Dysphagia Knowledge Hub — 吞嚥困難知識庫
IDDSI Test Syringes — Buying Guide for Hong Kong and Global Buyers (2026)
TL;DR: Not every syringe labelled “10 mL” is valid for the IDDSI Flow Test. The only dimension that matters is a barrel length of 61.5 mm from the zero line to the 10 mL line. BD 303134 (North America), BD 302143 (Australia / Singapore) and BD 302995 (luer-lock, North America) are the IDDSI-development reference syringes. In Hong Kong, valid 10 mL slip-tip syringes are sold over-the-counter at Watsons, Mannings and licensed medical supply shops from HK$3–15 per unit; bulk cartons are available from LCH Pharma and other wholesalers. Every new batch must be verified with a 10 mL plain-water drain test before clinical use.
1. Why the Syringe Specification Matters
The IDDSI Flow Test is the only practical, portable way to classify thin and thickened liquids into IDDSI Levels 0, 1, 2 and 3. The test is simple: you draw 10 mL of liquid into a syringe, hold it vertically with your finger blocking the tip, release the finger, and measure how much liquid remains after exactly 10 seconds (IDDSI Framework Testing Methods v2.0, July 2019, p.4–5).
- Less than 1 mL remaining → Level 0 (Thin)
- 1–4 mL remaining → Level 1 (Slightly Thick)
- 4–8 mL remaining → Level 2 (Mildly Thick)
- More than 8 mL remaining → Level 3 (Moderately Thick / Liquidised)
This test depends on one physical constant: the length of the barrel between the zero mark and the 10 mL mark must be 61.5 mm. A syringe barrel that is shorter produces a shorter residence time, artificially classifying thick liquids as thinner than they are. A longer barrel does the opposite. The original IDDSI research team chose 61.5 mm because that was the barrel length of the BD 10 mL slip-tip syringe they used in validation studies, and the resulting residual-volume cut-offs (1 mL, 4 mL, 8 mL) are calibrated against that specific geometry (IDDSI FAQ: “How do I find the right syringe?”, accessed 2026-04-17).
The “not all 10 mL syringes are the same” warning
IDDSI’s own guidance states plainly: “Although 10 mL syringes were initially thought to be identical throughout the world based on reference to an ISO standard (ISO 7886-1), it has subsequently been determined that the ISO document refers only to the nozzle of the syringe and that variability in barrel length and dimensions may exist between brands.” IDDSI further notes it is aware of syringes labelled 10 mL that in fact have different barrel dimensions, and of some that hold 12 mL despite the “10 mL” label (IDDSI FAQ, accessed 2026-04-17).
The practical implication is that you cannot grab any syringe from a pharmacy drawer and assume it works. You must either buy a part number that IDDSI has confirmed, or verify your syringe yourself using the water-drain method described in Section 5.
2. The IDDSI Reference Syringes — BD Part Numbers by Region
BD (Becton, Dickinson and Company) manufactured the syringes used in IDDSI’s original 2015–2017 validation work. The developers recorded manufacturer code BD 301604 on the validation batch. Because BD sells the same physical product under different regional SKUs, the practical part numbers you can order today vary by country (IDDSI “BD Syringes for IDDSI Flow Test” reference card, updated 2020-04-06).
| Region | BD part number | Tip type | Notes |
|---|---|---|---|
| North America (US / Canada) | BD 303134 | Slip tip | The primary IDDSI reference |
| North America | BD 302995 | Luer lock | Luer-lock accepted as equivalent |
| Australia | BD 302143 | Slip tip | IDDSI-approved for AU |
| Singapore | BD 302143 | Slip tip | Same SKU as Australia |
| Europe (UK / EU) | Verify locally | Slip tip | BD distributors stock equivalent 10 mL slip-tip; always measure barrel length before approving a batch |
| Hong Kong / Mainland China | Not a published BD SKU | Slip tip | Use verification test (Section 5) |
| Japan | Not a published BD SKU | Slip tip | Use verification test; Terumo 10 mL slip-tip is widely used but must be verified |
| Taiwan | Not a published BD SKU | Slip tip | Use verification test |
Luer lock vs. slip tip. Either is acceptable as long as the barrel length is 61.5 mm. The tip style does not affect the test, because you block the outlet with your fingertip, not with a hub fitting. Slip tips are marginally easier to block cleanly and are the style used in most IDDSI documentation photos.
