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Anaesthesia 2015
Barker et al. | Guidelines on peri-operative management of diabetes
Appendix 2
Example of a variable-rate intravenous insulin infusion regimen observation chart. Reproduced by kind
permission of the Norfolk and Norwich University Hospitals NHS Foundation Trust.
BLOOD GLUCOSE MONITORING CHART (adults, not pregnant)
B
Paent Name:
Hospital Number:
Date of birth:
Consultant:
Date
(dd/mm/yyyy):
Time:
Blood glucose
reading (mmol/L)
OR PATIENT LABEL
A SINGLE reading in a RED area requires acon
TWO consecuve readings in the AMBER areas
require acon
This is the ACCEPTABLE glucose range
This is the IDEAL glucose target range
Ward:
Blood glucose readings (mmol/L)
Ketone levels
Diabetes Inpatient Specialist Nurse bleep - 0407 - available Monday to Friday 9am to 5pm
Urine
Blood
30
25
20
15
10
5
0
++++
+++
++
+
Nil
ALL ACTION TAKEN MUST BE DOCUMENTED IN THE HOSPITAL NOTES
Inials
14 © 2015 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists of Great Britain and Ireland