hypoglycemia

Question 1

treatment of hypoglycemia

Answer 1

• Administer 10-20 g of glucose PO provided the patient is sufficiently conscious to swallow safely.
• Gain IV access and administer glucose IV if the patient has a significantly altered level of consciousness or cannot swallow safely:
  a) 100 ml of 10% glucose IV for an adult.
  b) 2 ml/kg of 10% glucose IV for a child.
• Administer glucagon if unable to gain IV access:
  a) 1 mg of glucagon IM for a patient aged five years and over.
  b) 0.5 mg of glucagon IM for a child aged less than five years.
• Repeat the glucose measurement every ten minutes until the glucose concentration is consistently greater than 3.5 mmol/litre. Administer further doses of glucose if required, but do not repeat glucagon IM.

Question 2

The patient may receive treatment for hypoglycaemia and be given a clear recommendation that transport by ambulance to a medical facility is not required, provided all of the following criteria are met:

Answer 2

a) b)
c) d) e)
f ) g) h)
It is an isolated single episode, and
It is not due to overdose (including accidental) of insulin or oral hypoglycaemics, and
It is not complicated by seizure or clinically significant injury, and
The patient recovers fully and can mobilise normally, and
The blood glucose concentration is greater than 3.5 mmol/litre, ten (or more) minutes after glucagon or the last glucose administration, and
A competent adult can stay with the patient for the next four hours, and The patient eats a meal (preferably with complex carbohydrates), and The patient is given the hypoglycaemia information sheet, which is explained to them and the accompanying adult.

Question 3

if referring elsewhere the patient must be given a clear recommendation to……..

Answer 3

The patient must be given a clear recommendation to have their treatment reviewed (for example by their GP or diabetes service personnel). If the patient is aged less than or equal to 18 years or has been recently diagnosed with diabetes, this review must occur within 24 hours.

Question 4

dose of 10% glucose

Answer 4

a) 100 ml of 10% glucose IV for an adult.
b) 2 ml/kg of 10% glucose IV for a child.