Hyperinsulinism and D20W delivery

  1. Hi, I'm a private duty nurse working 1-2x/mo w a 2 year old w hyperinsulinism. He has 99% of his pancreas removed and still requires round the clock D20W delivered via GT. He gets a very specific amount delivered per hr, which is bumped down to another very specific amount (to the decimal) per hr during his tube feed. My concern is, his D20W is being delivered by an Infinity GT pump, which I have found in other cases is not the most accurate in its delivery. Even its manual states that a certain +/- in accuracy should be expected. Precise, hairline accuracy is not hugely important when it's formula being delivered (in most cases), but this child gets BS checks q4h and his glucose results are all over the map, from 50 (asymptomatic) to 350. There are action plans in place, of course, but I'm not totally comfortable with using a feeding pump in this manner. Thoughts? Experiences? Is this ok?
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    About CloudySue, LPN

    Joined: Jun '07; Posts: 741; Likes: 1,171


  3. by   classicdame
    wow. First off, I hope the MD has been notified of your concerns. A different care plan may be in order. Have never dealt with this issue. Hope you find your answer