Mix 250 units of regular human insulin in 250 mL of normal saline (1 U/mL). Flush approximately 30 mL through the line prior to administration. Do not use a filter or filtered set with insulin. Piggyback the insulin drip into intravenous fluid using an intravenous infusion pump with a capability of 0.1 mL/hr.
What do I need to start insulin infusion?
111–140 mg/dL Start insulin infusion @ 1 unit/hour. 141–175 mg/dL Start insulin infusion @ 2 units/hour. 176 – 220 mg/dL Give 2 units IV bolus of regular insulin and start insulin infusion @ 2 units/hour. 221– 300 mg/dL Give 4 units IV bolus of regular insulin and start insulin infusion @ 3 units/hour.
When should I start insulin infusion?
Insulin infusions must commence at least 2 hours prior to an invasive procedure if the patient is to be fasted. Additional maintenance intravenous fluid (in addition to the glucose infusion) may be prescribed depending on the patient’s volume status, renal and cardiac function.
How do you administer IV insulin?
If pushing undiluted insulin, inject insulin rapidly IV push. a. If following ACLS guidelines, mix 50 ml 50% dextrose in a mini-bag with 10 unit regular insulin and give IV over 15 – 30 minutes.
What is the starting rate for insulin drip?
The initial insulin dose is a continuous IV insulin infusion using an infusion pump, if available, at a rate of 0.1 U/kg/h.
How do you give insulin infusion in DKA?
Key DKA management points
- Start intravenous fluids before insulin therapy.
- Potassium level should be >3.3 mEq/L before the initiation of insulin therapy (supplement potassium intravenously if needed).
- Administer priming insulin bolus at 0.1 U/kg and initiate continuous insulin infusion at 0.1 U/kg/h.
How do you make insulin infusion for DKA?
A mix of 24 units of regular insulin in 60 mL of isotonic sodium chloride solution usually is infused at a rate of 15 mL/h (6 U/h) until the blood glucose level drops to less than 180 mg/dL; the rate of infusion then decreases to 5-7.5 mL/h (2-3 U/h) until the ketoacidotic state abates.
What is an insulin infusion?
Intravenous insulin is only administered in a diabetic or other emergency; people with diabetes administer their daily insulin doses subcutaneously. Intravenous insulin therapy is a treatment procedure to manage high blood sugar (hyperglycemia) with intravenous infusion of insulin.
How long is an insulin drip good for?
IV insulin has a very short duration of action (minutes), and the onset of basal subcutaneous insulin is 1-2 hours. Thus, IV insulin should be continued for 1-2 hours after the first administration of subcutaneous basal insulin.
Do you dilute IV insulin?
Regular insulin can be given as an IV push undiluted. The only reason to dilute it is to facilitate low dose continuous infusion if this is what is needed.
What type of insulin should be administered before discontinuing an IV insulin infusion?
A short-acting or rapid-acting insulin should be injected before IV insulin drip discontinuation (1 or 2 hours before, respectively), or an intermediate- or long-acting insulin should be administered 2-3 hours before discontinuing the IV drip if the patient is not expected to eat.
What should I monitor with insulin drip?
The ADA and AACE recommend hourly blood glucose monitoring for patients receiving IV insulin therapy except for patients with stable blood glucose within the target range, for whom monitoring can be performed every 2 hours. Some protocols have used a monitoring schedule of every 4 hours.