The RT News
Newsletter of Division 11
March 2008

Message from the Chair:
“Chicago: My AER Kind of Town”

Have You Tried This?

• Kapoosh, a knife holder
• Spiral Eye Needles
• Silicone Oven Mitts

In Memoriam:

APH Ad:

Sugar Blues: Insulin Pens – What are they and how do they work

1. Identifying pen if using more than one:
   • some pens have a physical feature, a band or the dosage knob, that is different in color for each insulin formulation in that pen style.
   • For those that have no distinctive marking, a piece of bright fluorescent tape can be placed on the pen cap and moved to each succeeding pen for that insulin. A matching piece of tape can be placed on the box of 5 pens.
   • Rubber bands can be placed on the cap, usually no more than 2 or 3. The client can be instructed to follow one of the following memory devices - time of day (1 band on morning pen, 2 bands on evening/nighttime pen; 1 band for 1x/day insulin, 2 bands for the 3x/day/mealtime insulin pen.)
2. Removing pen tip from package:
   • each pen tip or needle is packaged separately and is usually purchased in bulk quantities of 100.
   • A small paper tab is pulled off to remove the individual pen tip from its paper package.
3. Applying pen tip to pen – the pen tip screws on clockwise; the outer cover is pulled off first, followed by a second smaller cover
4. Priming pen/performing “air shot”-- Priming is necessary before each injection in order to remove air bubbles.
   • Priming usually requires drawing up and expelling 2 units of insulin until an insulin drop can be seen at the tip of the needle.
   • For visually impaired an insulin drop can be felt or smelled; or
   • Flick the insulin drop on the inner forearm. Blowing on it will help user discern the moisture.
5. Operating dose dial/setting dose – an audible and tactual click can be heard and felt with each increment of insulin drawn
6. Correcting dose dialing error – most can be back dialed. For absolute accuracy dial back to zero if a dialing error is made and then redial.
7. Injecting insulin (pushing down dosage knob) - each pen varies in the injection force required to fully depress the dosage knob.
   • The greater the insulin dose the more extended press required.
   • A ratcheting type of sound provides feedback that the insulin is leaving the pen tip, and a hard end feel can be noticed when the knob has been completely depressed.
8. Removing pen tip – the outer cover is reapplied and turned counterclockwise to remove the needle.
   • A pen needle clipper is also now available from Owen Mumford, if the person as difficulty aligning the outer cap and pen needle.
9. Safe disposal of the used needle in an enclosed container is essential.
10. Inserting insulin cartridge (on refillable) – when the insulin cartridge is inserted the rubber stopper end should be placed at the end of the pen where the needle attaches.
    • Pens vary on added techniques required to set the cartridge properly in the pen. See pen manual instructions or pen company/representative for details.
11. Knowing when insulin pen is empty.
    • Each pen will only give 300 units total and when that point has been reached the pen is empty and will no longer dial.
    • If the person is in the middle of his dosage he can choose to give this amount and then finish the dose from a second new pen.
    • If the pen has little in it he can choose to throw the pen away and take his full dose with the new pen.
    • To obtain a close figure of how many doses the pen contains follow this example:

    • John takes 40 units of Lantus per day
    • 300 units divided by (40 units + 2 units for priming prior to each use) = 7 doses of 40 units each, 2 priming units per dose and 6 units left over.
    • A person can also keep a progressive mathematical computation subtracting each dose as taken from the same insulin pen.

Humalog, Humulin N, Humalog Mix 75/25, Humulin Mix 70/30, Humulin Mix 50/50, Lantus, Levemir, Novolog, Novolin R, Novolin N, Novolog Mix 70/30, Novolin Mix 70/30. Cartridges or penfills are available in: Apidra, Humalog, Lantus, Novolog, Novolin R, Novolin N, Novolog Mix 70/30, Novolin Mix 70/30. One company, Owen Mumford makes a refillable pen which is compatible with Humalog cartridges.

About the Author, Debra A Sokol-McKay:

Wanted: Your Expertise On Paper

We NEED Action – We NEED YOU !
Nominees for Chair-Elect

PCO Job Announcements

1. Coordinates all aspects of the VRT Program
2. Teaches VRT specific courses (on-line and face-to-face): Principles of Rehabilitation Teaching, Independent Living, and Communication Courses, and Co-Teach Core Courses
3. Recruits and advises VRT students
4. Teaches and assists with supervision in other certified areas ( e.g., O&M or Low Vision or TVI)
5. Serves as a member of the Graduate Studies management team
6. Assures that the VRT program meets State, Middle State and ACVREP Standards, and assists in other program area standards
7. Maintains records and prepares all reports for accreditation, grant, and program approval.
8. Coordinates curriculum development and design of VRT courses and assists in other program development.
9. Develops and manages VRT extramural grant efforts including collection of data and preparation of state, federal and other required reports for VRT and assists in other extramural grant efforts.
10. Arranges and supervises VRT internships and assists in other certification areas, including community and in-house student/client/patient assessment and instruction.

1. Coordination of all aspects the fieldwork, practicum and internship experiences for masters degree and certificate students in the four program disciplines
2. Works cooperatively with the four program directors.
3. Works with qualified and certified supervising TVIs, O&M specialists, Low Vision Rehabilitation Therapists, and Vision Rehabilitation Therapists.
4. Coordination of CRSP, which includes development of contracts with individuals, school districts and others for the provision of comprehensive assessments and direct services.
5. Recruitment of additional qualified and certified supervisors in all four program areas.
6. Processing and correction of fieldwork, practicum and internship assignments.
7. Supervision of interns as appropriate with qualifications.
8. Works with all four program directors to assure programs meet State Standards, as well as other standards for personnel preparation set forth by CEC, AER, and ACVREP.
9. Works with program directors on grants report preparation for state, accreditation, and other program credentials.
10. Overall management of fieldwork, practicum and internships including collection of data for all official uses.
11. Teaching responsibilities as appropriate with qualifications and interest.

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