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The most consequential mistakes include shaking the vial , using normal saline instead of bacteriostatic water in a vial that will be accessed repeatedly (saline carries no antimicrobial preservative), and reusing syringes , which both introduces bacteria and dulls the needle

Bacteriostatic water, by contrast, is designed for the multi-dose case: a powdered product reconstituted into a solution drawn from over multiple days or weeks

Some protocols might also use intramuscular injections (into muscle), though subcutaneous is more common due to better tolerability

Compounding lets the prescriber match the vehicle to the body site and skin condition rather than accepting whatever vehicle the manufacturer chose

A) Figure A: connect the needle Step 3