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 Cardiology and ER Nursing.
Jerry-Mouse-Facepalm.jpg
Specializes in SNU/SNF/MedSurg, SPCU Ortho/Neuro/Spine.

... Weirdo... What if your patient needs 100 of lantus + coverage? He will look like hell raiser btpy the end of the night....

Specializes in Cardiology and ER Nursing.
... Weirdo... What if your patient needs 100 of lantus + coverage? He will look like hell raiser btpy the end of the night....

Because your post needed a visual.

hellraiser.jpg

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.

I think this may be the key. Nice job!

As a student, the poster may have misunderstood what the NP relative was saying.

I remember the instructor STRESSING the difference between units and mls . . . .something I would never have known before I decided to become a nurse.

Specializes in SNU/SNF/MedSurg, SPCU Ortho/Neuro/Spine.

hellraiser-pinhead-c10040177.jpeg

After 100 of lantus + sliding coverage + hs dose of regular :yeah:

I know where this might be coming from. I am a Type-2 that uses Lantus & Novolog. There's a book called "Dr. Bernstein's Diabetes Solution." He suggests no more than 7u per injection and in thin patients, prefers 3-5 unts max. His argument is better absorbed and I believe he mentioned large doses can be attacked by immune system further decreasing absorbtion.

That's okay if someone wants to go through that at home, but yeah, definite increased infection risk in hospital.

I read the book, but don't follow that advice myself. I daily give 50u Lantus in same site and typically 10-15u of Novolog every time I eat depending on how many carbs.

On another note, I typically use the same needle for my pen for a good week! Too lazy to go to box and get new one each time. After a few uses, they start to hurt and then I get new one. Never had an issue.

That 5 unit thing sounds nuts to me .

Now I know a lot of people that will reuse the needles and lancets that does seem to be common .

Specializes in Medical.
As a student the poster may have misunderstood what the NP relative was saying. I remember the instructor STRESSING the difference between units and mls . . . .something I would never have known before I decided to become a nurse.[/quote']

I don't think that's possible, though. Your instructor emphasised the difference because inexperienced staff can draw up mls by accident - a friend once caught two grads walking into a patient's room with 12ml of Actrapid :eek: But I've never heard of anyone being prescribed a 500ml dose of insulin, which would certainly be too large for one site.

I don't think that's possible, though. Your instructor emphasised the difference because inexperienced staff can draw up mls by accident - a friend once caught two grads walking into a patient's room with 12ml of Actrapid :eek: But I've never heard of anyone being prescribed a 500ml dose of insulin, which would certainly be too large for one site.

I think we are in agreement here.

:)

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