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{{Use British English|date = February 2019}}
{{Use mdy dates|date = February 2019}}
{{Infobox machine
[[File:NeedleBevels.svg|thumb|Different [[bevel]]s on hypodermic needles]]▼
| image = NeedleBevels.svg
| classification = [[Medical device]]
| industry = [[Healthcare industry|Healthcare]]
| application = [[Injection (medicine)|Injection]]
| inventor = [[Francis Rynd]]
| invented = {{start date and years ago|1844|df=y|p=y}}
}}
[[Image:Syringe and hypodermic.jpg|thumb|[[Syringe]] on left, hypodermic needle with attached [[colour code]]d [[Luer Taper|Luer-Lock]] connector on right]]
[[File:HypodermicBronami.svg|thumb|Hypodermic needle features]]
A '''hypodermic needle''' (from [[Greek Language|Greek]] ὑπο- (''hypo-'' = under), and δέρμα (''derma'' = skin)) is a very thin, hollow tube with one sharp tip. It is one of a category of medical tools which enter the skin, called '''sharps'''
A hypodermic needle is used for rapid delivery of liquids, or when the injected substance cannot be ingested, either because it would not be [[Absorption (pharmacokinetics)|absorbed]] (as with [[insulin]]), or because it would harm the [[liver]]. It is also useful to deliver certain medications that cannot be delivered orally due to vomiting. There are many possible [[Injection (medicine)|routes]] for an injection, with [[intramuscular]] (into a [[muscle]]) and [[intravenous]] (into a [[vein]]) 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]] of a sterile [[substrate (biology)|substrate]]. The hypodermic needle reduces contamination for two reasons: First, its surface is extremely smooth, which prevents airborne [[pathogens]] from becoming trapped between irregularities on the needle's surface, which would subsequently be transferred into the media (e.g. [[agar]]) 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.<ref>{{cite journal|last=Elsheikh|first=HA|author2=Ali, BH |author3=Homeida, AM |author4=Lutfi, AA |author5= Hapke, HJ |title=The effects of fascioliasis on the activities of some drug-metabolizing enzymes in desert sheep liver.|journal=The British Veterinary Journal|date=May–Jun 1992|volume=148|issue=3|pages=249–57|pmid=1617399|doi=10.1016/0007-1935(92)90048-6}}</ref><ref>{{cite journal|last=Korenman|first=SG|title=Estrogen receptor assay in human breast cancer.|journal=Journal of the National Cancer Institute|date=September 1975|volume=55|issue=3|pages=543–5|pmid=169381|doi=10.1093/jnci/55.3.543}}</ref><ref>{{cite journal|last=Scott|first=Gene E.|author2=Zummo, Natale|title=Sources of Resistance in Maize to Kernel Infection by Aspergillus flavus in the Field|journal=Crop Science|date=1 January 1988|volume=28|issue=3|page=504|doi=10.2135/cropsci1988.0011183X002800030016x}}</ref><ref>{{cite journal|journal=Mycologia|year=1988|volume=80|issue=3|pages=291–297|jstor=3807624|doi=10.2307/3807624|title=Experimental Infection of Host Grasses and Sedges with Atkinsonella hypoxylon and Balansia cyperi (Balansiae, Clavicipitaceae)|last1=Leuchtmann|first1=Adrian|last2=Clay|first2=Keith}}</ref>
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===Early use and experimentation===
The ancient [[Greeks]] and [[Roman people|Romans]] knew injection as a method of medicinal delivery from observations of snakebites and poisoned weapons.<ref name="ReferenceA">{{cite journal |vauthors=Norn S, Kruse PR, Kruse E| year = 2006 | title = On the history of injection | journal = Dan Medicinhist Arbog | volume = 34 | pages = 104–1 | pmid = 17526154 }}</ref> 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.<ref name="Kotwal, Atul 2005">
[[Christopher Wren]] performed the earliest confirmed experiments with crude hypodermic needles, performing intravenous injection into dogs in 1656.<ref name="Kotwal, Atul 2005"/> 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,
===19th-century development===
[[File:SyringeAllGlass.jpg|thumb|Syringe made entirely of glass, similar to the Wood design, except it is etched with volume marks.]]
