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INTRAVENOUS INSULIN PROTOCOL
Here we explain the protocol of intravenous insulin, and the protocol regarding this is followingly
- IV(Intravenous Insulin Protocol)
- Regular insulin (Human at rapid/Insulin/Humalog) 50 units to be dissolved in 50 ml of NS(Normal Saline).
- For diabetic patients add 5unit of Human at rapid, in DNS(Dextrose Normal Saline)solution and 10unit Human at rapid in 5℅dextrose solution.
- If presented the first time in ICU/Emergency, take a baseline capillary blood glucose (CBG) and insulin infusion to be started as per protocol.
- If presented from OT/ward -take the direction from primary consultant, Anesthetist and insulin infusion.
- Take CBG hourly after starting the infusion.
- The principle is to keep blood glucose level between (130-180) [as per guideline [140-180].
- Check every two hourly if two consecutive CBG regarding<120mg and >80mg.
- Check again every hourly if 2 consecutive regarding, >200mg.
- Inform on-call doctor if CBG <80mg and >400mg.
Check CBG every hourly whatever may be the blood glucose level in the following conditions:-
- severe sepsis/septic shock
- patient on Vasopressor support
- first postoperative day
- H/O recurrent Hypoglycemia
- on hemodialysis
- Acute MI in 48 hours
- universal safety precaution and hand hygiene protocol to be followed every time to be giving insulin
INTRAVENOUS INSULIN PROTOCOL TABLE
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