Insulin syringe question

P_RN, ADN, RN · Dec 5, 2002

Yesterday at work a doctor said to give 8 units of reg. insulin - and don't waste time getting an insulin syringe.

"why doctor, it's no trouble at all......." said while not bothering him and skipping along to GET the insulin syringe. Protect your patient, protect your license.

Docs THINK they run the show, but have you ever seen a hospital that could workk WITHOUT nurses?

ricquet · Dec 5, 2002

i definately agree with you P_RN. These doctors nowadays are so not nice. i am a senoir in a BSn program and i feel like iwould leave the profession because of the way some of these MDs behave. But i am not becaose i do my work and they do theirs

ohbet · Dec 6, 2002

This question about giving insulin in a syringe measured in mls came up for me a month ago.

I was orienting a new nurse ,new to the hospital,old with experience, she asked me to check her insulin prior to admin. and she was using an ml syringe. My mind went "boingoingoingoing". I said "you cant give insulin in that syringe",this is the first time I had seen insulin in a ml syringe> She said "sure you can,its the same measurement" but then she used the insulin syringe so I wouldnt go into post tramatic stress.

BUT IF A ICC SYRINGE IS MARKED OF IN 1/100THS ON AN MLS,ISNT IT THE SAME?

flowerchild · Dec 6, 2002

TO AVOID ERRORS: Only use an insulin syringe for insulin. The other syringes are not marked the same as an insulin syringe. I've seen errors when a busy nurse used a TB or 1 ml syringe for insulin. It's too easy to draw up 80 U instead of the 8 U that was supposed to be given.

TKOLRN, BSN, RN · Dec 7, 2002

When an issue like this pops up, I stop. I picture myself seated in a court room. The prosecuting attorney says to the expert witness, herself a nurse, "What would a prudent nurse have done in this instance"...I base my actions on the answer to that question, and I have posed it to myself many, many times in 16 years of ER nursing. Not ONCE have I been sued, not ONCE have I been deposed and not ONCE have I killed a patient. I may have pissed off some physicians along the way,but I went home with a clean conscience and patients that were better off for it. It's YOUR license and THEIR life!!

Anaclaire · Dec 7, 2002

TKOLRN,

Your phrasing and insight are perfect and powerful in my opinion!!! One of the MAIN reasons nurses work is to administer the medicines and treatments ordered by physicians. We must always think of our potential courtroom scene when pondering one of those "What should I do?" questions in our minds!

Bravo to you and thanks for such a brilliant post!

Most sincerely,

Anaclaire

RNforLongTime · Dec 7, 2002

I would and have ALWAYS used an insulin syringe!

Scooby365 · Dec 7, 2002

Theoretically the 1cc syringe could be used, but why tempt fate. I am going to jump on the bandwagon and say hand him the insuline and the syringe and let the moron give it himself.

Youda · Dec 7, 2002

As a diabetic, I will tell you that if anyone tried to give me an insulin dose in a standard syringe, I'd have to smack them alongside their heads just to hear their shrunken brains rattle around.

Insulin syringes are designed to give, accurately, very small doses. This isn't just due to the markings on the barrel, but the shape of the barrel, the shape of the plunger (flat instead of curved), and the amount of med that is still in the syringe. A possible alternative would be a TB syringe because it is also made to deliver small doses.

The only exception would be in an emergency situation when the BG's were dangerously high, you were going to give it IV, and it would be more important to get the BG down quickly. Even in that situation, 8 units isn't going to do much for bringing down a critically high BG!

If the doc wanted to use a standard syringe, why did he want a goofy amount like 8 units? Why didn't he say he wanted .25 cc's or whatever? What was the patient's BG, just out of curiosity?

**canoehead, BSN, RN** · Dec 7, 2002

WEll, that's the question, what is the difference btwn a TB syringe and an insulin syringe, they are both marked off in small units, and presumably someone has measured those units accurately right? :)

P_RN, ADN, RN · Dec 7, 2002

A 3cc syringe even with a tiny needle can't possibly measure eight/one hundreths of a cc. The smallest marks are for minims which I hope no one is still using. Eight units is small but I have seen sliding scales that ordered TWO or THREE units. Yeah right!

A tuberculin syringe is marked off in tenths, so 0.8 cc would "equal" 80 units. The needle is a bit larger 27 I believe.

The real danger I see is looking at that 0.8 and thinking it means 8 units. Use the insulin one.

Pretzlgl · Dec 7, 2002

Thanks all - I'm glad I'm not totally off my rocker...

Youda - the BS was 346. An otherwise healthy patient. Ambulatory surgery patient. No other medical problems. Certainly not an emergency situation. Just a moron for a doctor - why would anyone want to potentially allow a mistake to occur?? I just don't get it. I think it was more the "I'm the doctor, you're the nurse" syndrome going on. I like the advice of just handing the doc the syringe and the insulin - I will do that should this arise again. Thanks for your insight Youda.

P RN - thanks for your post - good visuals.

So if you would use a 1 cc syringe, how much would you give? 100 units per cc so you would give .08 cc? Just curious about that.