- In your Betaseron pre-pack you will have:
- One pre-filled saline syringe.
- One vial of Betaseron.
- 2 alcohol prep pads.
- A vial adapter with a 27 gauge needle inside a blister pack.
- You will need to supply:
- One cotton ball
- A container to dispose of used syringes and vials
- Before you start:
- Confirm the expiration date on the pre-pack label is current.
- Wash your hands with a disinfectant soap.
- Open the blister pack by peeling off the label. Check the oblong blister pack with the vial adapter, the vial of Betaseron and the syringe to make sure their seals are intact.
- For convenience, you may turn the tray over to place the Betaseron vial in the circular well and the prefilled syringe in the U-shaped trough.
- Remove the cap from the Betaseron vial.
- Clean the top of the vial with an alcohol prep.
- Peel the label off the blister pack containing the vial adapter. Take care to not touch the round part of the adapter; it is sterile.
- Keeping the vial adapter in the blister pack, place the Betaseron vial cap-down onto the vial adapter and push down on the vial until the adapter pierces the rubber top of the Betaseron vial and the vial locks into place. You may find it helpful to hold the outside of the vial adapter's blister pack to steady the process.
- Remove the rubber cap from the saline syringe using a twist and pull motion.
- Remove the joined vial and adapter from the blister packaging by lifting it by the vial. Do not touch the short end of the adapter (opposite the needle) since it is sterile.
- Connect the syringe to the vial adapter by turning the syringe clockwise and gently tightening it.
- Slowly push the plunger of the syringe until all the liquid is transferred to the vial. The plunger will return to its original position when you release it. (The vial down position minimizes foaming. ??)
- Gently swirl the vial to completely dissolve the Betaseron. Do not shake the vial.
- Inspect the solution once the Betaseron has dissolved: the solution should be clear, colorless, and not contain particles. Do not use the solution if it does not pass this test.
- With the vial in a horizontal position (needle up), push the plunger all the way in and hold it as you turn the syringe assembly so that the vial is on top (pointing up).
- Slowly pull the plunger back to withdraw the entire contents of the Betaseron vial into the syringe.
- Turn the syringe assembly so that the needle end is pointing up (vial horizontal). Tap the syringe wall to release any air bubbles and allow them to float to the top of the syringe. Slowly push the plunger to the 1 mL mark on the syringe (or to the amount prescribed by your doctor) expelling the air from the syringe into the vial.
- If there is still air in the syringe, turn the syringe assembly back to the 'vial on top' position and redraw more fluid. Repeat the 'needle up' procedure in the previous instruction to expel any air from the syringe.
- Remove the vial adapter and the vial from the syringe by twisting the vial adapter to the left. You will hear some escaping air as the pressure in the vial is released. Dispose of the vial into your used syringe container.
Setting up the new style Autoject
- Unscrew the syringe housing from the injector body, and place the narrow end of the syringe housing against the yellow part of the injector body. Push the syringe housing into the injector body until the spring locks in place.
- Leaving the needle cover on, insert the prepared Betaseron syringe into the syringe housing so the syringe wings drop into the wider part of the housing.
- Screw the syringe housing and injector body together without touching the release button.
- Turn the teal-colored depth adjuster until the oval black dot appears in the oval window in the syringe housing.
- Place the grey depth-setting piece onto the end of the depth adjuster. You may have to gently turn and push the depth-setting piece to get it to seat onto the depth adjuster.
- Turn the depth-setting piece on the depth adjuster until the tip of the needle shield touches the inside edge of the depth-setting piece.
- Remove the depth-setting piece.
- Keep 1 "circle" diameter away from previous injection sites.
- Do not pinch the skin into a 'tent'.
- Wipe the area to inject with an alcohol pad; allow to dry.
- Pull on the needle cover to remove it. This will take some effort and you will hear the spring in the Autoject 'sing' when the cover comes off.
- Have your cotton ball handy. Line up Autoject with your thumb and finger to adjust for "no pressure."; the Autoject should rest gently on the skin.
- Face the Autoject window toward you to watch for the yellow sign that the solution has been injected.
- Pull down slightly on the Autoject to release the safety and push the blue button. Wait 5 seconds or look for yellow in the window before removing the needle from the skin.
- Remove the Autoject, remembering there is a needle exposed on the end, and press the cotton ball on the injection site.
- After any bleeding or medication seepage has stopped, remove the syringe from the Autoject and dispose of it.
- Put the Autoject in its holder, clean up and pack the kit away.