How to Prime Insulin IV Tubing

Diabetes mellitus involves 2 types of metabolic conditions, which are characterized with increased glucose levels in the blood or are commonly termed as hyperglycemia. The two types are type 1 insulin dependent diabetes and type 2 non-insulin dependent diabetes mellitus. The condition involves the hormone insulin, which is secreted by the pancreas and is necessary for regulating glucose in the blood. In this case, the pancreas has little or no production of the hormone. This results in a toxic condition, called hyperglycemia wherein the cells starve to death from glucose deprivation. The main reason is that insulin is needed for the transport of glucose from the intravascular space to the intracellular level.

Things You'll Need

  • Regular insulin
  • Tuberculin syringe
  • IV fluid
  • Macroset or soluset
  • Infusion pump

Instructions

    • 1

      Determine the type and dosage of insulin to be infused. Always verify with your physician about insulin specifications including the dosage and the type. Check for the main IV line to be given to a patient.

    • 2

      Prepare the insulin; aspirate the accurate amounts using the insulin syringe. Insulin is measured in units or “u.” Only the insulin syringe has an accurate calibration of the hormone. Other forms of syringes are not appropriate in preparing the hormone.

    • 3

      Mix the insulin with the correct solution. Plain, normal saline solution is usually used in insulin drips, but some doctors may change this according their preference. Attach the macroset or the soluset in the IV solution. Take note that in some preparations, insulin is premixed with a little IV solution in the soluset.

    • 4

      Open the IV regulator. This allows the passage of the intravenous fluid to the tubing commonly called the priming procedure. This eliminates the air in the IV tubing. Close the IV regulator. Make sure to close the regulator if the fluid is coming out of the syringe to avoid spillage.

    • 5

      Attach the syringe of your set to the Y-port of the mainline. After proper priming, make sure you attach and secure your side drip. It is common in a hospital setting that side drips are sometimes unhooked due to patient mobility and unsecured placement. Regulate the IV rate. Tubings are usually attached to the infusion pump for accuracy. In case it is not available, manual regulation is used with proper knowledge of the flow rate of the different sets.

Tips & Warnings

  • Insulin, depending on the type has different categories based on their onset, peak and duration. The focus of the treatment is to control the blood sugar and prevent the occurrence of hyperglycemia. Some have rapid effects resulting in hypoglycemia, which is as dangerous as hyperglycemia. Thus, the need to check the type of insulin before administration is of prime importance.
  • Patient is of great risk of developing lipodystrophy and diabetic coma if the line is not patent. Make sure that regular insulin is used for the infusion since other forms of the hormone are not compatible for IV infusion. Monitor the patient’s blood sugar regularly during the infusion. Make sure you have medications available if hypoglycemia occurs.
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References

  • Mayo Clinic: Diabetes
  • Brunner and Suddaarth’s Textbook of Medical Surgical Nursing; Vol 2, 10th Edition; Suzanne C. Smeltzer and Brenda G. Bare; 2004
  • Photo Credit Thinkstock/Comstock/Getty Images

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