Glucose 10%

Question 1

What is the presentation?

Answer 1

500ml bag 10% glucose (10g per 100ml)

Question 2

How does it work?

Answer 2

A hypertonic crystalloid solution that provides a readily available source of energy (Glucose)

Question 3

What is the onset time?

Answer 3

Within 1 minute

Question 4

What are the indications?

Answer 4

Demonstrated hypoglycaemia where oral glucose administration is inappropriate in:

Altered conscious state in known diabetic or of otherwise unknown cause where blood glucose level is below 4mmol/L.
Cardiac arrest, only if hypoglycaemia is suspected as a contributory cause of the arrest, not an early indication.

Question 5

What are the contraindications?

Answer 5

Not to be used if there is no patent IV access

Question 6

What are the precautions? (8)

Answer 6

1) Patients should ideally be cannulated with a large gauge cannula into a large vein, with patency confirmed with a free flowing bolus (>20ml) of 0.9% normal saline, before administering glucose 10% using a 20ml syringe via the injection port, titrated to effect. Administration via an IO should utilise a 20ml syringe and a three way tap.
2) High concentration of IV glucose may aggravate dehydration due to its hypertonicity whereby it draws water from the cells.
3) IV glucose is corrosive and IV patency must be ensured before administration.
4) Careful titration of glucose in head injured patients is vital as glucose leaking into CNS tissue will aggravate the injury, resulting in cerebral oedema.
5) Monitor blood glucose level carefully; beware of drop in level again after the patient has recovered.
6) Even if fully recovered, patients should be encouraged to be transported to a medical facility to ensure effective follow up and review.
7) IO administration is only as a last resort after all other avenues have been exhausted and the patient needs lifesaving glucose.
8) Do not wait on scene for glucose to take effect.

Question 7

What is the adult dose?

Answer 7

10g (100ml of 10%) IV
Repeat dose up to 10g (100ml) if patient remains hypoglycaemic
Maximum total dose is 20g

Question 8

What is the paediatric dose?

Answer 8

2.5ml/kg (0.25g/kg or 250mg/kg) up to 100ml (10g) IV/IO
Repeat dose up to 2.5ml/kg, once only
Maximum total dose is 20g

Question 9

What is the newborn dose?

Answer 9

2ml/kg (0.20g/kg or 200mg/kg)

Repeat once only, if clinically indicated

Question 10

What are the side effects?

Answer 10

Hyperglycaemia
Diuresis
Tissue necrosis
Thrombophlebitis