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Wed 23 Nov, 2005 11:18 am
Insulin
Has anyone heard the reason for not aspirating on insulin, because it causes tissue damage?
I think because we only do insulin injection to the subcutaneous, no blood vessels there.
The reason you aspirate is to check to make sure you are not in a blood vessel. Question: why are you wondering why there might even be blood in fat? The actual needle isn't even long enough to reach blood. Unless in very rare cases, the patient is so thin, but even that is so rare it basically doesn't even count. You never aspirate on insulin or heprin and the reason why for heprin is because that will case major discomfort for your patient because it is very irritation to the surrounding tissue. Hope that helps. Good Luck.
I beg to differ, after 32 years of nursing I can site multiple times I have hit blood vessels when giving insulin. What you are saying doesn't make any sense. Of course you have blood vessels in the fat, how do you think fat lives if it does not recieve blood. Didn't you do an OR rotation when you were in school? If you did, you would know there are blood vessels in fat. The fat is under the skin surface, how do you think the skin cells are supplied with blood unles those vessels run thru the fat. I do not know what they are teaching you ladies in school today, but we were taught to always aspirate with insulin.
Yes, there are blood vessels in the subcu region and yes it was practiced before to aspirate before injecting insulin but nowadays since we're using insulin pen or the likes that the needles are very thin and short that there's very little chance that we'll hit a blood vessel. I've not heard any association between aspiration and tissue damage.
insulin injections
Again I beg to differ. We were using insulin and TB syringes when I started nursing 32 years ago. I occasionally hit blood vessels with those needles over a 32 year career. Whatever they teach you young nurses today is fine for you, but I know I have hit vessels and I will never give insulin without aspirating to make sure I am not in a blood vessel. If I go to court I have to stand on my experience and knowledge so I retain the right to do what I can justify. If you don't aspirate you won't know you hit a vessel and when your patient has problems you will wonder what happened, maybe just say he is a brittle diabetic and never know you injected him with iv insulin instead of sq.
According to the latest literature, aspiration is no longer needed when injecting insulin. Aspiration was an extra step in the injection process that was not only time consuming, but also wasn't possible to do with a pen device. It's no longer considered necessary by doctors.
Another reason for not recommending aspirating relates to the possibility of bruising from the inevitable wiggling of the tip of the needle that's going to occur as you aspirate. Shifting your fingers and/or hands to do the aspirating would seem likely to increase the chance that there will be additional trauma in the skin tissues, causing micro-bleeding and thus causing visible bruising.
insulin is very irritaing to the tissue as it burns while it goes into the patients skin(especialy lantus) thats why insulin should be given at room temp. and never cold. as far as aspirating i was never tought to aspirate insulin.besides the needle is only 1/2" long.