Mixing Insulins for Subcutaneous Administration

Key Concepts

• Common Insulins Involved: Intermediate or long-acting insulin like NPH and short-acting insulin like regular insulin.
• Mixing Rule: Draw up clear (regular) before cloudy (NPH).
  • Clear before cloudy helps prevent cross-contamination and ensures accurate dosing.

Steps to Mix Insulins

1. Calculate Total Volume Needed

   • Example: 10 units NPH + 5 units regular = 15 units total.

2. Prepare Vials

   • Open both insulin vials.
   • Clean the tops with separate alcohol pads to avoid contamination.

3. Air Injection

   • Draw back air in the syringe equal to the total insulin dose needed (15 units in this example).
   • Inject 10 units of air into the NPH vial (cloudy).
   • Remove the needle from NPH.
   • Inject 5 units of air into the regular insulin vial (clear).

4. Drawing Insulin

   • Regular Insulin First: Invert regular insulin vial and draw up 5 units.
     • Draw slowly to avoid overdrawing.
   • NPH Insulin Second: Insert needle back into NPH, invert vial, and draw 10 units.

5. Administration Preparation

   • If not administering immediately, recap and label the syringe:
     • Include drug names, doses, date, time, and your initials.

Important Points

• If you overdraw insulin at any point, discard and start over as mixed insulin cannot be reinjected into vials.
• Following the steps precisely prevents cross-contamination and ensures correct dosing.

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Reminder: Practice these steps to ensure patient safety and effective treatment administration. Happy nursing!