Hypoglycaemia Flashcards
What is the minimum flush for IV Dextrose?
10mL before and after Dextrose admin.
What steps need to be taken for a hypoglycaemia pt who has fully recovered but does not fit the Treat and Refer guideline who refuses transport?
- Rpt advice for transport using friend/relative assistance
- Document refusal and leave pt in care of third party
- Advise the pt of actions to take if symptoms reoccur
- Advise of need to make early contact with LMO for follow up
When should you consult for further Dextrose doses?
- In a suspected insulin overdose, even if pt BGL >4 and pt obeying commands
- If both doses of Dextrose have been administered but BGL <4 and unable to admin oral carbohydrates.
What is the management for BGL <4, Responds to Commands?
Glucose 15g oral gel, rpt once after 15mins if inadequate response. If continues to respond poorly, Rx with Dextrose/Glucagon.
If poor response to oral gel then?
If poor response, consider Dextrose or Glucagon 1IU IM
What is the management if BGL <4, Does Not Respond to Commands?
IV cannula in large vein
CONFIRM IV PATENCY WITH LARGE FLUSH
Dextrose 10% 150mL (15g) IV, with a minimum of 10mL flush
If unable to insert IV, Glucagon 1IU IM
How is pt response to “BGL <4, Does Not Respond to Commands” management assessed for adequacy?
What is the further management?
After 5-10 minutes, assess patient GCS/BGL.
If GCS <15, further 100mL Dextrose IV, titrate to conscious state.
If GCS 15, cease Dextrose admin, consider TnR.
Per the CPG’s, what are the signs and symptoms of a suspected hypoglycaemic episode?
What do these symptoms indicate?
Hx diabetes
Unconscious/altered conscious
Pale
Diaphoretic
Indicate a need to assess BGL.
If next meal is more than _____ mins away, encourage patient to…?
20 min.
Encourage to eat long acting carb such as sandwich, fruit, glass of milk.