Why IDDSI does not publish an approved-brand list for every country
IDDSI has not certified or endorsed non-BD brands because the testing methodology was validated on a specific reference geometry, not on a brand-neutral standard. The organisation’s position is that users of any other 10 mL syringe are responsible for confirming compliance themselves. In regulated clinical environments (hospitals, aged-care facilities), this is normally done once per procurement batch and documented in quality records.
3. Where to Buy IDDSI-Valid Syringes in Hong Kong
Hong Kong does not have a dedicated “IDDSI syringe” SKU in its retail pharmacy system. Fortunately, the 10 mL slip-tip syringe is a completely unregulated medical consumable in Hong Kong — it does not require a prescription, and it is stocked by almost every community pharmacy alongside insulin syringes and wound-irrigation supplies.
Retail pharmacies (small quantities)
- Watsons (屈臣氏) — stocks BD and generic 10 mL slip-tip syringes in packs of 5 or 10. Typical price: HK$3–5 per syringe. Availability varies by branch; Central, Admiralty and Kwun Tong branches with pharmacist counters are the most reliable.
- Mannings (萬寧) — similar stocking pattern. The “Mannings Plus” and “Mannings Baby” branches are more likely to have syringes in stock because they also carry enteral feeding supplies.
- Independent pharmacies in Jordan, Sham Shui Po, and Mong Kok — these typically have the widest stock and the best prices, especially for cartons. Ask for “10mL 針筒冇針嗰啲” (10 mL syringe without needle).
Medical supply specialists (mid-volume)
- Lun Cheong Hong (聯昌行) — LCH Pharma — wholesale medical and clinical supplies distributor. Stocks BD, Terumo, Nipro and Exel 10 mL syringes. Sells by the carton (typically 100 units per box). Good for care homes and commercial kitchens that need 100+ units.
- Harmony Medical, King Medical — similar product range; serve clinics and small hospitals.
- ALS Health 安耆健康 — carries dysphagia-specific equipment; may stock IDDSI-specific kits.
Public hospital pharmacies (not retail-facing)
HKQAA and HA hospitals have internal supplies through HA Materials Management. These are not retail-facing, but speech-language pathologists working in HA can usually obtain test syringes on internal request. Community caregivers cannot order from this channel.
What to pay in Hong Kong, 2026
| Channel | Unit price (HK$) | Minimum order |
|---|---|---|
| Watsons / Mannings | 3–5 per syringe | Pack of 5 |
| Independent pharmacy | 2–4 per syringe | Single unit often available |
| LCH Pharma / wholesaler | 0.80–1.50 per syringe | Carton of 100 |
| Direct BD distributor | Quote on request | Usually 10-carton minimum |
For a Hong Kong family caregiver performing occasional tests at home, a pack of 5 from Watsons at around HK$20 is more than sufficient — each syringe can be cleaned and reused for weeks. For a care home, dietitian practice, or commercial food producer running regular quality-control tests, a wholesale carton is the right choice.
4. Where to Buy Globally
Online marketplaces
- Amazon (US, UK, DE, JP) — search “BD 303134” (US) or equivalent regional SKU. Prices on Amazon US run USD 10–20 for a pack of 10. Amazon Japan lists Terumo 10 mL slip-tip at around ¥1,200 per pack of 10.
- eBay — BD, Terumo, Nipro and generic slip-tip syringes are widely available. Verify seller reputation; counterfeit medical consumables occasionally appear.
- Medical supply e-commerce (Grainger, McKesson, Medline in the US; AliMed; IVY League Medical in the UK) — carry BD part numbers with full traceability.
IDDSI’s own shop
IDDSI sells an IDDSI Funnel (not a syringe) as an alternative validated flow-test device. The funnel is a rigid plastic funnel calibrated to the same cut-offs as the syringe test, released in 2020 after peer-reviewed validation (Steele CM et al., Dysphagia, 2020, “Validation of the IDDSI Funnel for Liquid Flow Testing”). For institutions performing high volumes of flow tests, the funnel is more durable and eliminates per-batch verification.
- IDDSI Funnel — available via iddsi.org; approximate price USD 65 per unit. Shipped internationally.
