Why 27G × 1.25" with Regular Bevel for Comfortable Deep Subcutaneous Access

The 27-gauge needle (0.4mm outer diameter) represents one of the finest needles commonly used in clinical practice, significantly reducing injection pain and tissue trauma compared to larger gauges—essential for pediatric patients, patients with needle anxiety, frequent injections (diabetes, biologics), and any situation where patient comfort is paramount. The 1.25-inch (32mm) length provides the extended reach necessary for deep subcutaneous injections in patients with adequate adipose tissue, select intramuscular injections in thin patients or specific anatomical sites (deltoid in smaller adults), and procedures requiring needle depth beyond standard 5/8-inch or 1-inch lengths. The regular bevel (standard 12-15 degree angle) with Terumo's triple-sharpened technology creates ultra-sharp tips that glide through tissue with minimal insertion force, reducing the "pinch" sensation patients feel during needle penetration. This gauge-length combination is particularly valuable for administering biologics, immunotherapy injections, hormone therapy, and medications where patient compliance depends on minimizing injection discomfort across extended treatment courses.

Key Features & Benefits

Key Features:

• 27-gauge (27G) needle with 0.4mm outer diameter for minimal discomfort
• 1.25-inch (32mm) length for deep subcutaneous or select IM injections
• Regular bevel with precision-sharpened tip for smooth penetration
• Triple-sharpened bevel technology reduces insertion force
• Stainless steel cannula for strength and sharpness retention
• Color-coded hub (typically gray for 27G per ISO standards)
• Transparent or translucent hub for blood flashback visualization
• Compatible with both Luer Lock and Luer Slip syringes
• Thin-wall construction for improved flow (product dependent)
• Sterile, individually packaged in rigid protective shields
• Box of 100 needles for clinical inventory management
• Latex-free construction for allergy safety
• Manufactured by Terumo (trusted global medical device company)
• Meets ISO and international quality standards
• Single-use, disposable design

Benefits:

• Fine gauge minimizes injection pain and patient anxiety
• Extended length reaches deep subcutaneous tissue
• Sharp bevel reduces tissue trauma and bruising
• Compatible with multiple syringe types (Lock and Slip)
• Color-coded hub enables quick gauge identification
• Clear hub allows blood return visualization when needed
• Sterile packaging ensures infection control
• Latex-free protects sensitive patients and healthcare workers
• Reliable Terumo quality with consistent performance
• Cost-effective bulk packaging for clinical use
• Single-use design prevents cross-contamination

Clinical Applications

Terumo 27G × 1.25" hypodermic needles are appropriate for:

✓ Deep subcutaneous injections (biologics, immunotherapy, hormone therapy) ✓ Insulin administration for patients with adequate adipose tissue ✓ Enoxaparin (Lovenox) and other anticoagulant injections ✓ Tuberculin testing (PPD) when 25G-26G unavailable ✓ Allergy immunotherapy injections ✓ Subcutaneous immunoglobulin (SCIG) administration ✓ Growth hormone injections ✓ Fertility medication administration (hCG, gonadotropins) ✓ Intramuscular injections in thin patients or children (deltoid site) ✓ Vitamin B12 injections in appropriate patients ✓ Vaccine administration (when patient comfort prioritized over standard gauge) ✓ Pediatric injections requiring comfort and appropriate depth ✓ Geriatric patients with fragile tissues ✓ Patients with needle phobia requiring gentlest option ✓ Frequent injection regimens where comfort affects compliance ✓ Aspiration procedures in sensitive areas ✓ Local anesthetic administration for minor procedures ✓ Research and laboratory applications

Usage & Application

Pre-Use Preparation:

1. Verify clinical indication:
   • Confirm medication order, dose, route, patient identity
   • Check patient allergies
   • Perform "5 Rights" verification
   • Verify 27G × 1.25" appropriate for medication and patient
2. Consider gauge-length appropriateness:
   • 27G advantages: Minimal pain, reduced tissue trauma, patient comfort
   • 27G limitations: Slower medication flow, not suitable for viscous medications, may bend if technique poor
   • 1.25" length appropriate for:
     • Deep subcutaneous injections (obese patients, adequate adipose tissue)
     • Select IM injections in thin adults (deltoid)
     • Medications requiring specific depth
   • 1.25" length may be excessive for:
     • Very thin patients (risk hitting bone or going too deep)
     • Pediatric patients (shorter needles often appropriate)
     • Standard subcutaneous injections in average patients
3. Gather supplies:
   • Terumo 27G × 1.25" needle (verify package intact, not expired)
   • Appropriate syringe (1-3 mL typical for this gauge)
   • Medication
   • Alcohol swabs
   • Clean gloves
   • Gauze pads
   • Adhesive bandage
   • Sharps container
4. Hand hygiene and glove up:
   • Wash hands thoroughly for at least 20 seconds
   • Don clean gloves
5. Inspect needle package:
   • Check sterile shield for damage
   • Verify expiration date
   • Ensure rigid shield intact
   • Discard if compromised

Attaching Needle to Syringe:

For Luer Lock Syringes:

1. Remove protective cap from syringe tip
2. Remove needle from shield by grasping hub
3. Align needle hub threads with syringe tip threads
4. Rotate needle clockwise while pushing gently
5. Twist until firmly seated (typically 1/4 to 1/2 turn)
6. Verify secure connection

For Luer Slip Syringes:

1. Remove protective cap from syringe tip
2. Remove needle from shield by grasping hub
3. Align needle hub with syringe tip
4. Push straight onto syringe tip with firm pressure
5. Push until hub fully seated against barrel
6. Verify secure connection

Drawing Medication:

1. From vials:
   • Clean rubber stopper with alcohol swab
   • Draw air equal to medication volume
   • Insert needle, inject air, invert vial
   • Withdraw medication slowly (27G has narrow bore—takes longer)
   • Remove air bubbles, verify dose
2. From ampules:
   • Break ampule carefully
   • Insert needle and draw medication
   • ALWAYS replace needle before injection (prevents glass particle injection and ensures sharp needle)
3. Viscous medications:
   • 27G NOT recommended for viscous medications (oil-based hormones, thick suspensions)
   • Excessive force required may bend needle or damage medication
   • Consider larger gauge (21G-23G) for viscous substances

Subcutaneous Injection Technique:

Site Selection:

• Abdomen: 2 inches from navel (most common for 27G deep SubQ)
• Thigh: Anterior/lateral aspect, middle third
• Upper arm: Posterior triceps area
• Upper buttocks: Avoid for most SubQ (IM site)

Procedure:

1. Clean site:
   • Wipe with alcohol swab in circular motion
   • Allow to air dry completely (30 seconds)—prevents stinging
2. Pinch or not pinch:
   • For patients with adequate adipose tissue: May inject without pinching
   • For average/lean patients: Gently pinch subcutaneous tissue
   • 1.25" needle requires careful assessment:
     • If patient lean, pinching essential (prevents IM injection)
     • If patient obese, no pinch needed (adequate subcutaneous layer)
3. Insert needle:
   • Hold syringe like dart
   • Insert at 45-90 degree angle depending on patient body habitus:
     • Lean patients with pinch: 45 degrees (prevents going too deep)
     • Average patients: 45-90 degrees
     • Obese patients: 90 degrees (adequate subcutaneous tissue)
   • With 1.25" needle, do NOT insert to hub unless patient very obese
   • Typical insertion depth: 3/4 to 1 inch for most patients
4. Release pinch (if used):
   • Release skin fold before injecting
   • Allows medication to disperse in tissue
5. Inject medication:
   • Push plunger slowly and steadily
   • 27G requires steady, gentle pressure (fine bore creates more resistance)
   • Do not inject too rapidly (causes discomfort)
6. Count to 5:
   • After plunger fully depressed, count slowly to 5 before removing needle
   • Ensures complete medication delivery
   • Prevents medication leakage from injection site
7. Withdraw needle:
   • Pull straight out at same angle inserted
   • Quick, smooth motion
8. Do not massage:
   • Unless specifically indicated by medication instructions
   • Massaging can affect absorption rate
9. Apply pressure and bandage:
   • Apply gentle pressure with gauze if bleeding
   • Apply adhesive bandage if needed

