Hypoglycaemia

Question 1

Hypoglycaemia should be considered for …

Answer 1

… any patient presenting with confusion / convulsions / coma.

Question 2

Clinical Severity Prompts (2)

Answer 2

BGL < 3mmol/L

Confusion / seizure / coma

Question 3

History Prompts (6)

Answer 3

Onset

Associated symptoms:

• confusion, visual disturbances, headache, dizziness, pallor

Relevant past history

Medication history

Events

Allergies

Question 4

Airway - Assessment

Answer 4

Assess patency

Question 5

Airway - Intervention

Answer 5

Maintain airway patency

Question 6

Breathing - Assessment

Answer 6

Respiratory rate and effort

SpO2

(Auscultation)

Question 7

Breathing - Intervention

Answer 7

Assest ventilation if required

Apply O2 to maintain SpO2 > 95%

Question 8

Circulation - Assessment

Answer 8

Skin temperature (touch)

Pulse - rate/rhythm

Capillary refill

Blood Pressure

Cardiac Monitor

Question 9

Circulation - Intervention

Answer 9

IV cannulation / pathology

Monitor vital signs frequently

Question 10

Disability

Answer 10

AVPU/GCS - monitor LOC frequently

BGL - if < 3 mmol/L and conscious administer simple sugar

or

if unconscious or confused administer IV 50% Glucose 50ml or IM Glucagon 1mg (if IV access unavailable)

Monitor BGL 15 minutely

Question 11

Measure & test

Answer 11

Pathology - bloods for FBC, UEC, BGL, ABGs/Venous blood gas (if available)

Temperature

U/A

Fluid input/output - FBC

Question 12

Specific Treatment

Answer 12

Possible alcohol abuse? ⇒ give IM Thiamine 100mg