How to add insulin to an IV Fluid Container

[HoShKyLo]

Hi All,

Looking for some links on how to add insulin to an IV container....evidence recommends using a needle that is one inch in length to puncture the inner port of the bags BUT the insulin syringe needles are only 1/2 inch...I am aware some staff are puncturing the port with a 22 guage then trying to line up the insulin syringe and instill the dose of insulin this way.....any ideas?

[HoShKyLo]

Excellent....That was one way I was thinking of encouraging staff....Do you only use the TB syringe with the IV insulin or do you also find staff using it with sc doses?

[HoShKyLo]

Sorry never answered the rest of your question.....most pts are admitted to the general medical units where the insulin is 25 units in 250 cc of IV fluid 0.1 units/mL or if warranted to ICU where the concentration is 100 units in 100 cc 1 unit/mL

[Mobeeb, RN]

The use of the TB syringe is only for the IV admixture. Some of the older RN's use the TB syringe for subcu doses because they can see the lines of the syringe much better. I want to add that the admixture procedure I mentioned is a standard with our pharmacy. We also have to mix our own ABX and many other IV drips. We follow the pharmacy P&P regarding amount of diluent, etc.

[HoShKyLo]

You are making me smile...that is also the reason for usage of TB syringes here....

Thanks for your help....:wink2:

[ernrs2b]

In the ER, we don't have time to wait for pharmacy, so we mix our own and to answer your question...I draw it up in an insulin syringe to check with another nurse and then "squirt" it in to another syringe to inject in to the bag

[blinks14]

In the critical care units at our hospital nurses routinely mix their own meds, including insulin gtt's. Anytime I get a pt on an insulin gtt from the ICU the med was mixed by them. When I need another bag on my floor though the pharmacy does it for me.

One of my best friends works in an ICU at another hospital in the area and they also mix their own drips.

[ERnewbieRN, BSN, RN]

In the ER, we don't have time to wait for pharmacy, so we mix our own and to answer your question...I draw it up in an insulin syringe to check with another nurse and then "squirt" it in to another syringe to inject in to the bag

Ditto this... and in my facility, we don't have pharmacy on weekends, so I guess DKA's can't come in on Saturday or Sunday Silly hospital!

But anyway, that's also what I do, since most of the time we either don't have time to wait for pharmacy, or the DKA's come in "inconveniently" on the weekends... Measure with the insulin syringe, and since you can't remove the needle, squirt the insulin into another syringe, attach a 1 1/2" needle, and inject into the bag. I made the mistake once of using the insulin syringe to inject into the bag and it didn't make it all the way in, so the patient's sugars didn't come down til someone else figured out what happened I won't be making that mistake again!!

[HoShKyLo]

keep the responses coming....i am amazed by this networking and sharing....all things mentioned i have seen done....now question...by a risk management point....the best way...evidence based way....i can't find any mention in reference material about this....:typing

[whipping girl in 07, RN]

There are actually insulin syringes that have a luer connector instead of a needle, we use those to draw up our insulin bolus and push through the luer port of the insulin line. You could use that with a regular needle.

I prefer for Rx to mix the insulin gtts if possible though. Would hate to have a brain cramp and screw it up.

[RXtech]

There are actually insulin syringes that have a luer connector instead of a needle, we use those to draw up our insulin bolus and push through the luer port of the insulin line. You could use that with a regular needle.

Yes!!! We just started using them in our pharmacy. I wish we had found them sooner!

[RNrural]

In the rural areas such as the one I work in the RN's mix everything. We do not have a pharmacist 24 hours a day. If it needs mixed, no matter what it is, we get it out of the pyxis and mix it.

[blondy2061h, MSN, RN]

The problem with using a longer needle is that it can catch a few units of the insulin, maybe 2-3. Probably not a huge difference, but it will make your concentration slightly off. If you draw up the insulin with the same needle you're injecting with, you'll be catching the same amount of insulin in it on the way in and out so your concentration will be more accurate. If you're putting 100 units in something and using U-100 insulin, that's just 1 ml.