Insulin drip Y site question

[ohbejoyful]

Hi I recently had a patient on an insulin (regular insulin) drip also ordered D5NS which showed in my work provided medication comparability search engine as being compatible. One of the nurses (one year experience just like me) said that cannot be done because it will neutralize the dextrose or vice versa. My question is... is that right? It made a little sense at the time but then why would they be compatible if they affect each other in any way? Does is matter if you Y site them together? Or does insulin only work on glucose once it reaches the body and metabolizes? Would like to know what is correct. Thanks

[fhcp1220]

Yes they are compatible, and no, insulin doesn’t neutralize dextrose (vice versa).

Dextrose based solutions may be used for many different reasons. An example is if the patient’s sodium was high and you wanted to reduce any means of giving fluids that contained sodium in it (normal saline has sodium, and so does Ringers Lactate). All the patient’s IV fluids may be changed to D5W.

Another example is if the patient isn’t being fed (where I currently am, people are intubated and need tight control of their blood sugars because they’re so sick), you can run insulin and (my hospital uses) D10 together—if the patient is being fed with feeds, then the D10 may be swapped out with a non-dextrose solution.