Description

• Clear colourless solution 100IU/ml in 1.5 ml cartridges.
• Discard if discoloured or shows precipitate.

Charted on fluid chart giving:

• rate in ml/hr
• dose in units/kg/hr

Also charted on drug chart under continuous infusions

• Instructions for 1st and 2nd dilution: Base fluid, type and volume
• Insulin to be added
• Units/kg/ml

Charted on the prescription chart:

• dose in units
• dosing interval
• rate of administration

Administration of Insulin

Continuous IV Infusion:

Note:  Insulin infusion is not to be filtered.

First dilution (1 unit/ml):

1. Dilute 50 units (0.5 ml) of insulin into 49.5 ml D5W to make a solution of 1 unit/ml. Mix well.
2. Using a 5 ml syringe draw up required amount of insulin (1 unit/ml) as charted.
3. Discard the remainder of the 50ml syringe of insulin (1 unit/ml).

Second dilution

1. With another 50ml syringe draw up D5W at an amount to make the solution to a total of 50ml.
2. Add the insulin dose (1 unit/ml from the 5ml syringe.  Mix well.
3. Prime the BC 566 (no filter is required).
4. Leave syringe and extension for 1 hour to saturate the plastic binding sites.
5. Flush a further 20ml of the prepared solution into a gallipot.
6. Connect to a continuous infusion pump and then to infant.
7. Change solution and tubing every 24 hours.

1. No dilution required.

Observation and Documentation

1. Monitor blood glucose frequently (initially 1-2 hourly until stable).
2. Check urine for glucose at least 4-hourly.
3. Monitor for signs of hypoglycaemia.
4. Notify doctor / NS-ANP immediately if dextrose or intravenous nutrition infusion is interrupted e.g. tissued drip. Insulin infusion may need to be discontinued until dextrose infusion is restored.
5. When insulin is in the IVN or dextrose infusion, a separate cannula will be required for IV medications.

Storage

• Store in refrigerator (2-8°C) in carton.
• Protect from light.
• Discard opened cartridge after use.

Selected References