Insulin Pens An interactive, instructional module on the correct technique of insulin pens

Instructions Click on pen needle to go back one page. Click on logo to go to the next page. Blue Text indicates actions to be performed or demonstrations. TEXT

Objectives Upon finishing this module, you should be able to … Identify areas of the body where insulin can be administered Demonstrate how to load a dose of insulin with an insulin pen Demonstrate how to administer a dose of insulin with an insulin pen Identify how to discard used pen needles

Why are you taking insulin? Insulin is an injectable medication that is used to treat either Type I or Type II diabetes mellitus. It helps control your blood sugar and is important in preventing symptoms associated with high blood sugar. Those symptoms can include increased thirst, headaches, frequent urination, and fatigue.

Types of insulin Insulin Type Color Onset ((time) Peak ((time) Duration(time) Rapid Acting: Humalog® (lispro), Novolog® (aspart), Apidra® (glulisine) Clear 0 - 15 minutes 30 - 90 minutes Up to 5 hours Short Acting: Novolin R® 30 minutes 2 - 5 hours Up to 8 hours Intermediate Acting NPH: Humulin N®, Novolin N® Milky white when mixed (rotate vial to mix) 2 - 4 hours 6 - 10 hours Up to 20 hours Long Acting: Lantus® (glargine), Levemir® (detemir) 1 - 2 hours No peak Up to 24 hours Premixed - Short and Intermediate Acting: Humulin® 70/30, Novolin® 70/30, Humulin® 50/50 Milky white 30 minutes - 1 hour 1 - 6 hours 14 hours Premixed - Rapid and Intermediate Acting: Humalog-Mix® 75/25, Novolog-Mix® 70/30, Humalog® 50/50 30 minutes - 12 hours

Why use insulin pens? Convenient and disposable Easy and conspicuous to store Easy to prepare insulin doses Less painful than traditional syringes

How to use insulin pens

locations The upper arms are good locations to inject insulin. However, only use the outside and back of the arm. The abdomen is a popular location due to its ease of access. Inject insulin at least 2 inches away from the bellybutton. Insulin should be injected in only a few sites on the body. Click on shaded areas to learn more about that location. The thighs and buttocks are a convenient location because of easier access to subcutaneous tissue. Only use the outside of the thighs.

Supplies needed Insulin pen Pen needle Alcohol swab http://www.diabeteshealth.com/browse/products/pens/ http://shanghaikdl.en.made-in-china.com/product/nMcQFoZOMGId/China-Insulin-Pen-Needle.html http://www.tridentpharm.com.sg/Othert-Disposables.htm

Procedure Unwrap alcohol swab. Use a circular motion to clean area to inject, working from inside to outside. Use the same swab to clean the top of the insulin pen with one simple swipe across the surface. Click text to see. Allow skin to air dry.

Procedure D d Peel back cover on the pen needle. Remove cap from insulin pen. Screw in pen needle clockwise.

Procedure Refer to dosage window on pen. Twist the end of the pen until the correct dose is in the window. Before every shot, prime the pen by discharging 2 units into the air. Dial pen to amount of units needed. http://petdiabetes.wikia.com/wiki/Insulin_pen

procedure At area to inject, pinch an inch of skin. Insert needle into skin at 90○ angle. Push down on the other end of the insulin pen all of the way down. Wait a few seconds. Remove needle from injection site. http://www.phartoonz.com/2010/10/24/how-to-give-an-insulin-injection/

procedure 36°F - 86°F Twist pen needle counterclockwise to remove. NEVER keep pen needle on insulin pen. Place cap on insulin pen. Store at room temperature. 36°F - 86°F

procedure Discard pen needle in sharps container. *** Any container made of hard plastic or metal can be used as a sharps container. Which of the following containers would be appropriate to use as a sharps container? Click on picture for answer. OK! OK! OK! http://www.accesshealth.com.au/practice-supplies/accessories/1403/terumo-sharps-container-14lt/ http://www.whataboutclients.com/archives/2008/09/index.html http://www.asktheexterminator.com/flies/Homemade_Drain_Cleaner_printer.shtml http://www.123rf.com/profile_jckca http://www.blackgarbagebags.com/2010/11/how-are-garbage-bags-made/ http://realanonymousgirl.wordpress.com/2011/03/21/fishing-in-the-toilet/

Video Demonstration

Are you ready to test your knowledge Are you ready to test your knowledge? Go back to review any material you would like. Click the logo to proceed to assessment

assessment To answer a question, click on the letter next to the corresponding answer. A Click here to begin http://www.clker.com/clipart-mouse-pointer.html

Question #1 Which area of the body should you NOT inject insulin? CORRECT! Please click the logo to continue. A Abdomen Upper Arm Fingers Outside of Thighs B That is incorrect. Please try again. That is incorrect. Please try again. That is incorrect. Please try again. C D

Question #2 It is okay to inject insulin within 2 inches of the bellybutton. CORRECT! Please click the logo to continue. A True False B That is incorrect. Please try again.

