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.
Ok, as far as the air, I was saying that it's not like it's going to the bloodstream like an IV line does. Of course I know that the insulin gets to the bloodstream... Am I making sense?
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 know why it is so hard for people to understand that. This came up for me during clinicals and I knew not to remove the air. My clinical instructor didn't listen to me and asked another nurse who agreed with the instructor that they were supposed to remove the air. Against my wishes, (because I'm just a student) they told me to give the Lovenox without the air bubble. I didn't want to and the instructor told me right there that if I didn't do it, I would get a med error. I stuck with my senses and told them that I didn't feel comfortable to give the med. The instructor took the syringe from me, removed the air bubble and gave the dose to the patient.
When we got our papers back from that week, I got a med error. No one would talk to me about it. (apparently, instructors stick together no matter what.) I wrote a rebuttal as well as went to a website with instructions for giving Lovenox and never heard a word about it until the end of semester when my final review showed that my med error was removed. Hmmmm, go figure.
Specializes in icu, er, transplant, case management, ps.
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:
i am sorry but the only time i have trouble with air getting into my syringe, when i haven't drawn it up, is when i am squeezing out the last few units of insulin out of the vial. when i draw up my insulin, the solution flows into the syringe filling any air pockets, except like i said, when the vial is almost empty.
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.
I just learned this over on the "Less painful heparin injections?" thread in the med savvy forum. I've been using it with great success.
I have worked in the hospital in preop before, and we have had small air bubbles go straight into t he blood vessels without any aderse effect on th4e patient.
with insulin you are striving for accuracy....it would take quite a large air bubble to stop the hear, and you wouldn't be abble to get that ina 1/2 or 1 cc insulin syringe anyways.
Specializes in icu, er, transplant, case management, ps.
I have worked in the hospital in preop before, and we have had small air bubbles go straight into t he blood vessels without any aderse effect on th4e patient.
with insulin you are striving for accuracy....it would take quite a large air bubble to stop the hear, and you wouldn't be abble to get that ina 1/2 or 1 cc insulin syringe anyways.
You have a good point there. I doubt the 1/2 of a cc is going to do me much harm, like you said.
RNmom08
140 Posts
Ok, as far as the air, I was saying that it's not like it's going to the bloodstream like an IV line does. Of course I know that the insulin gets to the bloodstream... Am I making sense?