Priming Insulin infusions

[ChantalNICU 4]

Hello, I am a NICU nurse in training and for my study I have an assignment. For this assignment I want information from as many NICU's as possible about priming the infusion sets before starting the insulin infusion. Does this happen in your NICU, and if so, how? Do you have protocols I can use?  Which concentrations are used and which flow rate 

[Stefan Johansson 513]

@ChantalNICU thanks for posting! Wished I could share my own experience but it is very small... and now I work in a level-2 context.

Just wanted to share 1) the video from the 2019 Meetup (below), 2) the hyperglycemia protocol from Sydney (https://www.slhd.nsw.gov.au/RPA/neonatal/protocols.html) and 3) the Auckland insulin guideline (http://www.adhb.govt.nz/newborn/DrugProtocols/InsulinPharmacology.htm)

I can check with my level-3 colleagues in Stockholm after the summer vacation, if they have their own local guideline.

 

 

[ChantalNICU 4]

Thank you for your response @Stefan Johansson! I woud really appreciate it if you could check with your colleagues after the summer vacation. I look forward to seeing your response.

[Francesco Cardona 88]

Interesting subject.

In Vienna, we prime insulin infusion systems before use. The insulin is prepared as ordered, we start off with 0.05-0.1 IE/kg/h. After 30min, the insulin in the infusion system is discarded and the same amount/dilution prepared with the same system before use.

Let me know if you need more information @ChantalNICU

[Bernhard Bungert 23]

Interesting Subject. And More literature than we would believe, including YouTube  Videos. We have primed a few years ago but we stopped  because non of our problems were resolved. Despite a lot of tricky literature there are to many variables (tube and line materials, Insulin measurment (Timing, method) wanted Insulin concentration, dont forget filters)... ..  to finde the right answer. Hard work for chantalnicu.😊

[ChantalNICU 4]

Thank you @Francesco Cardona for your response! 

And also thank you @Bernhard Bungert Indeed, it is an interesting subject and indeed, I am working hard . Lots of literature but unfortunately not specifically focused on the neonatal unit and materials. You describe that the problems were not solved. What problems are you referring to? I am assuming that you are referring to persistent hyperglycemia.

@Stefan Johansson May I ask if you have already checked with your level-3 colleagues in Stockholm? I am very curious  

[Stefan Johansson 513]

@ChantalNICU Sorry for the delay... (yes, I had forgotten ) 

this is the written guideline: after preparation, the pumpsyringe and tubings are filled and kept for 20min. Then the tubings are flushed with the solution and then connected to the patient.

 

[ChantalNICU 4]

@Stefan Johansson Thank you for your answer. I have one more question; Is the guideline used throughout Sweden?

[Stefan Johansson 513]

@ChantalNICU I suppose there could be variations, this is the Stockholm version