PEDIATRICS Vol. 91 No. 6 June 1993, pp. 1155-1157
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Casella, S. J.
Right arrow Articles by Long, C. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Casella, S. J.
Right arrow Articles by Long, C. A.

Accuracy and Precision of Low-Dose Insulin Administration

Samuel J. Casella MD1, Marilyn K. Mongilio RN, BSN1, Leslie P. Plotnick MD1, M. Polly Hesterberg RN1, and Carol A. Long RN, MSN1

1 From the Departments of Pediatrics and Nursing, The Johns Hopkins University School of Medicine, Baltimore, MD.

Objective. To determine the lowest dose of concentrated (U100) insulin that can be reproducibly delivered.

Methods. A telephone survey was used to determine current practices in major pediatric hospitals regarding the administration of low doses of concentrated insulin. A sensitive gravitometric technique was used to determine the error in measurement of low doses of U100 insulin by pediatric nurses and parents of diabetic children.

Results. A telephone survey revealed that doses as low as 0.5 or 1.0 U (5 to 10 µL) are routinely administered in pediatric hospitals. In our study of pediatric nurses, attempts to deliver 0.5, 1.0, and 2.0 U resulted in delivered doses of 0.975 ± 0.315, 1.638 ± 0.376, and 2.153 ± 0.435 U (mean ± standard deviation of the mean), respectively. The use of 0.3-mL syringes compared to 0.5-mL syringes did not improve accuracy or precision. Taken as a group, parents of children with diabetes were more accurate (mean delivered dose of 1.063 ± 0.276 for the 1-U dose), but the individual means ranged from 0.641 to 1.300 and coefficients of variation ranged from 5% to 33%. Only three of the seven parents could deliver 1.0 U with acceptable precision and accuracy.

Conclusions. When currently available syringes are used, insulin injections of less than 20 µL (2 U of U100) have an unacceptably large error. It is recommended that, in the inpatient setting, diluted insulin be used if the prescribed dose is less than 2.0 U.

Key Words: syringes • medication errors • insulin • diabetes mellitus

Submitted on August 18, 1992
Accepted on January 20, 1993




This article has been cited by other articles:


Home page
 Am J Health Syst PharmHome page
A. J. Erstad, B. L. Erstad, and D. E. Nix
Accuracy and reproducibility of small-volume injections from various-sized syringes
Am. J. Health Syst. Pharm., April 15, 2006; 63(8): 748 - 750.
[Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
K. Keith, D. Nicholson, and D. Rogers
Accuracy and Precision of Low-Dose Insulin Administration Using Syringes, Pen Injectors, and a Pump
Clinical Pediatrics, January 1, 2004; 43(1): 69 - 74.
[Abstract] [PDF]

Home page
 Arch. Dis. Child.Home page
M G Gnanalingham, P Newland, and C P Smith
Accuracy and reproducibility of low dose insulin administration using pen-injectors and syringes
Arch. Dis. Child., July 1, 1998; 79(1): 59 - 62.
[Abstract] [Full Text]

Home page
 JWatch GeneralHome page
MEASUREMENT ERROR WITH LOW DOSES OF INSULIN
Journal Watch (General), June 18, 1993; 1993(618): 6 - 6.
[Full Text]