Question #3 What is absolutely necessary before every injection? CORRECT! Please click the logo to continue. A Prime Insulin Pen Check Blood Sugar Eat a Meal Use a New Insulin Pen B That is incorrect. Please try again. That is incorrect. Please try again. That is incorrect. Please try again. C D

Question #4 Which of the following windows show that 11 units are ready to be administered? CORRECT! Please click the logo to continue. A 8 B 10 10 12 12 14 That is incorrect. Please try again. That is incorrect. Please try again. That is incorrect. Please try again. C D 10 2 12

Question #5 Which angle is the correct angle to inject insulin? Please click the logo to continue. A B C D That is incorrect. Please try again. That is incorrect. Please try again. That is incorrect. Please try again.

Question #6 CORRECT! A B That is incorrect. Please try again. Which of the following containers can you NOT store used needles? CORRECT! Please click the logo to continue. A B That is incorrect. Please try again. That is incorrect. Please try again. That is incorrect. Please try again. C D

Question #7 Open insulin pens can be stored at room temperature. CORRECT! Please click the logo to continue. A True False B That is incorrect. Please try again.

Cleaning Area of Injection Congratulations! You have finished the assessment. Click on any link below to go back and review any material. Click on logo if you feel comfortable using an insulin pen. Locations Dialing Dose Supplies Needed Administering Dose Cleaning Area of Injection Removing Pen Needle Attaching Pen Needle Discarding Pen Needle

locations The upper arms are good locations to inject insulin. However, only use the outside and back of the arm. The abdomen is a popular location due to its ease of access. Inject insulin at least 2 inches away from the bellybutton. Insulin should be injected in only a few sites on the body. Click on shaded areas to learn more about that location. The thighs and buttocks are a convenient location because of easier access to subcutaneous tissue. Only use the outside of the thighs.

Supplies needed Insulin pen Pen needle Alcohol swab http://www.diabeteshealth.com/browse/products/pens/ http://shanghaikdl.en.made-in-china.com/product/nMcQFoZOMGId/China-Insulin-Pen-Needle.html http://www.tridentpharm.com.sg/Othert-Disposables.htm

Procedure Unwrap alcohol swab. Use a circular motion to clean area to inject, working from inside to outside. Use the same swab to clean the top of the insulin pen with one simple swipe across the surface. Allow skin to air dry.

Procedure D d Peel back cover on the pen needle. Remove cap from insulin pen. Screw in pen needle clockwise.

Procedure Refer to dosage window on pen. Twist the end of the pen until the correct dose is in the window. Before every shot, prime the pen by discharging 2 units into the air. Dial pen to amount of units needed. http://petdiabetes.wikia.com/wiki/Insulin_pen

procedure At area to inject, pinch an inch of skin. Insert needle into skin at 90○ angle. Push down on the other end of the insulin pen all of the way down. Wait a few seconds. Remove needle from injection site. http://www.phartoonz.com/2010/10/24/how-to-give-an-insulin-injection/

procedure 36°F - 86°F Twist pen needle counterclockwise to remove. NEVER keep pen needle on insulin pen. Place cap on insulin pen. Store at room temperature. 36°F - 86°F

procedure Discard pen needle in sharps container. *** Any container made of hard plastic or metal can be used as a sharps container. Which of the following containers would be appropriate to use as a sharps container? Click on picture for answer. OK! OK! OK! http://www.accesshealth.com.au/practice-supplies/accessories/1403/terumo-sharps-container-14lt/ http://www.whataboutclients.com/archives/2008/09/index.html http://www.asktheexterminator.com/flies/Homemade_Drain_Cleaner_printer.shtml http://www.123rf.com/profile_jckca http://www.blackgarbagebags.com/2010/11/how-are-garbage-bags-made/ http://realanonymousgirl.wordpress.com/2011/03/21/fishing-in-the-toilet/

You have completed the learning module You have completed the learning module. Please demonstrate to an instructor on how to use an insulin pen.