|Reviewed by Dr
Carl Kuschel, Robyn Wilkinson, and Brenda Hughes
Administration details updated July 2002
Management of Insulin Administration
- 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
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):
- Dilute 50 units (0.5 ml) of insulin into 49.5 ml D5W to make a solution of 1 unit/ml. Mix well.
- Using a 5 ml syringe draw up required amount of insulin (1 unit/ml) as charted.
- Discard the remainder of the 50ml syringe of insulin (1 unit/ml).
- With another 50ml syringe draw up D5W at an amount to make the solution to a total of 50ml.
- Add the insulin dose (1 unit/ml from the 5ml syringe. Mix well.
- Prime the BC 566 (no filter is required).
- Leave syringe and extension for 1 hour to saturate the plastic binding sites.
- Flush a further 20ml of the prepared solution into a gallipot.
- Connect to a continuous infusion pump and then to infant.
- Change solution and tubing every 24 hours.
- No dilution required.
Observation and Documentation
- Monitor blood glucose frequently (initially 1-2 hourly until stable).
- Check urine for glucose at least 4-hourly.
- Monitor for signs of hypoglycaemia.
- 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.
- When insulin is in the IVN or dextrose infusion, a separate cannula will be required for IV medications.
- Store in refrigerator (2-8°C) in carton.
- Protect from light.
- Discard opened cartridge after use.
Pildes RS. Neonatal Hyperglycaemia. J Pediatr 1986; 109:905-7.
Ostertag SO, Jovanovil L, Lewis B, Auld PAM. Insulin pump therapy in the
Very Low Birthweight Infant. Pediatrics 1986; 78:626-30.
Collins JW, Hoppe M, Brown K, et al. A Controlled trial of Insulin
Infusion and Parenteral Nutrition in Extremely Low Birthweight Infants
with Glucose Intolerance. J Pediatr 1991; 118:921-7.
Paediatrician/Senior Nurse Meeting, National Women’s Hospital. 20.02.97
Hewson et al. Insulin infusions in the neonatal unit: delivery
variation due to adsorption. J Paed Child Health 2000;36:216-220.