Tricks for pushing D50 and Insulin through a line?

Kyrshamarks, BSN, RN · Jul 23, 2011

Actually with D50, the harder you push trhe plunger the harder it is to get into the patient, just use stready pressure and you might be surprised how easy it will go in.

KayRN910 · Jul 23, 2011

Nah, not too much other than try to have a 20 ga at least! And use elbow grease! :)

Oh, and push the D50 first. :)

I'm actually curious to see if anybody has any good tricks for this. I've tried twisting while pushing, but, not so helpful.

kelleann · Jul 23, 2011

Thank you Kyrshamarks! I worked up quite a sweat. :-) It felt like the plunger wasn't even moving.

kelleann · Jul 23, 2011

My nurse manager had inject the insulin directly into the D50 before administering. Pt. had a PICC. I literally was sweating while pushing that plunger! Hoped there was an easier way for next time.

Guest505077 · Jul 23, 2011

could you use a syringe pump to administer it instead?

working in NICU, we use them for everything..

kelleann · Jul 23, 2011

Hmmm, don't know Dragonfly55...anyone else know?

crb613, BSN, RN · Jul 23, 2011

D50 steady pressure is the only way I know. Insulin- if you have tports with a small rubbery end ( best I can describe it) just stick the insulin needle in there & have a ns flush on port....push at same time. This helps to get the insulin through without adhering to plastic tubing.

kelleann · Jul 23, 2011

Thank you!

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Jul 23, 2011

Pull back and check for blood return before pushing D50. D50 is terribly necrotic to tissue if you push it through an infiltrated line. If only once in your career this saves you, it's worth the misery and pain it will prevent for you and your patient. One hospital I worked at had a bad reputation throughout the community because a patient lost his arm due to an infiltrated IV and D50 push.

ayla2004, ASN, RN · Jul 23, 2011

could you use a syringe pump to administer it instead?
working in NICU, we use them for everything..

we use syringe pumps add insulin to d50 50ml over half hour

iluvivt, BSN, RN · Jul 23, 2011

Well D50 is hypertonic and viscous. If you had a PICC they are longer than other CVCs though less so since use of US guidance so it may feel different than using a short PIV.. Use the largest gauge lumen you have..if it is a triple lumen this is usually the middle lumen but they are labeled. Assess patency before giving the D 50...sometimes a lumen will be sluggish just before a total thrombotic occlusion occurs. Best to use a Central line if you have one and you did so that is optimal b/c of the hypertonic nature of D50 and extravasation can lead to severe tissue damage