Hypoglycemia Medical Directive

Question 1

Hypoglycemia Medical Directive

Answer 1

A Primary Care Paramedic may provide the treatment prescribed in this Medical Directive if authorized.

Question 2

Indications

Answer 2

Suspected hypoglycemia

Question 3

Conditions - Dextrose

Answer 3

Age: ≥2 years
LOA: Altered
HR: N/A
RR: N/A
SBP: N/A
Other: Hypoglycemia

Question 4

Conditions - Glucagon

Answer 4

Age: N/A
LOA: Altered
HR: N/A
RR: N/A
SBP: N/A
Other: Hypoglycemia

Question 5

Contraindications - Dextrose

Answer 5

Allergy or sensitivity to dextrose

Question 6

Contraindications - Glucagon

Answer 6

• Allergy or sensitivity to glucagon

- Pheochromocytoma

Question 7

Treatment

Answer 7

Consider glucometry
Consider dextrose (if available and authorized)
Consider glucagon (if not using dextrose)

Question 8

Consider dextrose (if available and authorized)

Answer 8

Age: ≥ 2 years

Concentration: 10% dextrose
Route: IV
Dose: 0.2 g/kg (2 ml/kg)
Max. single dose: 25 g (250 ml)
Dosing interval: 10 min
Max. # of doses: 2

Concentration: 50% dextrose
Route: IV
Dose: 0.5 g/kg (1 ml/kg)
Max. single dose: 25 g (50 ml)
Dosing interval: 10 min
Max. # of doses: 2

TItrate dextrose to a level of awareness where the patient can safely consume complex carbohydrate.

Question 9

Consider glucagon (if not using dextrose)

Answer 9

Age: N/A

Weight: <25 kg
Route: IM
Dose: 0.5 mg
Max. single dose: 0.5 mg
Dosing interval: 20 min
Max. # of doses: 2

Weight: ≥25 kg
Route: IM
Dose: 1 mg
Max. Single dose: 1 mg
Dosing interval: 20 min
Max. # of doses: 2

Question 10

Clinical Considerations

Answer 10

If the patient responds to dextrose or glucagon, he/she may receive oral glucose or other simple carbohydrates.

If only mild signs or symptoms are exhibited, the patient may receive oral glucose or other simple carbohydrates instead of dextrose or glucagon.

If a patient initiates an informed refusal of transport, a final set of vital signs including blood glucometry must be attempted and documented.

IV administration of dextrose applies only to PCPs authorized for PCP Autonomous IV.