Intramuscular Injection (Select Cases Only):

When 27G × 1.25" appropriate for IM:

• Thin patients where muscle close to surface
• Small muscle mass (pediatric, elderly, cachectic)
• Deltoid muscle in smaller adults
• Medications where patient comfort prioritized over rapid absorption

Site Selection (Deltoid most common for 27G IM):

• Deltoid: 2-3 finger widths below acromion
• Note: 27G too fine for most IM injections in average adults
• Larger gauges (21G-23G) preferred for standard IM

Procedure:

1. Clean site with alcohol, allow to dry
2. Stretch skin taut (do not pinch for IM)
3. Insert at 90-degree angle
4. May insert to hub or near-hub for IM (ensures medication reaches muscle)
5. Aspirate per protocol (pull back to check for blood—not always required)
6. Inject slowly
7. Withdraw quickly
8. Apply pressure (do not massage unless indicated)

Insulin Administration (Deep SubQ):

1. Site selection and rotation:
   • Rotate sites to prevent lipohypertrophy
   • Use different area each day
   • Track sites used
2. Technique:
   • 27G appropriate for insulin in patients with adequate fat
   • 1.25" may be excessive for many patients—assess body habitus
   • Insert at 90 degrees if adequate adipose tissue
   • Insert at 45 degrees if lean
   • Do NOT insert full 1.25" unless patient very obese
   • Inject slowly, count to 5-10 before withdrawal

Post-Injection Care:

1. Do not recap needle:
   • Use one-handed scoop technique only if recapping absolutely necessary
   • Preferably do not recap at all
2. Immediate disposal:
   • Dispose entire needle-syringe assembly in sharps container
   • Do not separate needle from syringe
   • Never set down used needles
3. Remove gloves and hand hygiene
4. Document:
   • Medication, dose, route, site, time
   • Patient response
   • Any adverse reactions
5. Monitor patient:
   • Observe for adverse reactions
   • Assess injection site after 10-15 minutes

Site Rotation for Frequent Injections:

For patients requiring frequent injections (daily insulin, biologics, immunotherapy):

• Divide body into quadrants or zones
• Rotate systematically to prevent tissue damage
• Do not inject into same spot within 1 inch of previous injection for at least 1 week
• Avoid areas with lumps, bruises, or skin changes
• Document injection sites

Troubleshooting:

Needle won't attach to syringe:

• Verify Luer Lock vs. Luer Slip match
• For Luer Lock: ensure twisting clockwise
• Check for damaged threads
• Ensure proper alignment

Needle bends during insertion:

• 27G very fine—bends easily if technique improper
• Ensure quick, smooth insertion (not hesitant pushing)
• Don't insert at extreme angles
• Don't force against resistance
• If bent, discard and use new needle—never use bent needles

Difficulty penetrating skin:

• 27G should penetrate easily if sharp
• Use quick, dart-like motion (not slow push)
• Ensure needle new and unopened
• Skin very tough in some areas (soles, palms)—select appropriate site

Medication won't inject or injects very slowly:

• Normal for 27G—narrow bore creates resistance
• Apply steady, gentle pressure (don't force)
• Viscous medications may not be suitable for 27G
• Consider larger gauge (23G-25G) for thick medications
• Verify needle not occluded

Blood appears in syringe during aspiration:

• For subcutaneous: withdraw needle, apply pressure, discard medication, prepare new injection
• Select different site
• May have hit small blood vessel

Patient reports excessive pain:

• 27G should be relatively painless
• Ensure alcohol dried before insertion
• Inject slowly (rapid injection causes discomfort)
• May have hit nerve—withdraw if sharp, shooting pain
• Needle may be dull—use new needle

Medication leaking from injection site:

• Count to 5-10 before withdrawing needle (ensures delivery)
• Insert at correct angle
• Don't withdraw needle too quickly
• Small amount of leakage acceptable
• Apply pressure briefly after withdrawal

Special Considerations:

Pediatric patients:

• 27G excellent choice for reducing injection pain
• 1.25" may be too long for young children—assess carefully
• Shorter needles (5/8", 1") often more appropriate
• Calculate doses carefully (weight-based)
• Use distraction techniques
• Topical anesthetic for anxious children

Geriatric patients:

• 27G ideal for fragile, thin skin
• Assess adipose tissue before selecting 1.25" length
• May need shorter needle if very thin
• Inject slowly (fragile tissues)
• Monitor for bruising (may be on anticoagulants)

Obese patients:

• 1.25" appropriate for deep subcutaneous injections
• May need longer needle (1.5") for some obese patients
• No pinch needed (adequate subcutaneous tissue)
• Insert at 90 degrees

Very thin/cachectic patients:

• 1.25" may be too long—risk of IM injection or hitting bone
• Consider shorter needle (5/8", 1")
• Use 45-degree angle with pinch
• Assess injection depth carefully

Patients with bleeding disorders/anticoagulation:

• 27G ideal—minimizes bleeding compared to larger gauges
• Apply pressure longer after injection (3-5 minutes)
• Monitor for hematoma
• Subcutaneous route preferred over IM (less bleeding)

Patients with needle anxiety:

• 27G one of best choices for reducing anxiety
• Explain that fine needle reduces pain
• Use distraction, relaxation techniques
• Quick insertion less painful than hesitant
• Consider topical anesthetic

Patients requiring frequent injections:

• Rotate sites systematically
• Use site rotation chart
• Assess for lipohypertrophy (lumps from repeated injections)
• Avoid injecting into lumps (affects absorption)
• 27G reduces cumulative tissue trauma

Diabetes patients (insulin):

• 27G appropriate for insulin
• Assess if 1.25" needed—many patients use shorter needles (4mm-8mm)
• Rotate injection sites
• Check for lipohypertrophy
• Inject at correct angle based on body habitus

Biologic medications (immunotherapy, growth hormone, etc.):

• 27G ideal for patient comfort with frequent injections
• Follow specific medication instructions for injection depth
• Room temperature medications inject more comfortably
• Rotate sites
• Patient may self-administer—provide thorough training

Storage:

• Store at room temperature 15-30°C (59-86°F)
• Protect from excessive heat, cold, humidity
• Keep in original packaging until use
• Store in clean, dry area
• Check expiration dates regularly
• Rotate stock using FIFO method
• Do not use past expiration date

Disposal:

• Dispose immediately in sharps container
• Never recap with two hands
• Do not separate needle from syringe
• Never place in regular trash
• When sharps container 3/4 full, seal and dispose per regulations

Infection Control:

• Always use aseptic technique
• Never reuse needles—single-use only
• Never share needles between patients
• Discard needles from damaged packages
• Clean injection sites before each injection
• Use new sterile needle for each injection
• Change needles between drawing and injecting

When to Contact Healthcare Provider:

• Persistent pain, redness, or swelling at injection site
• Signs of infection (warmth, drainage, fever)
• Severe bruising or hematoma
• Needlestick injury
• Questions about appropriate needle size
• Difficulty performing injection
• Allergic reaction after injection

Regulatory Compliance:

• Terumo needles meet FDA requirements
• Manufactured in ISO-certified facilities
• Comply with ISO 7864 (sterile hypodermic needles) and ISO 9626 (needle dimensions)
• Meet USP standards for sterility
• Color coding follows ISO 6009 standards (gray hub for 27G)
• Latex-free for healthcare safety