Only 5 units of insulin per injection site??

Nurses General Nursing

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While doing clinicals in the ICU I had the RN tell me that you should not inject more than 5u of insulin per injection site because the body cannot absorb more than that from one location. So for a patient that needs 15 units for example you would inject 5u in upper arm, 5u a few inches lower and 5u a few inches lower-all from the same needle and syringe.

I had never heard this so I asked him if he was taught this in nursing school. He said no but his brother who is an NP at a diabetes clinic teaches it to all his patients. I have scoured the internet for research to back this up but have not come across anything.

Has anyone heard this before? Do you believe its true? Is there research to back it up?

agldragonRN

1,547 Posts

Specializes in Wound Care, LTC, Sub-Acute, Vents.

umm..no

one time, i gave lantus 70 units in the abdomen.

i would not subject my patient to 14 unnecessary injections and from the same needle? infection control, anyone?

are you sure this person was indeed an rn?

Orange Tree

728 Posts

Specializes in Medical Surgical Orthopedic.

Whoa! I would lose count on some patients, and then what?

Specializes in Pediatrics.

Can you imagine how many more non compliant people would become with diabetes control if they had to give themselves 4 to 5 injections at a time?!

No never heard of it before, I wouldn't want to subject patients to any more injections than I had to.

nerdtonurse?, BSN, RN

1 Article; 2,043 Posts

Specializes in ICU, Telemetry.

Never heard of it, and since I have a lot diabetics in the unit, it's a bunch of whooey. I give Aspart on a sliding scale patient and watch blood sugars drop like a rock.

Where was she getting her info? Inside a box of Cracker Jack?

AZMOMO2

1,194 Posts

Specializes in Cardiac Care.

Who the heck would want to poke someone even 5 times? I feel bad enough when I have to give two shots at a time because their lantus. WOW I cannot imagine that... plus I have seen many people respond with lower blood sugars after dosing the regular way... sliding scale 1 shot 1 site!

xtxrn, ASN, RN

4,267 Posts

while doing clinicals in the icu i had the rn tell me that you should not inject more than 5u of insulin per injection site because the body cannot absorb more than that from one location. so for a patient that needs 15 units for example you would inject 5u in upper arm, 5u a few inches lower and 5u a few inches lower-all from the same needle and syringe.

i had never heard this so i asked him if he was taught this in nursing school. he said no but his brother who is an np at a diabetes clinic teaches it to all his patients. i have scoured the internet for research to back this up but have not come across anything.

has anyone heard this before? do you believe its true? is there research to back it up?

this is nuts.

i've given a lot of insulin. i've given myself a lot of insulin...... don't listen to this. talk to your instructor.

i've given myself up to 96 units of lantus at one fell swoop. his brother isn't who you answer to, period. there is no way i'd be doing 12 shots for my current lantus dose....you'd run out of sites to rotate before getting back to the same ones. :confused:

i need to shut up now, because i'm getting perilously close to using "wash-my-mouth-out-with-soap" language :D

lrobinson5

691 Posts

Never heard of that, and I'm in school now. The one thing they stress all of the time is that we give insulin in the abdomen because it absorbs the fastest from that site. If you want slower absorption use the extremities, but I haven't really seen it that much in my (limited) experience in the hospital.

Specializes in PICU, ICU, Hospice, Mgmt, DON.

That is DANGEROUS information...infection control for one...Using the same needle? In a diabetic patient who may be more prone to skin infection to begin with?

UM, NO!

elthia

554 Posts

Now we do have some of the endocrinologists order the larger doses of lantus to be given as split doses, but it is clearly ordered that way.

As in...Lantus 110 units subcut, to be given as 55 units in two divided injections in separate sites for a total for a total of 110 units.

Considering that our insulin pens are single use only, this requires a new needle for each injection, as the safety lock engages after each injection.

This is the only time I divide a dose, as I have an order to do so.

Specializes in Triage, MedSurg, MomBaby, Peds, HH.

Most of my patients are diabetic and I've never heard of this. I'd ask your instructor, who should probably in turn speak with the facility's educator. This RN sounds as if she needs to be educated.

rn/writer, RN

9 Articles; 4,168 Posts

Yeesh! How would people who need larger doses even begin to rotate sites?

I'd ask her where she got this information.

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