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GLUCOSE EMERGENCIES: 9.0

All Providers

  • Focused history and physical exam
    • Blood glucose assessment
    • Hypoglycemia defined as glucose <50 mg/dl with any degree of altered mentation
  • Treatment Plan
    • Discontinue insulin pump, if applicable; disconnect from patient’ skin
    • May encourage oral intake if mental status returns to normal
    • Criteria for scene release:
      1. normal capacity and patient does not want transport to medical facility
      2. no suicidal ideation or recent attempts
      3. Responsible party present that can assist patient
      4. OLMC contacted and agrees to release
      5. Age >18
  • Key Considerations
    • Do not give oral glucose to unconscious patient or diminished gag reflex
    • Transport any patient at risk for prolonged hypoglycemia such as long acting insulin or oral hypoglycemic overdose
    • Repeat blood glucose every 15 minutes to check for recurrence

ADULT

EMT
AEMT
  • Vascular access and fluid therapy per IV/IO Access and IV Fluid Therapy protocol
  • HYPOGLYCEMIA
    • Dextrose 10%: infuse 125 ml, then repeat blood sugar, if <100 mg/dl, repeat
    • Glucagon 1 mg IM if no IV/IO access
  • HYPERGLYCEMIA
    • Normal saline 1000 ml IV/IO over 30-60 minutes for BS >300 mg/dl
Paramedic

Pediatric

EMT
AEMT
  • Vascular access and fluid therapy per IV/IO Access and IV Fluid Therapy protocol
  • HYPOGLYCEMIA
    • Dextrose 10% 5 ml/kg IV/IO: may repeat as needed
    • Glucagon 0.1 mg/kg (Max dose of 1mg) IM if no IV/IO access
  • HYPERGLYCEMIA
    • Normal saline 20 ml/kg IV/IO over 30-60 minutes for BS >300 mg/dl
Paramedic