Hypo or Hyperglycemia

Section 5 -MEDICAL

5.10 HYPO / HYPERGLYCEMIA

INITIAL MEDICAL CARE (2.01): Provide OXYGEN or assist ventilations as appropriate for patient condition.

• Obtain history of time of patient's last medication dosage and patient's last meal.
• Obtain and record blood sugar level.
• Draw blood tubes, if available.

BLOOD SUGAR < 100 OR SIGNS AND SYMPTOMS OF INSULIN SHOCK / HYPOGLYCEMIA:

• If patient awake with intact gag reflex, administer GLUCOSE GEL up to 30 grams orally.
• If NO response or if patient exhibits ALTERED MENTAL STATUS (5.03):
  • DEXTROSE 50% 25 gm IVP for adults
  • For pediatric administration dilute DEXTROSE 50% to DEXTROSE 25% and refer to Broselow Tape.
  • If unable to obtain IV access, GLUCAGON 1 mg IM or IN. / If patient is between 10 kg (22lb) - 20 Kg (44lb) .5 mg IM or IN. Call for dosage order in pediatrics < 10 kg (22lb). GLUCAGON onset in 8-10 minutes.
• If LIMITED or NO response after initial DEXTROSE 50%:
  • Repeat DEXTROSE 50% 12.5 gm IVP for adults.
  • For pediatric administration dilute DEXTROSE 50% to DEXTROSE 25% and refer to

Broselow Tape.

• If the patient is a Trauma patient or a Stroke is suspected: Consider administration of ½ dose of D50 following Blood Sugar monitoring.

BLOOD SUGAR LEVEL > 250 WITH SIGNS AND SYMPTOMS OF HYPERGLYCEMIA / KETOACIDOSIS:

• Administer a fluid bolus of 200 - 300 ml. Continue IV infusion KVO.

PATIENT REFUSALS

If a patient has been treated for hypoglycemia or seizures, transport is not required if:

• The patient is stable

AND

• The patient has a competent adult that will remain with the patient for hours

AND

• The patient understands and agrees to eat, re-check blood sugar and call back if necessary.