Reply With QuoteOur TPN had the insulin in it so I don't see why not. Why is insulin not put in your TPN plus you do finger stick and cover?
Just curious
WR,,, three commas for Becca
Just wanting to hear if any of you ICU nurses run insulin on the same lumen of the CVL as TPN when necessary. This is a point of some debate within our unit and I would love to hear what others are up to.
Our TPN had the insulin in it so I don't see why not. Why is insulin not put in your TPN plus you do finger stick and cover?
Just curious
WR,,, three commas for Becca
I have worked in three ICUs. The first,did not permit anything except lipids to run through the same lumen as TPN. and that was with a double T adapter. The second unit piggybacked everything together and the third mixed TPN and lipids in the same bag and also piggybacked everything together. I just check the unit policy and follow it,you are then covered. Jeanie
I have worked in a number of ICU units. I agree with both responses already given. TPN usually already contains insulin. But having said that as an agency nurse you are responsible to follow hospital policy. So I always check the policy for the facility in which I am working and follow their protocols.
In a previous unit insulin was added to the bags but that was a long time ago and now we run an insulin infusion. Problem being we also run that much other stuff and usually only have a total of 3 lumens - one for inotropes, one for TPN/insulin?? and the third is quickly used up - plus we like to continuously monitor CVP.
We do regular finger sticks and/or art line blood sugar levels and adjust insulin accordingly.
What exactly do you mean by "cover"?
Jeanie, I am trying to formulate/update our ICU policy on this subject so checking the unit policy is a great idea but in my situation not much help - thanks for your comments though, Julie
As in rainbow coverage or sliding scale.. We did it for a week until the patient was stable on TPN..
WR,,, three commas for Becca
TPN should run on a stand alone line. There is a high risk of bacterial contamination with additional IV junctions or ports. It is not a compatibility problem but an infection control problem.
