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What Insulin Protocols Do You Use?

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by Cheers_G Cheers_G (Member)

1,220 Visitors; 58 Posts

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Hi everyone!

We are doing research on insulin protocols, so I was wondering what insulin protocols your hospitals use. You can keep the hospital private if you'd like but plz just maybe mention state/city?

Thank you!!!

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MaxAttack has 3 years experience and works as a ICU RN.

6,253 Visitors; 280 Posts

One hospital used a mild, moderate, and severe sliding scales while another used a multiplier. I found a better degree of control with the multiplier. Both targeted glucose levels in the 140-160's if I remember right. I wish I had copies of the actual protocols but if you have any specific questions I can probably remember some detail. Ft Lauderdale, FL

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CCU BSN RN has 7 years experience and works as a Staff RN.

4,088 Visitors; 239 Posts

We have a few separate insulin drip protocols for ICU, both of which I kind of hate.

Cardiac surgery protocol with target glucose 110-160, basically has you start for glucose over 150, and go up or down by 1 unit if outside range, but involves giving boluses which is a pain and IMO subject to more room for error, especially since we can't bolus from the pump and there is no great way to docent the boluses in our eMAR.

Medical protocol with target glucose 120-180, involves starting in a certain column based on someone's glucose and then moving to a new column if sugar is too high/too low. There aren't boluses but again, there's no great way to chart which column you're in, and if you forget or aren't told in report it's a pain. Also it has doses down to .1, and being on 4.7 units or 8.3, with a dosage that changes every hour...it seems there's a lot of room for error when you need to remember a new glucose levels, column, and obscure dose every hour.

 

Both allow us to start monitoring q2h once glucose stabilizes, neither involve standard frequent lab orders or IVF because we're not specifically treating DKA. 

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