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?

[crb613, BSN, RN]

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.

Same here

[crb613, BSN, RN]

double post....

[HoShKyLo]

Talk to me about the insulin syringes with leur-lock capabilites...who manufacturers them?

[highlandlass1592, BSN, RN]

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.

Been there, done that.

[delilahtwo]

Just a question as this has just come up in our facility. Why not use a 1cc syringe with a 1 inch or longer needle and draw up the insulin with that? Why does an insulin syringe have to be used at all in this situation? Drawing up with an insulin syringe, injecting into another syringe and then injecting into the bag results in a loss of insulin due to dead space in the syringe and needle resulting in inaccuracy. My opinion, draw up insulin with a 1 cc syringe (insulin is 100 units/ml so 50 units is 0.5ml) with a long enough needle and then inject into the iv bag.

[Indy, LPN, LVN]

We mix our own drips. The only reason I've ever seen a pharmacist wake up and come in to mix something in the middle of the night was for an epidural that they forgot to make the midnight bag. Too bad, I don't think I'd be making up a bag of fentanyl and marcaine! Nuh-uh.

For insulin it's 1 cc insulin U-100 in 100 ml bag of NS and that's it. So 3cc syringe with 1 1/2 inch needle. I double check with house supervisor when mixing it. I can also mix cardizem standing on my head justabouts. We mix dobutamine, levo, and that's about it. Usually we don't have to mix antibiotics because they come in little jar-looking thingamabobs that attach to the bag, you attach, snap, squirt and it mixes... you get whatever dose it comes in, you don't get to choose the dosage. Lucky the doctors are very familiar with the dosages available.

I did have to mix potassium once. Heh. That was the sup on a long phone call to pharmacy, three different people double checking the pharmacist's math, another phone call, and all the RN's in the house that night signing off on, and watching, the mix. Fun. That was for a DKA that just couldn't wait till morning to get her fluids and electrolytes straightened out. Seriously they need a night time pharmacist.