In December, ISMP published an article re: adverse glycemic events and critical emergencies. Safe practice recommendations included steps to avoid insulin mix-ups. Historically, we have experienced these errors in our ED and worked to limit the number of insulin products available, with a goal of removing regular insulin vials from the ED and sending patient-specific doses (diluted) for IV administration. Note: we also recently moved to EPIC with some prospective order review in the ED and Pyxis profiling, but there are still some gaps in coverage to be fixed)
One recommendation from was the use of a "Hyperkalemia Kit" (this is a new recommendation from ISMP).
- Does your institution stock regular insulin in the ED?
- If not, how do you dispense from pharmacy (kit vs. IV syringe, vs. diluted IV syringe i.e. 10mL total)?
- If you use a "kit", where/how is it stocked?
Thank you in advance for your perspective.