Materials Preparation

Insulin syringe (with a needle) Alcohol pad Short-acting insulin and intermediate-acting insulin bottles. Syringe collection container (with a lid and impenetrable protection)

Injection Steps

Wash your hands.
Check whether the insulin solution expires or goes bad, or whether the bottles have cracks or defects.
Remove the cap off the insulin bottle.
Before use, the intermediate-acting insulin bottle should be placed horizontally on the palm of the hand and gently rolled to make the medicine mix evenly. Do not shake the bottle up and down to avoid foaming.
Use alcohol pads to wipe the rubber stoppers of insulin bottles.
With the syringe needle pointing upwards, rotate it to remove the cap.
Extract the air which is equivalent to the required intermediate-acting insulin injection dose.
Place the intermediate-acting insulin bottle on the table, insert the needle into the rubber stopper, and press the plunger of the syringe to inject air, which will help draw out the required dose correctly.
Extract the air which is equivalent to the required short-acting insulin injection dose.
Place the short-acting insulin bottle on the table, insert the needle into the rubber stopper, and press the plunger of the syringe to inject air.
Hold the short-acting insulin bottle and syringe upside down (bottle above, syringe below). The bottle should be straight with the syringe, with the eyes looking straight at the scale. Pull the syringe plunger slowly till the scale a little larger than required dose. Note if there are any bubbles. Flick the air bubbles in the syringe from bottom to top with your fingers, push the excessive solution and air bubbles back into bottle, and then remove the syringe out of the bottle.
Insert the syringe into the intermediate-acting insulin bottle, hold it upside down, and pull the syringe plunger straight to the scale for required dose. Then remove the syringe out of the bottle. Note if there are any bubbles. If the dosage is incorrect, it must be discarded and re-extraction must be done, without returning the solution to the bottle.
Disinfect the injection site with an alcohol pad.
Choose the right site for injection and wait for at least 10 seconds before pulling out the needle.
After the injection is finished, put your thumb against the white plunger and push it up as far as it can go until you hear a "click," indicating that it is finished (the needle is completely enclosed), and you don't need to put the cap back on.
After use, the needle is thrown into the collection bin, which is then taken back to the hospital and discarded like medical waste.

Injection Sites

Abdomen: Both sides of the abdomen (cover the navel with the fist, and do not give an injection within the scope of the fist).
Thigh: Upper outer thigh.
Arm: The outer portion below deltoid.
Buttocks: Upper outer quadrants of the buttocks.

Injection Techniques

1. Skin pinching: For patients who are too thin or children, use only the thumb and index/middle finger for skin pinching to avoid pinching the muscle.
2. Injection angle: A 45- or 90-degree-angle injection can help reduce the risk of intramuscular injections.
3. Use different injection sites and do not repeat the injection on the same site. The current injection site should be about the width of a finger away from the last site.

Insulin Preservation

1. Insulin human Regular (RI): Unopened bottles can be refrigerated at 2 to 8 ℃ until expiry, while opened ones can be stored at room temperature below 30℃ for 6 weeks.
2. Insulatard HM (NPH): Unopened medicine bottles can be refrigerated at 2 to 8 ℃ until expiry, or at below 25 ℃ for 6 weeks, or below 30 ℃ for 4 weeks.

Syringe Collection

• Drop the used syringes into an impenetrable container and can choose not only take it to the injection room on the first floor of Lifu Medical Building or the first floor of Critical Care Center Building and discard it but also take it discard to the diabetes education room on the 6th floor of Meide Medical building.