Diabetic Emergencies/ hypo and hyperglycemia

Question 1

what are the differential impressions

Answer 1

1. hypoglycemia (blood glucose< 60 mg/dl)
2. hypoglycemic insult
3. iatrogenic hypoglycemia
4. hyperglycemia (blood glucose >300mg/dl)
5. diabetic ketoacidosis (Dka)
6. hyperosmolar hyperglycemia

Question 2

Bls actions # 1

Answer 2

universal care guideline

Question 3

Bls actions # 2

Answer 3

patient saftey line

Question 4

Bls actions # 3

Answer 4

Bgl < 60 you can give oral glucose 15-30 gm po

• For patients with intact airway reflexes

Question 5

Advanced life support actions/considerations # 1

Answer 5

Bgl <60 with vascular access

• Give thiamine 100 mg iv im( for adults with evidence of alcohol abuse or sighns of malnourishment)

Question 6

Advanced life support actions/considerations # 2

Answer 6

1. Dextrose 10 % 125-250 ml (12.5-25 gm) iv titrated to return of normal mental status
2. Pedi: d 10 5ml/kg iv titrated to retrun of normal mental status

As normal mental status is restored, stop infusion and recheck blood glucose: bg>60 , discontinue remainder. IF less than , continue infusion

Question 7

Advanced life support actions/considerations # 3

Answer 7

• Using thiamine first if indicated then d50
• Dextrose 50 % 12.5-25gm iv
• Pedi dose is dex 25% .5gm/kg iv

Question 8

Advanced life support actions/considerations # 4

Answer 8

• IF no vascular and <60 bgl five glucagon 1mg IM
• PEdi: glucagon .5 mg im

Question 9

Advanced life support actions/considerations # 4

Answer 9

• IF bgl is over 300 with vascular access give fluids 20 ml/kg iv io, repeat prn
• Pedi: same