Only 5 units of insulin per injection site??

Nurses General Nursing

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While doing clinicals in the ICU I had the RN tell me that you should not inject more than 5u of insulin per injection site because the body cannot absorb more than that from one location. So for a patient that needs 15 units for example you would inject 5u in upper arm, 5u a few inches lower and 5u a few inches lower-all from the same needle and syringe.

I had never heard this so I asked him if he was taught this in nursing school. He said no but his brother who is an NP at a diabetes clinic teaches it to all his patients. I have scoured the internet for research to back this up but have not come across anything.

Has anyone heard this before? Do you believe its true? Is there research to back it up?

Specializes in Medical.

I'm a diabetes CNS - you may, on occasion, split huge doses, but I've given over a hundred units in one site without incident. The important information about insuling and injection sites is 1) to rotate sites to avoid causing longterm issues with scarring and uneven absorption, and 2) ensure ultra long acting insulins are administered in a different area than all other insulins (eg opposite arms), while still rotating sites.

Congratulations to the OP for recognising that this was a bizarre concept, researching it, and seeking clarification here. That, right there, is the critical thinking we all hear so much about :)

Specializes in ED/ICU/TELEMETRY/LTC.

Yeah, well, my mother's first husband's step son by his third wife is a dermatologist too, but I'm not taking his advice either. Do what your instructor tells you, and if you get grief from this dodo again, ASK HIM TO SHOW YOU THE POLICY.

Specializes in MED/SURG STROKE UNIT, LTC SUPER., IMU.

This is crazy. I have given lots and lots of insulin and it absorbs just fine. Everyone has taked about the infection issue and the pain or multiple injections, all of which I was going to say, but no one addressed the fact that we are talking about using the same needle which is going to be dull at all get out after the first couple of shots. It would be like giving a shot with a blunt instrament! YIKES!

Specializes in Peds, School Nurse, clinical instructor.

simply not true...

That is crazy and so untrue! :uhoh21:

Specializes in Gerontology, Med surg, Home Health.

You could repost this in the Oops Things That Make You Go Huh!? thread. It's good practice to know your facility policy and not follow the suggestions of someone who quotes a relative which is the same thing, really, as an unknown source. :yeah: for questioning something that didn't seem right.

So basically...no its not true. Let your instructor know because You shouldn't say anything to the nurse except for "I am not comfortable doing that without verifying with my instructor" our instructors must be with us for every invasive procedure, especially insulin or heparin injections.

Specializes in Geriatrics, Pain, End of Life Care.

Consult your instructor. I have never heard of such a thing.

Oh my goodness - NO.

They make 100u syringes for a reason, and it's completely okay to give up to 100u per injection site (anything above 100u would have to be given in separate sites because they would need a second syringe of insulin anyway, so you could divide the dose into two separate injections as elthia previously stated).

I would have soooo many noncompliant patients if they had to give that many separate injections -- usually the finger stick and one poke to give the insulin is already the most they can handle. In addition, the risk for infection would be greater. And in the outpatient world, there is no way insurance companies would cover the use of that many syringes (so even if people were compliant with that philosophy, they would be tempted to re-use needles which makes infection an even greater possibility).

Any subQ medication is best absorbed in abdominal tissue, but rotating sites is still recommended.

I would inform your instructor about what this person is telling you -- your instructor may decide to speak with the ICU manager about this.

I'm glad you posted your question and doubted what this person was telling you. Way to go with your gut instinct! Good luck to you!

Specializes in Med-Surg; Telemetry; School Nurse pk-8.

No more than 5 mL per site for an IM injection. Is that where the number 5 is coming from?

Insulin is a whole different thing. This is an SC injection, given with it's own syringe, which is measured in units. 1 unit of insulin is NOT equal to 1 mL (1mL insulin would be about 100 units!!). Also, you are delivering insulin SC not IM. Someone has misunderstood something along the way.

Specializes in Nephrology.

Okay, I just figured out that with this plan I'd have to give myself about 40 shots a day. Um, no. Never heard of this, have nursed many diabetics and being one for over 15 years...... I feel for this person's pts if that is what they are being taught.

YEEOUCH!!! I take 65u 70/30 + SS in the AM, SS before lunch, and 40 + SS at dinner.

According to whomever, I might need over 30 injections/day!!! I think not!

I have a hard enough time convincing myself to do 3-4 injections/day, not including all those fingersticks.

Again, I say, YEEOUCH!!!

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