Hypo or Hyperglycemia

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Section 5 -MEDICAL

5.10 HYPO / HYPERGLYCEMIA

INITIAL MEDICAL CARE (2.01): Provide OXYGEN or assist ventilations as appropriate for patient condition.

  • Obtain history of time of patient's last medication dosage and patient's last meal.
  • Obtain and record blood sugar level.
  • Draw blood tubes, if available.


BLOOD SUGAR < 100 OR SIGNS AND SYMPTOMS OF INSULIN SHOCK / HYPOGLYCEMIA:

  • If patient awake with intact gag reflex, administer GLUCOSE GEL up to 30 grams orally.
  • If NO response or if patient exhibits ALTERED MENTAL STATUS (5.03):
    • DEXTROSE 50% 25 gm IVP for adults
    • For pediatric administration dilute DEXTROSE 50% to DEXTROSE 25% and refer to Broselow Tape.
    • If unable to obtain IV access, GLUCAGON 1 mg IM or IN. / If patient is between 10 kg (22lb) - 20 Kg (44lb) .5 mg IM or IN. Call for dosage order in pediatrics < 10 kg (22lb). GLUCAGON onset in 8-10 minutes.
  • If LIMITED or NO response after initial DEXTROSE 50%:

Broselow Tape.

  • If the patient is a Trauma patient or a Stroke is suspected: Consider administration of ½ dose of D50 following Blood Sugar monitoring.


BLOOD SUGAR LEVEL > 250 WITH SIGNS AND SYMPTOMS OF HYPERGLYCEMIA / KETOACIDOSIS:

  • Administer a fluid bolus of 200 - 300 ml. Continue IV infusion KVO.


PATIENT REFUSALS

If a patient has been treated for hypoglycemia or seizures, transport is not required if:

  • The patient is stable

AND

  • The patient has a competent adult that will remain with the patient for hours

AND

  • The patient understands and agrees to eat, re-check blood sugar and call back if necessary.