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Discussion

IV Compatibility

I just finished my first week of orientation in the ICU. It is going very well, I am just a little confused about compatibility. The patient I was caring for was on several different gtts, all running into the same thing. (I can't think of the name of it, but it has multiple openings to arrange all the lines running into the patient.)

Dopamine

Levophed

Insulin

Epi

Bumex

Versed

Fentanyl

D5.45

So technically all of this was running in together, as it was all going into the patient's cordis. I asked my preceptor if it would be inappropriate to push my other IV meds into the main line and she said it was fine. Is this true?

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    On 5/2/2012 at 4:26 PM, rgroyer1RNBSN said:

    Be safe just start another piv, heplock it, do pushes through it. And why D5 and insulin togather, I think doc needs to retake that day of pharm.

    In the setting of DKA, it's very common to run a Dextrose infusion and insulin at the same time. The primary management concern in DKA is the ketoacidosis, not the hyperglycemia. Insulin gtt is used for ketoacidosis, not hyperglycemia. The side effect of an insulin gtt is hypoglycemia, which is what dextrose is for.

    That's why you shouldn't stop the insulin gtt when your patient is no longer hyperglycemic. You wait for the gap to close and the bicarb to rise, and then you stop the drip.

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    Yes if pt is NPO we run the dextrose with the insulin.
    if the pt has a diet then we run 0.9 with the insulin.

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