[juliette]

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.

[Anonymous]

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

[jeanie]

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

[mercynurse]

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.

[juliette]

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"?

[juliette]

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

[Anonymous]

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

[1mg.epi]

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.