Hypoglycaemia Flashcards
If the patient is conscious, orientated and able to swallow what do you give?
Give 15-20g of fast-acting carbohydrate
e.g. 4-5 glucose tabs or 90-120mls of lucozade
Define hypoglycaemia
BG <4
If patient is mild and first treatment didn’t work, what next?
Treatment can be repeated 3 times.
If worsening call a senior
If BG >4 after treatment, what is next?
20g of long acting carbohydrate e.g. toast and milk
If the patient is conscious, able to swallow but confused, what do you do?
give 1.5-2 tubes of glucogel squeezed into mouth between teeth and gums
If glucogel ineffective, what next?
Can repeat 3 times
consider 1mg glucagon IM
or if deteriorating consider IV glucose
If patient is unconscious/fitting what do you do?
ABCDE
stop any IV insulin
Call for help
Give IV glucose
How do you give IV glucose?
20% in 75mls over 10 minutes
In a severe patient if initial management has not worked, what do you do?
Repeat IV glucose
Severe patient has now recovered, what do you do?
20g of long acting carbohydrate e.g. toast and milk
How often during management should you recheck BG?
10-15 minutes
Management for the next 24-48 hours? (5)
Continue subsequent insulin doses Check capillary blood glucose regularly review insulin regime or oral hypoglycaemic agent provide education on hypoglycaemia refer to diabetes team
Important restrictions of IM glucagon?
do NOT use in oral hypoglycaemic agent induced hypoglycaemia
may not work in patients who are undernourished, liver disease or in repeated hypoglycaemia
Symptoms of hypoglycaemia
Sweating, tremor, palpitations, dizziness
confusion, drowsiness, seizures, coma,
Hyperglycaemia
symptoms as for first presentation to GP of hyperglycaemia e.g. polyuria etc.
