Hypoglycaemia

Question 1

What is the treatment for Hypoglycaemia if the BGL is between 4-11

Answer 1

Consider other causes:

• stroke
• seizure
• hypovolaemia

Question 2

What is the treatment for Hypoglycaemia if the BGL is below 4 and the patient is responding to commands?

Answer 2

Glucose 15g oral

If inadequate response consider:

• Repeat Glucose 15g oral (max 30g)
• Dextrose IV
• Glucagon IM

Question 3

What is the treatment for hypoglycaemia with a BGL <4 and patient not responding to commands?

Answer 3

IV Cannula in large vein
- confrim IV patency

Dextrose 10% 15g (150mL) IV
- Normal saline 10mL flush

If GCS or BSL not returned after 5-10 mins

Dextrose 10% 10g (100mL) IV
- Normal saline 10mL flush

If unable to insert IV
- Glucagon 1 IU IM

Question 4

What are the contras for Glucose paste

Answer 4

Nil

Question 5

What are the contras for Dextrose 10%

Answer 5

Nil

Question 6

What are the contras for Glucagon

Answer 6

Nil

Question 7

WHat is the treatment for hypoglycaemia (BGL <4) in paeds who are responding to commands?

Answer 7

Glucose 15g oral

If doesnt work
- repeat 15g oral once
or
IM Glucagon

Question 8

WHat is the treatment for hypoglycaemia (BGL <4) in paeds who are NOT responding to commands?

Answer 8

Less than 25kg = Glucagon 0.5 IU (0.5mL) IM

Over 25kg = Glucagon 1 IU (1mL) IM

Question 9

what is the onset peak and duration of glucagon

Answer 9

Onset - 5min
peak - n/a
duration - 25mins

Question 10

what is the onset peak and duration of dextrose

Answer 10

Onset - 3min
peak - n/a
duration - depends