Morphine in TB Syringe, etc

Nurses General Nursing

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I am seeing nurses give morphine with a TB syringe. Is there a reason for doing this?? Even though that is a sc needle I would have thought to draw it up in a regular 1ml syringe with a half inch needle? Is this just a nursing preference?? Are they the same essentially?

Concentration is morphine 10mg per 1ml and the prescribed dose is 1 to 3mg every 4 hours PRN Therefore give 0.1ml to 0.3mls SC.

Also....

A nurse was giving insulin in a TB needle too! What?

I won't be doing that one I know. Insulin is in units.

I have seen a few odd practices and so when I see things done differently than I might do it confuses me! Ha!

Last one. When pt is getting heparin or Enoxaparin as well as insulin shots can the sites be intermingled? Or would you be avoiding the tummy area for insulin if it is being used for the lovenox? Does it matter?

Thanks

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Nurses use what they have and I can avow that the prefect instrument is not always available.

If I had two SQ injections at the same time I'd give them in the same region, albeit quite separated.

If that isn't good practice I'd be interested in knowing.

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Specializes in SRNA.

TB syringes have units of measurement down to 0.01mL, so it's entirely possible to measure 0.3mL of a 1mL vial dose that contains 10mg of morphine to give a 3mg dose to a patient. I do this too for certain medications that need precise measurement.

While insulin in measured in units, insulin is provided in concentrations of 100 units per mL. While it would be ideal to use an insulin syringe, drawing up 0.1mL in a TB syringe would be equivalent to drawing up 10 units, for example.

I've seen nurses do it before, but when we have insulin syringes available, I don't really see the need for it. The needles on insulin syringes are 30 gauge where I work whereas the smallest needle that you can screw on to a TB syringe at my employer is 25 gauge. I know which one I'd prefer to get poked with, so I can imagine my patients would prefer the same!

When a patient has multiple subcuteneous injections due at the same time, I space them out around 2 inches apart at least. Or I may do the insulin in the arm and the other in the abdomen.

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Specializes in Ortho, Case Management, blabla.
I am seeing nurses give morphine with a TB syringe. Is there a reason for doing this??? Even though that is a sc needle I would have thought to draw it up in a regular 1ml syringe with a half inch needle? Is this just a nursing preference??? Are they the same essentially???

They may be slightly shorter than the half inch needle (3/8 of an inch), but they easily get past the dermal layers into the SQ area.

You could say it is a preference, but I find it more convenient to use a TB syringe. Plus TB syringes are slightly cheaper and thereby a bit more cost effective..

A nurse was giving insulin in a TB needle too!!! Wha??????????

I won't be doing that one I know. Insulin is in units.

A unit of insulin is the same as a 100th of a milliliter. You can also use a 100 unit insulin syringe as a 1ml TB syringe. If you feel uncomfortable with it, then more power to you. Most of us don't really feel uncomfortable figuring out simple conversions in our heads and going from there.

Last one. When pt is getting heparin or Enoxaparin as well as insulin shots can the sites be intermingled? Or would you be avoiding the tummy area for insulin if it is being used for the lovenox? Does it matter???

You should be rotating injection sites, so this should be a non-issue. Since you have to give hep/lov in the abdomen, then you should be giving the insulin elsewhere. There are a zillion places you can give an SQ injection!

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Depends on the equipment you have. Our TB syr. are our 1 ml syr's. That is a wounderfuld way to get an accurate measurement. But, we use the IM needles for injection. BUT !!!!!!!! Insulin in a TB syrig. can lead to DEATH . If you see any one do that stop them or call the supervisor right away. If I ever see a nurse do that I will not only stop them but, if they considered it the correct way to administer insulin I would turn them into the BON for unsafe practice.

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Depends on the equipment you have. Our TB syr. are our 1 ml syr's. That is a wounderfuld way to get an accurate measurement. But, we use the IM needles for injection. BUT !!!!!!!! Insulin in a TB syrig. can lead to DEATH . If you see any one do that stop them or call the supervisor right away. If I ever see a nurse do that I will not only stop them but, if they considered it the correct way to administer insulin I would turn them into the BON for unsafe practice.

why would you have such a problem with insulin in a TB syringe? it can be measured accurately, providing that it is 100 U/ml.......somehow i dont think the BON is going to quite see your issue

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Specializes in MICU, neuro, orthotrauma.
why would you have such a problem with insulin in a TB syringe? it can be measured accurately, providing that it is 100 U/ml.......somehow i dont think the BON is going to quite see your issue

I am guessing it is due to a misremembering danger. I have used a TB syringe when the insulin syringe is not handy. As insulin is 100 units/mL, the conversion is simple enough. I also have used an insulin syringe to give heparin. But I label the syringe, if I have more than one so as not to confuse any issue.

I have found that I only want to use the 1 mL generic syringe when I am giving something IV rather than SQ. That is my trigger.

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Specializes in Ortho, Case Management, blabla.
time4meRN said:
Depends on the equipment you have. Our TB syr. are our 1 ml syr's. That is a wonderful way to get an accurate measurement. But, we use the IM needles for injection. BUT!! Insulin in a TB syrig. can lead to DEATH . If you see any one do that stop them or call the supervisor right away. If I ever see a nurse do that I will not only stop them but, if they considered it the correct way to administer insulin I would turn them into the BON for unsafe practice.

This topic has been beaten to death on these forums again and again https://allnurses.com/giving-insulin-t36667/

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Specializes in Spinal Cord injuries, Emergency+EMS.
I am guessing it is due to a misremembering danger. I have used a TB syringe when the insulin syringe is not handy. As insulin is 100 units/mL, the conversion is simple enough. I also have used an insulin syringe to give heparin. But I label the syringe, if I have more than one so as not to confuse any issue.

I have found that I only want to use the 1 mL generic syringe when I am giving something IV rather than SQ. That is my trigger.

is any insulin anywhere in the world not produced *today* as 100 units / ml ?

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Specializes in Assisted Living Nurse Manager.
is any insulin anywhere in the world not produced *today* as 100 units / ml ?

Yes, there is a U 500 that is used for extreme insulin resistance.

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Specializes in Assisted Living Nurse Manager.
november551 said:
This topic has been beaten to death on these forums again and again

The thread you are referring to was from 2003 and the actual question was quite different than what is posted here. The poster wanted help with a scenario on what to do when the insulin syringe breaks and your patient needs 50 units.

I would not use anything but an insulin syringe. What if something happened after you administered the insulin and then it was brought to light that you used a 3ml syringe or even TB syringe to deliver the needed units. I don't think things would go in favor of the nurse who did not follow protocol.

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I would not use anything but an insulin syringe. What if something happened after you administered the insulin and then it was brought to light that you used a 3ml syringe or even TB syringe to deliver the needed units. I don't think things would go in favor of the nurse who did not follow protocol.

How about the nurse who withheld insulin because there were no insulin syringes?

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