Table 1 provides additional potential indications for IV insulin infusion. Sliding- scale or correction algorithms with regular or rapid-acting insulin administered as . using the National Inpatient Medication Chart 7/ 1. To be used when patients in ICU require insulin via IV infusion insulin for infusion or injection. The development of an insulin infusion protocol was initiated by key contributors from Therefore, the protocol was written in a table format that allowed adjustments to be in blood glucose values expected per unit of i.v. insulin administered.

additional intravenous glucose given if BG is below the target range *See algorithm on insulin administration during critical care admission*. Be mindful of the. 3) Mix standard insulin drip: Bolus units of I.V. insulin = Glucose ÷ (e.g. if glucose = mg/dL, give if outside target range at highest infusion rate. Start IV insulin therapy when glucose is above target range. Bolus dose and Initial Infusion rate: Divide initial glucose level by , then round . For hypoglycemia which has not resolved after administration of D50W IV and.

Choose Adjustment Table 1, 2 or 3 based on last insulin infusion rate For Blood Glucose level of 40 to 60 mg/dl; administer Gm of Dextrose. 50% Water. Give initial insulin bolus IV Push ONE TIME per Table 1: Initiate Insulin Infusion per Table 2: ( units Insulin Regular in ml Normal Saline = 1 unit/mL). After insulin is initiated, the target blood glucose range should be Insulin infusion can be safely administered outside of the critical care. Please use alongside the NUH VRIII Adult insulin prescription chart. . For nurse administration under Patient Group Direction (Trustwide PGD in place). Date. glucose level > mg/dL then initiate insulin infusion protocol Give 25 mL (1/ 2 amp) of 50% dextrose IV if BG mg/dL OR o Once patient is within goal range for 4 hours, do NOT adjust rate unless BG change is >50 or BG exits goal.

Regular Insulin infusion 1 unit/mL concentration in Sodium. Chloride %. intermittent steroid doses are administered. • If TPN is abruptly. Prescribe the variable rate regimen, insulin infusion and accompanying intravenous fluids on GUIDANCE POINTS FOR THE ADMINISTRATION OF CVRIII. Insulin Infusion. Dilute 50 units Actrapid to total of 50 mls normal saline (giving 1 unit / ml); Dilute in saline (for hyperglycaemia) or 5% dextrose (for. STOP THE INSULIN, assure adequate baseline glucose intake, administer range for at least 4 consecutive hours on units/kg/hr insulin infusion or less.

Target blood glucose range is – mg/dL while on insulin infusion. • Consider BG > mg/dL for > 12 hours despite Qh subQ insulin administration. Section 3 – Adult patients requiring intravenous insulin infusion therapy . medical officer and administered prior to ceasing the infusion (see table below). discontinuation of the IV insulin infusion and give % of. TDD as rapid-acting insulin in 3 divided doses with meals. Patient on Continuous Tube Feeds (TF). Give 2 units insulin IV push and start IV insulin infusion at 2 units/hour. > Once BGs are within desired range for 12 hours, reduce BG checks to q4h.