Glucose IV

Question 1

Glucose IV

Presentation

Answer 1

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

Question 2

Glucose IV

Use

Answer 2

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.
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Question 3

Glucose IV

Type

Answer 3

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

Question 4

Glucose IV

Dose

Answer 4

Adult:
•	10g (100ml of 10%) IV
•	Repeat dose up to 10g (100ml) if patient remains hypoglycaemic
•	Maximum total dose is 20g
Paediatric:
•	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
Newborn:
•	2ml/kg (0.20g/kg or 200mg/kg)
•	Repeat once only, if clinically indicated
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Question 5

Glucose IV

Actions.

Answer 5

• Onset within 1 minute.

Question 6

Glucose IV

Contraindications

Answer 6

• Not to be used if there is no patent IV access.

Question 7

Glucose IV

Adverse effects

Answer 7

•	Hyperglycaemia
•	Diuresis
•	Tissue necrosis
•	Thrombophlebitis
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Question 8

Glucose IV

Precautions

Answer 8

• 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.
• High concentration of IV glucose may aggravate dehydration due to its hypertonicity whereby it draws water from the cells.
• IV glucose is corrosive and IV patency must be ensured before administration.
• Careful titration of glucose in head injured patients is vital as glucose leaking into CNS tissue will aggravate the injury, resulting in cerebral oedema.
• Monitor blood glucose level carefully; beware of drop in level again after the patient has recovered.
• Even if fully recovered, patients should be encouraged to be transported to a medical facility to ensure effective follow up and review.
• IO administration is only as a last resort after all other avenues have been exhausted and the patient needs lifesaving glucose.
• Do not wait on scene for glucose to take effect.
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