DOWNTIME ADULT ACUTE CARE INSULIN INFUSION FLOW SHEET - virginia 2026

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Discontinue when: Bicarbonate level is 17mmol/L. Anion gap is normalized. And/or blood ketones are negative to small.
IV can be infused through a peripheral or central line. The initial dosing of IV is recommended at 0.1 units/kg/h for patients presenting with DKA [11] and 0.025 units/kg/h in patients who are not in DKA but have hyperglycemic crisis, or for those who have renal insufficiency [3].
Continuous infusion (CII) to manage hyperglycemia is the accepted standard of care in the intensive care unit (ICU); however, the safety and efficacy of CII in the non-ICU setting has not been determined.
(Blood glucose 60) x the multiplier = infusion rate. The multiplier is the factor in the equation that determines the infusion rate. The standard default multiplier at initiation of the program is 0.02 but may be customized to the individual needs of your patient (ie.
remains the best way to control hyperglycemia in the inpatient setting, especially in critically ill patients. Intravenously administered is the preferred method to achieve the recommended glycemic target in the ICU.

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In addition, more frequent blood glucose monitoring (every 15-20 minutes) should be implemented until blood glucose is consistently 100 mg/dl. Some hypoglycemia protocols temporarily stop the infusion for hypoglycemia and restart it at a lower rate once hypoglycemia has resolved.
Preparation administration (Nursing staff): Using an syringe, draw up 50 units of soluble (Actrapid or Humulin S) and add to 49.5ml of 0.9% sodium chloride in a 50ml luer-lock syringe. Prepared concentration is 1 unit/ml. Secure a standard giving set to the IV fluid bag.

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