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."<ref>Logan Clendening, ''Source Book of Medical History'', p. 419 (1960)</ref> Irish physician [[Francis Rynd]] is generally credited with the first successful injection in 1844, in the [[Meath Hospital]] in [[Dublin]], [[Ireland]].<ref>Walter Reginald Bett, ''The History and Conquest of Common Diseases'' p. 145 (1954)</ref><ref>{{cite web|url=http://www.irishtimes.com/news/the-irish-doctor-who-invented-the-syringe-1.1105651|title=The Irish doctor who invented the syringe|website=irishtimes.com|access-date=4 April 2018}}</ref>
[[Alexander Wood (physician)|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.<ref>Kotwal, Atul. "Innovation, diffusion and safety of a medical technology: a review of the literature on injection practices". ''Social Science & Medicine'' Volume 60, Issue 5, March 2005, pp. 1133–1147</ref> 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.<ref name="ReferenceB"/>
Simultaneous to Wood's work in Edinburgh, [[Charles Pravaz]] 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 (physician)|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.<ref name="Kotwal, Atul 2005"/><ref name="ReferenceB"/> 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.<ref name="Brunton2">{{cite journal|last1=Brunton|first1=D.|date=2000|title=A Question of Priority: Alexander Wood, Charles Hunter and the Hypodermic Method|journal=Proceedings of the Royal College of Physicians of Edinburgh|volume=30|issue=4 |pages=349–351|doi=10.1177/147827150003000414 |s2cid=248921807 |doi-access=free}}</ref>
===Modern improvements===
[[Francis Rynd|Dr. Francis Rynd]] used the first "Hollow Needle" as a hypodermic syringe on Ms. Margaret Cox in Ireland on June 3rd, 1844. 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.<ref name="beckton">Beckton Dickinson and Company, "Four Major Phases of Injection Device Development", [https://web.archive.org/web/20150508145312/http://www.ahrn.net/library_upload/uploadfile/file2376.pdf Syringe and Needle History]</ref>
▲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.<ref name="beckton">Beckton Dickinson and Company, "Four Major Phases of Injection Device Development", [https://web.archive.org/web/20150508145312/http://www.ahrn.net/library_upload/uploadfile/file2376.pdf 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 [[Single-use medical devices|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 [[Polio vaccine|immunization against polio]] during the period required the development of a fully disposable syringe system.<ref name="beckton" />
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.<ref>{{cite web|url=http://www.sciencemuseum.org.uk/broughttolife/techniques/hypodermicsyringe.aspx|title=Hypodermic syringe|website=www.sciencemuseum.org.uk|access-date=4 April 2018|archive-date=July 3, 2012|archive-url=https://web.archive.org/web/20120703160400/http://www.sciencemuseum.org.uk/broughttolife/techniques/hypodermicsyringe.aspx|url-status=dead}}</ref> This period also marked a shift in interest from needle specifications to general sterility and safety.<ref name="beckton" />
The 1980s saw the [[History of HIV/AIDS#1981–1982: From GRID to AIDS|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 [[Sharps waste#Sharps containers|hard-surface disposal receptacles]] found in every medical office today.<ref name="beckton" />
By 2008, all-plastic needles were in production and in limited use. One version was made of [[Vectra (plastic)]] [[aromatic]] [[liquid crystal polymer]] 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%.<ref>{{cite thesis|url=https://smartech.gatech.edu/bitstream/handle/1853/26584/busillo_eric_200812_mast.pdf |first=Eric |last=Busillo |publisher= Georgia Institute of Technology |date= July 9, 2008 |title=Characterization of Plastic Hypodermic Needles}}</ref>
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See also [[Birmingham gauge]].]]
