insulin question

[RNmom08]

I have a quick question about drawing up insulin. Someone asked me and I wanted to be sure I have the answer correct. I never asked, just went with it and never thought about it.

Before you inject, you make sure the air bubbles are out of the syringe. Do we do that to assure accuracy of the amount of insulin? Someone (another student) said that it was because air couldn't be in the human body. I told them that the insulin wasn't going into the bloodstream so that it would be more for accuracy than anything.

Please don't flame me for asking a simple question like this, I feel stupid for not know the EXACT reasoning already.

Thanks!

[vashtee, RN]

You actually intentionally add an air lock with an IM injection, so I'd say you tap out bubble for accuracy.

[RNmom08]

That's what I thought.

[leslie :-D]

insulin most certainly does go in the bloodstream.

adipose tissue is highly vascular.

tapping out air bubbles on any medication, is for pt safety.

it's unlikely there will be an adverse event (w/sc or im), but is still good/safe practice.

leslie

[DutchgirlRN, ASN, RN]

Correct, if insulin didn't get into the bloodsteam there wouldn't be any purpose in giving it.

Insulin is absorbed quicker from the abdomen than from the arms and absorbs faster from the arm than from the thighs.

Tiny air bubbles are not dangerous, but they will decrease the amount of insulin in the syringe.

No question is a stupid question if it's one you need an answer to and that goes for all of us no matter how long we've been nurses. I ask questions all the time. Nursing changes daily. Good luck with your clinicals.

[woody62, RN]

Correct, if insulin didn't get into the bloodsteam there wouldn't be any purpose in giving it.

Insulin is absorbed quicker from the abdomen than from the arms and absorbs faster from the arm than from the thighs.

Tiny air bubbles are not dangerous, but they will decrease the amount of insulin in the syringe.

No question is a stupid question if it's one you need an answer to and that goes for all of us no matter how long we've been nurses. I ask questions all the time. Nursing changes daily. Good luck with your clinicals.

I take NPH twice a day. I draw it up in my insulin syringe to the humber of units I am taking then add about two units of air, invert and inject. The two units of air invert with my inversion. And I have never suffered anything. And I generally use my abdomen. If you look at an insulin syringe, it is almost impossible to draw up air bubbles when you are drawing up insulin. I can only get air into my syringe after I withdraw it from my vial.

Woody:balloons:

[DutchgirlRN, ASN, RN]

I take NPH twice a day. I draw it up in my insulin syringe to the number of units I am taking then add about two units of air, invert and inject. The two units of air invert with my inversion. And I have never suffered anything. And I generally use my abdomen. If you look at an insulin syringe, it is almost impossible to draw up air bubbles when you are drawing up insulin. I can only get air into my syringe after I withdraw it from my vial.

Woody:balloons:

Lovenox comes preloaded with air and instructions are to "not" remove the air. You purposely let the air invert and inject. The air pushes the medication down into the SQ tissue and helps prevent bleeding and bruising. Is why you inject air with your insulin injections?

[woody62, RN]

Lovenox comes preloaded with air and instructions are to "not" remove the air. You purposely let the air invert and inject. The air pushes the medication down into the SQ tissue and helps prevent bleeding and bruising. Is why you inject air with your insulin injections?

I don't have preloaded syringes. And yes, that is why I inject with a small amount of air.

Woody:balloons:

[DutchgirlRN, ASN, RN]

I don't have preloaded syringes.

That I knew.

And yes, that is why I inject with a small amount of air.

Woody:balloons:

Thanks, that's interesting. I knew it was a big no no to remove the air from a Lovenox syringe but never thought about the same premesis of using air with other SQ injections.

[leslie :-D]

the extra air acts as a seal.

i just don't know all the meds it is indicated for.

leslie

[RedCell]

Tell your classmate if the patient has a normal heart (no communication between the left and right ventricles or atria), you can inject a syringe full of air directly into their right atrium and nothing bad will happen. The air bubbles will be absorbed and exhaled by absorption from their pulmonary circulation. On the other hand, inject that same syringe full of air into the carotid artery and now you get to practice your institution's stroke protocol.

[Myxel67]

i take nph twice a day. i draw it up in my insulin syringe to the humber of units i am taking then add about two units of air, invert and inject. the two units of air invert with my inversion. .. and i generally use my abdomen. if you look at an insulin syringe, it is almost impossible to draw up air bubbles when you are drawing up insulin. i can only get air into my syringe after i withdraw it from my vial.

woody:balloons:

actually, it's difficult for many people to draw up insulin without getting an air bubble in the syringe. the reason to tap it out is to get an accurate dose. air added after the correct dose has been drawn up should not be a problem. it will keep the insulin from seeping out. what we (and also the insulin manufacturer) recommend is holding the syringe in place for 7 to 10 seconds after injecting.

nph and regular insulin are absorbed best from the abdomen, but there is no difference in absorption for insulin analogs (humalog, novolog, apidra, lantus, levemir). one site is as good as another. just remember to rotate sites with a plan so that subq fat is not damaged.

:balloons: