Hypoglycaemia Flashcards
How can you safely discharge a patient after a hypoglycaemic attack?
Repeat capillary blood glucose in 15 minutes and continue to monitor until 2 capillary blood glucose readings of over 4.0mmols then patient can safely be discharged.
Best to get the patient out of dental pain so treat accordingly , to avoid future hypoglycaemic attack
Ask about T1DM MH and ask if it’s well controlled, last hypo and if frequent attacks explain to pt it’s best to speak to GP
How to treat MILD hypoglycaemia?
15-20g QUICK ACTING
CARBOHYDRATE AND 18g
LONG-ACTING
CARBOHYDRATE.
(1 bottle glucose liquid or 4
glucose tablets and 2
digestive biscuits)
How to treat MODERATE hypoglycaemia?
15 - 20g QUICK ACTING
CARBOHYDRATE
(2 tubes of
glucose oral gel)
How to treat SEVERE hypoglycaemia?
1mg S/C or IM GLUCAGON
once-only treatment
Call 999
How do you categorise hypoglycaemia?
using the AVPU scale
What is ‘MILD’ on the AVPU scale?
Conscious (AVPU =Alert)
Able to self help
Able to swallow.
What is ‘MODERATE’ on the AVPU scale?
Conscious (AVPU = Alert /
Verbal / Pain – touch only)
Unable to self help
Able to swallow.
What is ‘SEVERE’ on the AVPU scale?
Conscious (AVPU = Pain -
shake or earlobe pinch)
Unconscious (AVPU =
Unresponsive)
Aggressive
Fitting
Nil by mouth
how often can you administer glucagon per episode?
Only once
what do you give following glucagon as pt condition improves?
oral carbohydrate
how often can oral treatments be repeated?
up to 3 times
when do you consider discharge?
after 2 normal CBG readings
when do you escalate to 999?
If severe hypoglycaemia is categorised
OR
the pt remains hypoglycaemic following 3 administrations of quick acting carbohydrate
what is the dose of glucose oral gel?
a 25g tube contains 10g glucose - 2 tubes= 1 dose
should be followed by a long-acting carbohydrate (biscuit) as pt condition allows
how to administer glucose oral gel?
squirt the contents of the tube (25) into the lower buccal sulci
gently rub outside of cheek
pt may swallow the gel
