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?
The number of posts per page vary with each individual person depending on how you have your preferences set up. For example my screen shows 15 posts per page while many others only shows 10. Hence, the thread november is referring to will have only 4 pages for some, 5 pages for others. She is referring to the very last post in the thread which is a very detailed post regarding the conversion of units of insulin to cc's on a tb syringe.
By the way I'm not advocating using a TB syringe for insulin. I'm just trying to point out that it would be an acceptable substitute in the absence of an insulin syringe if you do a little bit of math. Also, I think the 30unit insulin syringes are cheaper than a TB syringe so using a TB syringe wouldn't be cost effective if you were planning on giving only a few units of insulin anyways.
BINGO!......yes,I remember when,,,etc........when insulin came in several diff strengths......but that is functionally no longer an issue...... .001 of a ml, is the same, no matter which syringe it is in
yep...if you pull up a stronger strength insulin into an insulin needle, it will still be the wrong strength. Does that make sense? the insulin needle doesn't make it magically the right strength. A unit is 1/100th of a milliter. Use your brains, people.
yep...if you pull up a stronger strength insulin into an insulin needle, it will still be the wrong strength. Does that make sense? the insulin needle doesn't make it magically the right strength. A unit is 1/100th of a milliter. Use your brains, people.
thank you!....CRITICAL THINKING, yes i was shouting! lol
If you are pulling 3mg of morphine from a 10mg container the most accurate way to get the dose is to pull it up in a syringe that is calibrated in 100 calibrations per 1cc. Tb syringes fit the bill. Same is true if you are pulling less than 1cc from a solumedrol 125mg vial. As far as using a tb syringe to give insulin, if both syringes are available I'd use an insulin syringe. Only real difference is the needle. Each syringe is calibrated in 100 per 1cc. 1/100 is 1/100 in both syringes.
I have used TB/Insulin syringes when I've had to give meds such as Droperidol or Ativan (docs end up ordering it in doses like 0.5 mg Ativan which if drawn from a 2mg/ml vial ends up being 0.25 ml - not exactly an easy amount to measure in a 3 ml syringe).
Of course, if I was giving it IM I DID take the time to swap needles
I see absolutely NO reason why this practice should be prohibited... much less reported to the BON!!
As long as your dose is right and your delivery method is right, why should it even be an issue?
I have used TB/Insulin syringes when I've had to give meds such as Droperidol or Ativan (docs end up ordering it in doses like 0.5 mg Ativan which if drawn from a 2mg/ml vial ends up being 0.25 ml - not exactly an easy amount to measure in a 3 ml syringe).
Of course, if I was giving it IM I DID take the time to swap needles
I see absolutely NO reason why this practice should be prohibited... much less reported to the BON!!
As long as your dose is right and your delivery method is right, why should it even be an issue?
cheers,
Good points. And interesting thread.
I give a lot of subQ morphine - for hospice patients.
I give morphine (PO) in 1ml syringes all the time. Most of the time I give it, it's to a newborn withdrawing from methadone. Dosed at .05mg/kg it's pretty hard to draw up or give any other way.
Honestly why make things so difficult. Why put yourself into a situation where you have to use additonal math to correctly draw up insulin if an insulin syringe is readily available. It would be RARE to not have an insulin syringe availabe for use in a hospital setting. It is an increase in risk for mistake. They make insulin syringes for a reason. If there was no insulin syringe available, then maybe, but only if the blood sugar was high enough to risk it. We all are human and no matter how skillful we are at math, we still make mistakes and insulin is not something I would want to make a mistake with. Its just too dangerous. Plus we are setting examples for our patients and they need to only use insulin syringes. What would they think if they see us not doing so. It isnt good practice in my opinion for many reasons.
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frez
88 Posts
If you go to the last post on the thread that november posted on page 5 there is a detailed answer.
Frez