Using insulin syringes for another purpose

[kiszi, RN]

Yes, it's drilled into our heads in nursing school, and it's even printed right on the syringe -for U-100 unsulin only- but does anyone ever use insulin syringes for other SQ meds?

Let me explain my rationale:

Pt. needs 1mL of heparin SQ. Smallest needle available is 25g 5/8".

Giving it is a difficult task considering the small sub Q layer some of these tiny ladies have. Also quite a painful jab. 100 units of insulin=1ml, correct? So just draw up to 100 units, and spare the pt. quite a bit of trauma by using a smaller needle. Similarly if the dose is 0.5ml, use the line for 50 units.

Please don't flame me for not going "by the book". I would however appreciate any solid reasons why this is or is not a good practice. Is there something I'm missing here?

[cardiacRN2006, ADN, RN]

Actually, for Sub-q heparin I use a TB syringe. We don't have 100unit insulin syringes, only 50units.

I also use a TB syringe when I'm drawing up Phenergan or Benedryl, etc, any med where I don't need the entire mL of fluid. So Benedryl is 50mg/mL and the order is usually 25. It's easier to measure with the TB syringe, and then I squirt the syringe into my prefilled NS flush.

[txspadequeenRN, BSN, RN]

i have a patient that i give sub-q morphine to in a insulin syringe.

[TheCommuter, BSN, RN]

My workplaces provides us with the 100iu insulin syringes. I have used them on occasion to administer SQ heparin, glucagon, and other medications that call for subcutaneous administration.

[pagandeva2000, LPN]

I've used insulin syringes to administer heparin. Have not had to use them to administer glucagon (although I know that people have), because the kits we have include their own syringe.

[TazziRN, RN]

The first time I saw someone use an insulin syringe for something else, I spent time trying to explain to him why he couldn't do that. Imagine how stupid I felt when it was pointed out to me that the insulin syringes are either 0.5 or 1 ml syringes, so they can be used for other meds.

[HeartsOpenWide, RN]

I worked at a needle exchange clinic, they passed out insulin syringes to the heroin addicts

[preciousmofo]

We use them to give lidocaine for numbing prior to an IV stick.

[NurseNature]

But... aren't there some meds that you have to have a larger guage needle? Does it usually say what guage needle is needed for each med in the med handbooks, or was this just something I have heard in school?

[BluntForceTrauma]

When giving a medication such as Heparin where the whole vial will be given (5,000 units/ml), I will use a 100Units insulin syringe if a TB syringe isn't readily available, which ever one I see first. But for other medications when measured doses such as 0.25 mL are called for, I will definitely use a TB syringe.

[Reno1978, BSN, RN]

I think this is where good nursing judgement comes in. Like others have said, I wouldn't be opposed to using an insulin syringe to do a 1mL heparin subcuteneous injection. I feel bad when I have to give sq injections using a 25g 5/8" needle, which is the smallest gauge and shortest we stock on my unit.

During my community practicum in school I was assigned to a HIV clinic and some clients injected Fuzeon BID and it was a 1mL sq and many were advised by the nurses to use the 1mL insulin needles to help with the injection site reactions that are common with that medication since they're 29g needles. The Fuzeon package comes with either 25g or 27g needles for injection and the clients seemed to have more comfort injecting with insulin syringes instead.

Insulin syringes are marked specifically for U-100 insulin. I think that having it printed on the syringe that it's "for use with U-100 insulin only" is more to make sure that U-100 insulin isn't drawn up in a different type of syringe rather than preventing the syringe from being used for other medications. I could see how that may cause a complication. I wouldn't feel comfortable drawing up 7 units of insulin in a TB syringe, for example.

[Burnt Out, ASN, RN]

If I have a 1 ml insulin syringe and I do not have access to a smaller subq needle (like a guage smaller than 25 5/8) and the exact volume of med to be given is 1 ml, I will use an insulin syringe.