{{Further|Birmingham gauge}}
The main system for measuring the diameter of a hypodermic needle is the [[Birmingham gauge]] (also known as the Stubs Iron Wire Gauge); the [[French catheter scale|French gauge]] 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
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 male and female luer lock and hub—produced by pharmaceutical equipment manufacturers—are two of the most critical parts of disposable hypodermic needles.<ref>{{Cite news|url=https://www.davenportmachine.com/cycle-times/medical|title=Medical Industry Cycle Times {{!}} Davenport Machine|work=Davenport Machine|access-date=2018-01-03|language=en-US}}</ref>
==Use by non-specialists==
Hypodermic needles are usually used by medical professionals ([[dentist]]s, [[phlebotomist]]s, [[physician]]s, [[pharmacist]]s, [[nurse]]s, [[paramedic]]s), but they are sometimes used by patients themselves. This is most common with [[Diabetes mellitus type 1|type one diabetics]], who may require several [[insulin]] injections a day.<ref>{{cite web|url=https://www.drugs.com/cg/giving-an-insulin-injection.html |title=Giving an Insulin Injection |publisher=Drugs.com |access-date=2010-08-19}}</ref> It also occurs with patients who have [[asthma]] or other severe [[Allergy|allergies]]. Such patients may need to take [[desensitization (medicine)|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]] (e.g. [[EpiPen]]),<ref>{{cite web|url=http://www.epipen.com/ |title=How to Stop Allergic Reactions |publisher=EpiPen |access-date=2010-08-19}}</ref> [[diphenhydramine]] (e.g. [[Benadryl]]), or [[dexamethasone]]. Rapid injection of one of these drugs may stop a severe allergic reaction.
[[Multiple sclerosis]] patients may also treat themselves by injection; several MS therapies, including various [[interferon]] preparations, are designed to be self-administered by subcutaneous or intramuscular injection.<ref>{{cite web|url=http://www.mult-sclerosis.org/mstreatments.html|title=Multiple Sclerosis Treatments |publisher=mult-sclerosis.org|date= 2008-01-21|access-date=2013-01-13}}</ref>
[[Transgender]] people may also inject their own [[hormone replacement therapy]], using either [[intramuscular injection]] or [[subcutaneous injection]] methods.
Hypodermic needles are also used for [[Play piercing|erotic piercing]].<ref>{{cite journal|first=Neil|last=Buhrich|title=The association of erotic piercing with homosexuality, sadomasochism, bondage, fetishism, and tattoos|journal=[[Archives of Sexual Behavior]]|volume =12|issue=2|date=April 1983|pages=167–171|doi=10.1007/BF01541560|s2cid=59352980}}</ref>
==Phobia==
{{Main|Fear of needles}}
It is estimated that anywhere from nearly 3.5 to 10% of the world's population may have a [[phobia]] of needles (trypanophobia),<ref>{{Cite web|url=http://www.fearof.net/fear-of-needles-phobia-trypanophobia/|title=Fear of Needles Phobia – Trypanophobia|website=www.fearof.net|date=January 23, 2014 |language=en-US|access-date=2018-01-03}}</ref> 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.<ref>{{cite web|url=http://www.futurescience.com/needles.html |title=The Needle Phobia Page |publisher=Futurescience.com |access-date=2010-08-19}}</ref> For children, various techniques may be effective at reducing distress or pain related to needles.<ref name=":0">{{Cite journal|last1=Birnie|first1=Kathryn A.|last2=Noel|first2=Melanie|last3=Chambers|first3=Christine T.|last4=Uman|first4=Lindsay S.|last5=Parker|first5=Jennifer A.|date=2018-10-04|title=Psychological interventions for needle-related procedural pain and distress in children and adolescents|journal=The Cochrane Database of Systematic Reviews|volume=2020|issue=10 |pages=CD005179|doi=10.1002/14651858.CD005179.pub4|issn=1469-493X|pmid=30284240|pmc=6517234}}</ref> Techniques include: distraction, [[hypnosis]], combined [[cognitive behavioral therapy]], and breathing techniques.<ref name=":0" />
==References==
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* [https://web.archive.org/web/20160123071127/http://www.needlephobia.com/ The Needle Phobia Page]
* [http://www.dentalfearcentral.org/fears/needle-phobia/ Needle Phobia and Dental Injections]
{{Dosage forms|state=expanded}}
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