Treat and Release Hypoglycemia - Guideline

Question 1

New onset hyperglycemia in pediatric patient?

Answer 1

Requires ED eval.

Question 2

Patient/legal guardian wishes to refuse treatment after dextrose administration for hypoglycemia?

Answer 2

They have to sign the refusal.
Refusal is required when the patient is not a diabetic, the patient is on oral hypoglycemic medications, or takes intermediate and/or long acting insulin.

Question 3

If the patient’s symptoms have resolved, may consider release without transport.
All of the following conditions must be met:

Answer 3

• Not actively vomiting/is tolerating oral intake
• Patient had adequate response to single dose of dextrose - with VS in BLS range, normal mentation, and FSBG within normal limits.
• Patient has no acute conditions other than hypoglycemia (chest pain, shortness of breath, intoxication, liver disease, kidney disease, or febrile illness).
• Patient only on short acting insulin or premixed analog (e.g. NovoLog® 70/30 or Humalog® 70/30)
• Patient is not taking oral agents (other than metformin) for blood glucose control.
• Patient released to competent adult
• Patient or legal guardian refuses transport or patient and providers agree transport is not indicated