ogrern2002

Any insulin according to ADA and basic Nursing 101, any injectable drug from a multidose vial should be discarded or used in under 30 days...it has to do with the preservative used in the medication to stabilize it, usually something like Benzyl Alcohol. That is one of the reasons safe practice guidelines have us mark a vial. As for the refrigerating after opening of insulin...as long as it is not above around 85 degrees F for a prolonged period of time, no color changes, no cloudiness when it is supposed to be clear and no stopper floaties then it is in theory good for 4 weeks (28 days) after opening....it isn't so much the refrigeration that shortens the expiration date, it is a combination of exsposure to heat and or use. That is why it is important to look at your all your vials.....and truelly only use those vials that state multi-dose vials for more than one dose....I caught a nurse using a dated one dose vial of lido one day trying to infiltrate a laceration....the lido had lost it's effect...we looked it had been opend 3 days previously and was a single dose 20ml vial but somebody thought they were going to save a buck or two and had put it back in the drawer.....single dose vials have no preservatives so as soon as they are accessed and air contaminated the drug usually starts to degrade and sometime it is just a matter of minutes.....the insulin that is a main focus here does have preservatives added and an adjusted pH that aids in the stability of it so yes good for up to 28-30 days after first accesssing......sorry to get geeky on people but I like to have a reason to back up my opinions and stances on things hope everyone is having a good day

Do you happen to store your insulin in the fridge? A cold injection burns...I found that out the hard way myself...and it is safe to store the bottle you are using out of the fridge for up to 4 weeks. My suggestion is to draw and let it sit for 5 to 10 minutes to warm then inject. At least that is how I have done it for years and how I taught kids to do it.

We aren't using NS we are using Bacteriostatic NS, there is a difference, Bacteriostatic has an alcohol preservative that temporarily knocks out the nerve endings locally. However in sufficient amounts the alcohol in the Bacteriostatic can be neurotoxic....that is why you don't use preservative containing drugs in an epidural or with neonates. The other thing is since it is not a "caine" it does not have the sting or electric shock feeling that accompanies the "caines" It is funny I have seen studies, and talked with people in my practice as an IV Nurse, they are having things like Heart Bypasses, Craniotomies, Mastectomies, and they are more scared of the pain of the IV start....I would think as compassionate and caring nurses who's job it is to promote health and alliveiate pain and suffering we would look towards something that might help. Granted it is another poke, but it is like having a TB test....an Intradermal...if done right with good technique..can be virtually painless.

The chemical make up of lantus when mixed with another insulin changes and when injected produces a rather hard and sometimes painful marble like area in the tissue....it also negates the effect of both insulins, and the only way to soften the area so the body will absorb it is to inject more short acting insulin.....it isn't fun either way.......

Try a web search under The Barbara Davis Center for Childhood Diseases. The produce the Pink Panther book for diabetics by Dr Peter Chase. I was a patient of his many years ago and I still have my original Pink Panther book...it has gone through many changes over the years but last I knew it was online in full text and illistration, and just a great over all diabetes reference. Hope this helps.

My facility is currently looking at writing a policy regarding the use of an analgesic (such as Lidocaine, ELmax, Bacteriostatic NS), My question is does anyone else have in policy a requirement to use one prior to an IV start? What are people's feeling on the routine use of analgesics prior to IV starts? Part of the policy also wants a followup 30 to 60 minutes after the start if the patient has pain? Is this reasonable?