Japan
In Japan, Terumo 10 mL slip-tip syringes are the dominant clinical product. Terumo SKUs are not listed on the IDDSI reference card, but Japanese dysphagia research groups (JSDR — Japan Society of Dysphagia Rehabilitation) routinely use Terumo syringes after in-house verification. The Terumo SS-10ESZ is a commonly used reference in Japanese clinical papers.
Taiwan
Taiwan’s clinical community uses both BD-imported syringes (via distributors such as Sunny Pharmaceutical 三豐藥品) and Taiwan-manufactured equivalents from 泰陞 (Terumo Taiwan), 華 伸 and others. Taiwan Food and Drug Administration (TFDA) regulates these as Class I medical devices. For IDDSI work in Taiwan, hospitals typically source from their existing syringe supplier and verify a sample batch before starting quality-control runs. The Taiwan Dysphagia Society (台灣吞嚥醫學會) references IDDSI methods but does not mandate a specific syringe SKU.
Mainland China
Mainland Chinese medical supply markets stock BD, Terumo, KDL (江西三鑫) and numerous domestic brands. The T/SATA 084-2025 standard, which formalises GBA-region care-food viscosity classification in line with IDDSI, specifies the same IDDSI Flow Test method and the same 10 mL syringe. In practice, Chinese care food producers and testing labs use BD or Terumo syringes sourced through domestic medical supply distributors (搜搜通, 1688 wholesale, or regional medical device companies).
5. How to Verify Any Syringe in 30 Seconds — The Water-Drain Test
IDDSI’s FAQ answers one critical question: Can I perform the IDDSI flow test with any 10 mL syringe? The answer is: only if you verify it first. The verification procedure is trivially simple and must be done before you trust any new batch (IDDSI FAQ, accessed 2026-04-17).
Procedure:
- Fill the syringe with 10 mL of plain room-temperature water.
- Hold the syringe vertically, tip down, with your fingertip blocking the tip.
- Release your fingertip and simultaneously start a stopwatch.
- Stop timing when the last drop falls.
Pass criteria:
- If the syringe empties in approximately 7 seconds (± 1 second), the barrel geometry is close enough to the 61.5 mm IDDSI reference that your flow-test readings will be clinically valid.
- If the syringe empties in less than 5 seconds or more than 10 seconds, the barrel geometry is wrong — discard that batch and source another brand.
You should also take a ruler or Vernier calliper and physically measure the distance from the 0 mL line to the 10 mL line. It must be 61.5 mm. If you are buying a bulk carton, measure one syringe from each of several cartons, not just one — manufacturing variance within a single brand is usually small, but not always zero.
Log the brand and batch. Once a batch is verified, record the manufacturer, part number, and lot number in your quality records. Re-verify when you start a new brand or a new lot.
6. Common Mistakes Caregivers and Kitchens Make
- Buying a needle syringe. You do not want a needle. Ask for “syringe, 10 mL, no needle” or “10 mL slip-tip without needle”. In Hong Kong Cantonese: “10mL 針筒冇針”. A needle hub will block the tip inconsistently and invalidate the test.
- Using a 12 mL syringe labelled 10 mL. Some low-cost brands mark “10 mL” at the 10 mL fill mark but extend the barrel to 12 mL total capacity. The 0-to-10 mL distance on these syringes is usually around 56–58 mm — short enough to fail the water-drain test. Measure, don’t trust the label.
- Mixing luer-lock and slip-tip within the same quality programme. Either is acceptable individually, but operator technique differs slightly (slip tips are easier to block cleanly with a fingertip). Pick one tip style and stick with it to reduce operator variability.
- Using the syringe for a food thicker than Level 3. The Flow Test is only valid for Levels 0–3. Foods at Level 4 and above must be tested with the fork drip, spoon tilt or fork pressure tests. If your syringe cannot be filled or the liquid does not move at all, the sample is thicker than Level 3 and the syringe test does not apply.
- Testing at the wrong temperature. IDDSI tests are performed at the intended serving temperature. A thickened drink that passes Level 2 at room temperature may fail at refrigerator temperature because thickener viscosity is temperature-dependent. Warm the sample to serving temperature before testing.
- Not letting starch-based thickeners equilibrate. Cichero et al. (2013, Journal of Texture Studies) demonstrated that starch thickeners continue to increase in viscosity for up to 30 minutes after mixing. For quality control of starch-thickened drinks, wait at least 10 minutes after mixing before testing, and re-test at 30 minutes if the product sits before consumption.
