>> Hi, I'm Dr. Emily Walker, a VA pharmacist, and I would like to discuss
with you the proper way to give yourself insulin using an insulin pen.
There are many different types of insulin pens available from the VA.
In this video, I will be demonstrating one specific type
of insulin pen called the "FlexPen."
Other names of insulin pens prescribed
by your provider may include FlexTouch, SoloSTAR, or KwikPen.
What is important for you to know is that the correct technique that I will show you
in this video is very similar to what you would use for any of the other insulin pens mentioned.
Remember, what insulin to use, how much to give,
and when to give yourself the insulin will be told to you by your VA provider.
Let's get started.
When you're preparing to give yourself insulin, you want to make sure
that you place all the proper supplies on a flat surface ready to go.
These supplies include your insulin FlexPen, or whatever insulin pen you may be using,
your pen needles, an alcohol swab, and a sharps container.
If you do not have a sharps container, you can use a heavy plastic container
such as an old laundry detergent bottle and write "used needles"
on the side with a permanent marker.
Before injecting yourself, wash your hands with soap and water.
When your hands are dry, pull off the pen cap from the insulin pen and set it aside.
Next, inspect the insulin through the viewing window.
Do not use the insulin if you notice a change in color
or if you notice things floating in the insulin.
By inspecting the insulin pen, you will also be double checking
that you have the correct type of insulin.
As I mentioned already, for our example today, I'm using the NovoLog FlexPen
which has been prefilled with insulin aspart.
After inspecting the insulin pen, put it down and open an alcohol swab.
Wipe the rubber stopper on the end of the insulin pen with the swab.
Allow the rubber stopper to air dry completely.
Do not blow on the rubber stopper to dry it as this will introduce germs from your mouth.
Next, pick up the pen needle and remove the protective paper covering.
Grasp the base of the pen needle and carefully screw the pen needle on to the insulin pen.
Make sure the pen needle is screwed on straight and hand-tightened
so that it pierces the rubber stopper completely.
Make sure you do not over-tighten the pen needle as the pen needle base is plastic and can crack.
Next, pull off the clear plastic outer needle cap.
You will see a second inner needle cap still covering the needle.
Remove the inner plastic needle cap.
Both plastic caps can be disposed of in your regular household trash.
It is important to always use a new pen needle
for each injection to reduce the risk of infection.
Never reuse or share needles with your family or friends.
Next, you will complete an air shot with the insulin pen
which should be done before each injection.
An air shot is sometimes called "priming."
Doing so removes any air that is trapped in the needle.
Turn the dial up to two units.
Hold your insulin pen with the pen needle pointing straight up
and lightly tap the insulin pen with your finger a few times
to make sure any air bubbles move to the top.
Next, press the push button all the way in.
The dial should return to zero.
You should see a drop of insulin appear at the tip of the pen needle.
If the drop does not appear, repeat the process.
This can be repeated up to six times.
If it still does not work, try using a new pen needle.
If that doesn't work, then try a new insulin pen.
Next, select your insulin dose.
Check to make sure the dial is set to zero,
then turn the dial selector to the desired number of units.
The pointer arrow should line up with your desired dose.
The dose can be corrected up or down by turning the dial.
For example, if you were prescribed insulin aspart 10 units before meals,
you will dial up to 10 in the pen window while making sure the arrow lines
up with the desired number of units.
Be careful not to press the push button while selecting your dose
or the insulin will come out prematurely.
You will hear a click for each unit you dial.
It is not recommended that you attempt to dose based on how many clicks you hear
as this may result in an incorrect dose.
Please note, towards the end of the insulin pen use, you will not be able to dial more
than the number of units remaining in the insulin pen.
Next, if your skin is not clean, use an alcohol swab to clean the site before injection.
If you've just bathed, you may not need to clean the area with alcohol.
Remember, alcohol can be very drying to your skin,
so you don't want to apply alcohol to your skin if not needed.
Insulin can be injected into either your abdomen or stomach area, buttocks,
on the high hip upper outer area, thigh, or upper arm.
That is the back fattier part of your upper arm and not the muscle area.
The needle you are using is thin and may bend.
You may find that pinching your skin gently before injection can prevent bruising
and decrease the chance of bending the needle.
It is recommended that you rotate to different sites each time you use the insulin pen.
If you plan to be physically active right after the injection, it is recommended to rotate
around your stomach area only rather than to the arms, legs, or buttocks.
Avoid injecting insulin into any area of skin that has pits, is thickened, or has lumps.
Avoid injecting where the skin is tender, bruised, scaly, or hard.
In addition, stay one to two inches away
from your belly button, scars, or skin with open wounds.
If you are injecting more than one type of insulin, use different injection sites
as the insulins won't work as intended if injected in the same site together.
For instance, give your basal or long-acting insulin on the left side of your stomach
and then give your bolus or rapid-acting insulin on the right side of your stomach.
Insert the insulin pen into your skin straight in and not angled.
Again, if there is not enough fatty tissue, pinch a one to two-inch portion of skin in fat.
Once the insulin pen needle is inserted into your skin, keep it in place
and press the push button on the insulin pen all the way in and maintain it pressed
until the arrow next to the dial returns to zero.
Keep it pressed for a full six seconds after the dial is at zero
to make sure all the insulin is injected.
Now you can remove the insulin pen.
A small drop of insulin may appear at the end of the needle.
This is normal and can be expected.
If a drop of blood appears on your skin after you remove the insulin pen,
press the injection site lightly with a gauze pad.
Do not rub the area.
Once the injection is completed, do not recap the needle
as this can cause an accidental needle stick injury.
Remove the pen needle from the insulin pen
by grasping the sides of the plastic hub and twisting.
Discard the pen needle into the sharps container.
Place the pen cap back on and store the insulin pen in a safe location.
Your insulin pen can be stored at room temperature below 86 degrees Fahrenheit for up
to 28 days away from heat or light.
It is recommended that you keep your unused insulin pens in the refrigerator between 36
to 46 degrees Fahrenheit as the insulin pens can be safely stored
until the expiration date on the label.
Never freeze insulin.
When the insulin pen has been completely used up,
it will not allow you to give any additional doses.
At that time, you can discard your insulin pen
with the pen needle removed into your household trash.
The pen needles should always be placed into a sharps container.
You have successfully given yourself a dose of insulin using an insulin pen.
Good job. I thank you for your service to our country and I'm honored
to be of service to you this day.