Hypoglycaemia Adult Flashcards
Mgx of Hypoglycaemia
Glucose Paste 15g
Dextrose 10% initial 150ml (15gm) IV
can repeat 100ml (10g) after 5-10/60 if inadequate response
Glucagon 1U (Paed ≥25kg 1U, <25kg 0.5U)
Rule out other cause of ACS
AEIOUTIPS
Seizure
Stroke
Hypovolaemia
3 P’s of Hypo
Polyuria
Polydipsia
Polyphagia
Important IV Dextrose info
large cannula (18-20g) flushed 10mL normal saline prior and post admin to ensure patency of IV in vein. Dextrose is hypertonic solution that can cause necrosis of the tissues if IV not patent
When must hypo be T/F to hospital
- Inadequate response to Mgx
- Multiple presentations in short period of time
- Unknown cause
- First presentation
- Increased episodes without review
- Other predisposing issues associated with presentation
- Unable to leave at home with responsible third party to be monitored for 4/24
Treat and Refer - LEAVE AT HOME
- Pt has been given self care advice and a health information sheet
- Refer pt to diabetes primary care provider within 24hr if possible
- prior to departing the scene
1) remove cannula if insitu
2) confirm BGL >4mmol at least 10/60 post tx
3) confirm pt/carer understands the advice given
Treat and REfer - DO NOTS
- Incomplete recovery
- Risk of prolonged/recurrent hypo
-> unwitnessed onset/prolonged episodes - pt on oral medication
- OD on medication (intentional/accidental)
- Unable or unwilling to consume further carbohydrates
- No dx of diabetes
- Suspected cause requires further investigation
- Injury/seizure obtained
- Pregnancy
Dextrose Indications
Hypoglycaemic episode (<4mmol) in pt with altered conscious state unable to administer oral glucose
Dextrose Contras
Nil
Dextrose Precautions
Nil
Dextrose Side Effects
Nil
Glucagon Indications
- Hypoglycaemic episode (<4mmol) in pt with altered conscious state unable to administer oral glucose
- Severe Anaphylaxis in pt not responding to adrenaline, remaining hypotensive with cardiac hx and on beta blockers
Glucagon Contras
Nil
Glucagon Precautions
Nil
Glucagon Side Effects
N/V (rare)
