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Step 5: Remove air bubbles With the vial still inverted and the needle still inside, look for air bubbles in the syringe barrel

This is why the 2ml reconstitution works best for the earlier phases of a protocol when doses are lower

Panteli M, Pountos I, Jones E, Giannoudis PV

The presence of hiatal hernia is important in defective barrier function both by removing the augmentation that the crural diaphragm provides the LES and by lowering the threshold for TLESR to occur

Step 3: Introduce Water Along the Vial Wall (Not Directly onto Powder) This is the most critical step in the entire process and also the one most commonly done wrong