Insulin drip questions

[nurses4all]

I have questions about insulin gtts.

When you run an insulin gtt through a PICC line, if the rate is very slow (less than 20 cc's an hour), does the line need to be flushed with NS while the drip is running to keep it patent?

If it was flushed, wouldn't that bolus the Pt. with the insulin remaining in the line? How many cc's would the Pt. actually get from what's in the line? And then, after it was flushed, considering how long the interior line is, wouldn't that cause the insulin to take a couple hours, if running at about 20 cc's an hour or less, to actually reach the Pt.?

Thanks for your help. I hope I put this in the right place.

[MelissaRN]

I'v never heard of doing that, maybe I'm wrong. I've run morphine through central lines at slow rates for comfort care patients and never had to flush and also ran heparin through them with no trouble. On the triple lumens I always flush the other ports and that doesn't effect what's running.

[zacarias, ASN, RN]

I have questions about insulin gtts.

When you run an insulin gtt through a PICC line, if the rate is very slow (less than 20 cc's an hour), does the line need to be flushed with NS while the drip is running to keep it patent?

Thanks for your help. I hope I put this in the right place.

Hey there,

Good of you to be concerned about keeping the line open but when an insulin drip is running, you should have main fluid running too (D51/2NS, NS etc.) for your patient. If your patient doesn't need fluid, then we just have a bag of saline hanging running at 20cc/hr. You're right, we don't want to bolus the patient with insulin.

Definitely check your facility's policy and procedure.

[KacyLynnRN]

I've never run an insulin drip by itself, even through a saline well...I always run it with the fluids if the patient is recieving them, and if not, with normal saline at KVO rate (currently 21, 25 cc/ hr? I can't remember right now) and have the insulin running into the fluid. I've just always asked the Dr if it's OK (if the pt. has no orders for fluids) and I've never been told no yet. I would think if you are running anything less than KVO rate (especially into a PICC) you might develop a problem. Just my two cents.

:) Kacy