin just rub it a little bit. You might want to kind of fan it and let it dry

a little bit because sometimes when you inject the needle into the skin it might cause a

little bit of a stinging or burning from the alcohol not from the medication. You go ahead

and just pull the cap straight off of your needle and go ahead and pull what we call

the plunger that's this little thing sticking out here. And hold onto the barrel of the

syringe and you will simply pull the plunger down to the number one. There is a little

black rubber stopper in this syringe and it is sometimes kind of hard for you to see but

you will actually pull that rest of the black stopper all of the way down until you reach

the top of the line. In this one there is actually two layers of lines and you can measure

it by stopping at the top layer of the plunger not by the point of the plunger. So basically

you are going to draw in 1cc of air into this syringe. And then you will take your bottle.

And when it's brand new you will have a plastic cap on it which is a protective cap and you

will just simply pull it off you will also take your alcohol and clean that off. Even

though the first use it is clean underneath that plastic cap it's OK just to get in the

habit of cleaning the top of the stopper because each time you give the injection you will

need to clean it just too basically clean off any um. It's really not a sterilization,

alcohol is not a sterilization product but it will just clean off the surface of any

kind of dirt or anything that might have gotten on top off it. And then you will simply leave

it on a surface clean surface and a flat table or whatever you feel comfortable with and

you will go ahead and just inject the needle in through the rubber stopper at the top of

the bottle and each time you practice this and the more shots you give you will actually

develop your own technique and so you don't have to be exact on what I'm showing you.

And it’s just whatever you feel comfortable doing on how you need to hold your syringe

and how you need to hold your bottle and actually when you inject it into the somebody. So,

I'm going to hold the bottle and I'm just going to take my dominant hand, and of course

I'm left handed. And, I'm going to push the plunger down. So basically I'm pushing the

air into the bottle. So now you're ready to withdraw the medication and you're going to

simply just turn up the bottle upside down, hold up your syringe and as I said before

everybody is going to develop their own technique I actually just grasp the syringe with my

pinky and fourth digit and then I have it held like this and I'm stabilizing it up here.

And I'm going to pull this plunger back and I'm going to draw past the 1. And the reason

for that is just so you can actually, you're going to have an air bubble probably here

at the top of the syringe and then you can draw more than you need and then push it back

up and by pushing that back up to the one you actually push the air bubble out. And

in this one it is out and sometimes it's real common that you will have still some air bubble

in it. If that happens you can actually take your finger and tap it or for me it’s easier

I can just stabilize the bottle and stabilize the syringe and you can tap it on the side

of the table and that brings those bubbles to the top of the surface and gets rid of

them. So now you are ready to just pull the syringe straight back out. So we've got the

medicine drawn up and now we're ready to give the injection. And we've already cleaned the

surface and so what I'm going to do is I'm going to make a C with my thumb and index

finger and basically put it down on the skin and kind of just pull the skin taught and

you don't necessarily, this is a muscle shot and so you don't have to pinch up on the skin

or anything. So I'm just going to kind of pull it taught and then I'm going to take

this and you can hold it some people hold it like a dart like they're going to throw

a dart, you can hold it somehow like a pencil if you're going to hold a pencil and write

so again whatever you feel comfortable with. So as I'm going in I'm going to go straight

in basically at a 90 degree angle and I'm going to go ahead and just push in and you're

going to go all the way down to the hub of the needle basically you are going to cover

up all the needle with the skin. So here I actually take this C and I brace my pinky

against the skin and I grab it with my thumb and index finger. That way it is stable and

you're not wobbling around as you're pushing down into the medicine and you won’t hopefully

it won’t be painful for the patient if you do that. So' I've got it stable here where

I'm not going to move the syringe just as I'm pushing the medicine in. So then I just

take this free hand and I grab it here and I push the medicine into the skin. And you

don't have to go real slow, and you don't have to go real fast, if you just go at a

gentle pace then you basically are done and you let go of the syringe at the surface of

the skin and you just pull straight back out, and you’re done. You can actually take the

alcohol swab if you want and go ahead and massage that area. It actually helps the medicine

get more absorbed into the body. And if it’s bleeding you might want to apply a band aid.

Some people don't bleed, some people do bleed. A lot of people who are on blood thinners

might bleed and probably do need a band aid. The most common area for a patient if they

are giving it to themselves would be on the outside of your thigh. On the lateral side

of your thigh. If you take your hand and you go from your knee up to your groin area and

you divide that into three sections it's going to be that middle third section where you

can get that shot to. After you complete the injection then you need to make sure you properly

dispose of the needle. And you can use many household items such as a milk carton with

a lid. You can actually use a liquid detergent bottle that has a lid or you can also use

a coffee can with a lid. As long as they have lids and they are secure where people can't

reach in and get them and or they can puncture through the surface of the container.