- Reusing without cleaning. Syringes labelled “single use” are intended for single clinical use with sterile fluids into patients. For repeat IDDSI testing of food and drink at home, rinse the syringe thoroughly with warm water immediately after use, clear the tip, and air dry. Replace if the plunger stiffens or the barrel becomes scratched.
7. Frequently Asked Questions
Do I need a new syringe every day? No. For non-clinical IDDSI testing of food and drink (not injected into patients), a single clean syringe can be used for weeks. Discard if the plunger stiffens or the markings become unclear.
Can I use an oral-dispensing syringe (the kind pharmacies use to dispense infant medicine)? Only if the barrel length is 61.5 mm. Most oral dispensing syringes have shorter or differently proportioned barrels because they are optimised for dosing, not flow. Verify before use.
Is the IDDSI Funnel better than the syringe? It is more durable, and once purchased it eliminates the per-batch verification step. For large institutions, it is a reasonable investment. For home caregivers and small kitchens, the syringe remains the cheaper and more widely available option.
Can I 3D-print my own? Several makers have published open-source STL files for flow-test devices. These are not IDDSI-validated and the 3D-printed surface finish typically alters flow slightly compared to injection-moulded plastic. Use only for teaching, not clinical classification.
What if my retailer does not have a 10 mL slip-tip in stock? Try a different pharmacy. 10 mL syringes are extraordinarily common consumables and no pharmacy should be more than a short walk from one that has them. If desperate, a 5 mL or 20 mL syringe cannot substitute — the test is defined for the 10 mL barrel length.
Citations and Sources
- International Dysphagia Diet Standardisation Initiative (IDDSI). IDDSI Framework — Detailed Definitions and Testing Methods, Version 2.0, July 2019. https://www.iddsi.org/standards/framework
- IDDSI FAQ. How do I find the right syringe to use for the IDDSI flow test? Accessed 2026-04-17. https://www.iddsi.org/faqs/q-how-do-i-find-the-right-syringe-to-use-for-the-iddsi-flow-test
- IDDSI FAQ. What does a 10 mL Slip Tip syringe look like and can I be sure it is the same around the world? Accessed 2026-04-17. https://www.iddsi.org/faqs/q-what-does-a-10-ml-slip-tip-syringe-look-like-and-can-i-be-sure-it-is-the-same-around-the-world
- IDDSI FAQ. Can I perform the IDDSI flow test with any 10 mL syringe? Accessed 2026-04-17. https://www.iddsi.org/faqs/q-can-i-perform-the-iddsi-flow-test-with-any-10-ml-syringe
- IDDSI. BD Syringes for IDDSI Flow Test — International Codes (Updated April 6, 2020). https://www.iddsi.org/images/Publications-Resources/TestingCards/bd-syringes-for-iddsi-flow-test-international-codes.pdf
- Cichero JAY, Lam P, Steele CM, et al. (2017). “Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework.” Dysphagia, 32(2), 293–314.
- Cichero JAY, Jackson O, Halley PJ, Murdoch BE. (2013). “How Thick is Thick? Multicenter Study of the Rheological and Material Property Characteristics of Mealtime Fluids and Videofluoroscopy Fluids.” Journal of Texture Studies, 44(4).
- Steele CM, Hanson B, Riquelme LF, et al. (2020 / validation published 2024). “Validation of the IDDSI funnel for liquid flow testing.” Dysphagia. PubMed PMID 38613313.
- Hadde EK, Cichero JAY. (2019). “The effect of xanthan gum-based thickener on the swallowing function of patients with dysphagia.” Food Hydrocolloids, various.
- 香港社會服務聯會 (HKCSS). 《照護食標準指引》2023年版. https://www.carefood.org.hk
- 深圳市分析測試協會. T/SATA 084—2025 《適老易食食品(適老照護食)》, effective 2025-06-07.
This article paraphrases publicly-available international testing methodology from IDDSI and references the HKCSS and GBA care food standards. For clinical practice, refer to the current official IDDSI documentation at iddsi.org and to a qualified speech-language pathologist. This page is not medical advice.
Last updated: 2026-04-17 · License: CC BY 4.0 · Maintained by Editorial Team — a Hong Kong social enterprise producing IDDSI-compliant care food for people living with dysphagia. Trade, institutional and distributor enquiries: [email protected]. This page is educational only; see About for our clinical partners and social mission.