Hypoglycemia Medical Directive

Question 1

What are the indications?

Answer 1

• Suspected hypoglycemia

Question 2

What are the two medications for hypoglycemia directive?

Answer 2

• Dextrose & glucagon

Question 3

What are the conditions for dextrose?

Answer 3

• Age= >2 yrs
• LOA= Altered
• HR= n/a
• RR= n/a
• SBP= n/a
• Other= hypoglycemia

Question 4

What are the conditions of glucagon?

Answer 4

• Age= n/a
• LOA= altered
• HR= n/a
• RR= n/a
• SBP= n/a
• Other= hypoglycemia

Question 5

What are the contraindications for dextrose?

Answer 5

• Allergy or sensitivity to dextrose

Question 6

What are the contraindications for glucagon?

Answer 6

• Allergy or sensitivity to glucagon
• Pheochromocytoma

Question 7

What is the treatment for dextrose? (if available and authorized)- 10% dextrose

Answer 7

• Age= >2 yrs
• Route= IV
• Dose= 0.2g/kg (2ml/kg)
• Max. single dose= 25g (250 ml)
• Dosing interval= 10 min
• Max. # of doses= 2

Question 8

What is the treatment for dextrose? (if available and authorized)- 50% dextrose

Answer 8

• Age= >2 yrs
• Route= IV
• Dose= 0.5g/kg (1ml/kg)
• Max. single dose= 25g (50ml)
• Dosing interval= 10 min
• Max. # of doses= 2

Question 9

What should you do when giving dextrose?

Answer 9

• Titrate to a level of awareness where the pt can safely consume complex carbs

Question 10

What is the treatment for glucagon? (Weight= <25 kg)

Answer 10

• Route= IM
• Dose= 0.5mg
• Max. single dose= 0.5mg
• Dosing interval= 20 min
• Max. # of doses= 2

Question 11

What is the treatment for glucagon? (Weight= >25 kg)

Answer 11

• Route= IM
• Dose= 1 mg
• Max. single dose= 1 mg
• Dosing interval= 20 min
• Max. # of doses= 2

Question 12

What are the clinical considerations for hypoglycemia?

Answer 12

• If the pt responds to dextrose or glucagon, he/she may receive oral glucose or other simple carbohydrate
• If only mild s/s are exhibited, the pt may receive oral glucose or other simple carbs instead of dextrose or glucagon
• If a pt initiates an informed refusal of transport, a final set of vital signs including BG must be attempted and documented.
• IV administration of dextrose applies only to PCPs authorized for PCP Autonomous IV