How do you set up an insulin infusion?

How do you set up an insulin infusion?

Insulin infusion

1. 50 ml syringe.
2. Dilute 50 units Actrapid to total of 50 mls normal saline (giving 1 unit / ml)
3. Dilute in saline (for hyperglycaemia) or 5% dextrose (for hyperkalaemia)
4. Start infusion depending on hourly BM readings.

How is insulin drip calculated for DKA?

Remember that insulin is dosed based on weight. E.g., In DKA, you give 0.1 U / Kg as IV bolus and then 0.1 U / Kg/hr IV continuous infusion. For example, for a 47kg patient, I rounded up to give 5 units /hr of continuous infusion. But one of DKA’s diagnostic criteria is a blood glucose of > 250.

What is titration of insulin?

Working out the right amount of insulin to take can often be quite a daunting task. People injecting insulin are advised to alter their insulin doses depending on a variety of factors such as meal time carbohydrate load, pre injection blood glucose, planned or completed exercise and so on.

How do you adjust an insulin drip?

IV. Protocol: Insulin Infusion

1. Turn off Insulin Drip for 30 minutes.
2. Blood Glucose on recheck still <70. Give 25 ml of D50 IV (or 10-12 grams Glucose)
3. Recheck Blood Glucose every 30 minutes. Restart infusion when Glucose >100 mg/dl. Decrease Insulin Drip rate by 1.0 u/h.

When should I start insulin infusion?

All four sets of guidelines recommend initiating insulin therapy in patients with persistent hyperglycemia (blood glucose > 180 mg/dl). After insulin is initiated, the target blood glucose range should be 140-180 mg/dl for the majority of patients.

When is an insulin drip needed?

Intravenous insulin infusion is preferred for patients with type 1 diabetes mellitus, hemodynamically unstable patients with hyperglycemia, and also patients in whom long-acting basal insulin should not be initiated due to changing clinical status (hypothermia, edema, frequent interruption of dextrose intake, etc.).

How do you start insulin drip in DKA?

Key DKA management points

1. Start intravenous fluids before insulin therapy.
2. Potassium level should be >3.3 mEq/L before the initiation of insulin therapy (supplement potassium intravenously if needed).
3. Administer priming insulin bolus at 0.1 U/kg and initiate continuous insulin infusion at 0.1 U/kg/h.

What is the anion gap for DKA?

In mild DKA, anion gap is greater than 10 and in moderate or severe DKA the anion gap is greater than 12. These figures differentiate DKA from HHS where blood glucose is greater than 600 mg/dL but pH is greater than 7.3 and serum bicarbonate greater than 15 mEq/L.

How do you titrate insulin?

Titrating Insulin To normalize the FPG with long-acting basal insulin, it is safe to start empirically at 10 units daily or at a low dose of 0.15 U/kg/day. Patients should titrate the dose 2 units at a time every two to three days, based on SMBG, until the FPG is at goal.

How do I raise my insulin titrate?

Start basal insulin 10 units or 0.1-0.2 units/kg daily or divided BID. Titrate dose based on Fasting Plasma Glucose (FPG). Increase by 2-4 units or 10-15% every 3-4 days until FPG within target range, generally 80-130mg/dL (individualize).

When do you start insulin drip?

We suggest that a BG ≥ 150 mg/dL should trigger initiation of insulin therapy, titrated to keep BG < 150 mg/dL for most adult ICU patients and to maintain BG values absolutely <180 mg/dL using a protocol that achieves a low rate of hypoglycemia (BG ≤ 70 mg/dL) despite limited impact on patient mortality.

When should insulin drip start labor?

Insulin infusion protocol will be initiated at the time of admission to Labor and Delivery. Regular insulin at 1 unit/ml AND IV fluids at a rate of 100-150 ml/hr will be administered: For blood glucose < 80 mg/dL: No insulin AND IV fluids with 5% dextrose.

When to start insulin drip?

Frequency of testing is as follows: Check blood glucose every 30 minutes when blood glucose is more than 200 mg/dL or less than 100 mg/dL; after drip is stopped or decreased more than 50%; after bolus intravenous insulin dose is given; or when rapidly titrating vasopressors (eg, epinephrine, norepinephrine).

How to titrate basal insulin?

To normalize the FPG with long-acting basal insulin , it is safe to start empirically at 10 units daily or at a low dose of 0.15 U/kg/day.9 Patients should titrate the dose 2 units at a time every two to three days, based on SMBG, until the FPG is at goal.

What is an insulin titration?

Titration of insulin over time is critical to improving glycemic control and preventing diabetes-related complications. Insulin is secreted continuously by beta cells in a glucose-dependent manner throughout the day. It is also secreted in response to oral carbohydrate loads,…