Podcast
Questions and Answers
What is the initial threshold blood glucose level indicating hypoglycemia?
What is the initial threshold blood glucose level indicating hypoglycemia?
- 70 mg/dl
- 80 mg/dl
- 60 mg/dl (correct)
- 40 mg/dl
Which intervention should be performed if a patient with hypoglycemia is alert and oriented?
Which intervention should be performed if a patient with hypoglycemia is alert and oriented?
- Administer D10 intravenously.
- Provide orange juice sweetened with sugar. (correct)
- Initiate airway management.
- Consider IV dextrose treatment immediately.
For a patient aged 2 to 14 years with a blood glucose level of ≤ 60 mg/dl who cannot tolerate oral glucose, what is the recommended intravenous treatment?
For a patient aged 2 to 14 years with a blood glucose level of ≤ 60 mg/dl who cannot tolerate oral glucose, what is the recommended intravenous treatment?
- Dextrose at 3 ml/kg.
- D10 at 5 ml/kg.
- D50 at 1 ml/kg. (correct)
- D25 at 2 ml/kg. (correct)
What should be done if blood glucose remains ≤ 60 mg/dl after initial dextrose treatment?
What should be done if blood glucose remains ≤ 60 mg/dl after initial dextrose treatment?
Which condition is NOT a symptom typically associated with hypoglycemia?
Which condition is NOT a symptom typically associated with hypoglycemia?
What is the primary goal when administering supplemental oxygen to a hypoglycemic patient?
What is the primary goal when administering supplemental oxygen to a hypoglycemic patient?
If intravenous access is unavailable in the case of hypoglycemia, which alternative treatment can be provided?
If intravenous access is unavailable in the case of hypoglycemia, which alternative treatment can be provided?
What should be done if a patient with hypoglycemia is observed seizing?
What should be done if a patient with hypoglycemia is observed seizing?
The blood glucose level indicating hypoglycemia is ≤ ______ mg/dl.
The blood glucose level indicating hypoglycemia is ≤ ______ mg/dl.
One treatment option for a patient alert and oriented with hypoglycemia is to provide ______ juice sweetened with sugar.
One treatment option for a patient alert and oriented with hypoglycemia is to provide ______ juice sweetened with sugar.
For patients aged under 2 years with blood glucose ≤ 60 mg/dl, the recommended treatment is D______, at a dosage of 5 ml/kg.
For patients aged under 2 years with blood glucose ≤ 60 mg/dl, the recommended treatment is D______, at a dosage of 5 ml/kg.
If IV access is unavailable for hypoglycemic treatment, one option is to administer ______ 0.5 mg Intramuscularly.
If IV access is unavailable for hypoglycemic treatment, one option is to administer ______ 0.5 mg Intramuscularly.
For patients aged 2-14 years with blood glucose ≤ 60 mg/dl, the recommended IV treatment includes D______ at 2 ml/kg.
For patients aged 2-14 years with blood glucose ≤ 60 mg/dl, the recommended IV treatment includes D______ at 2 ml/kg.
If blood glucose remains ≤ 60 mg/dl after initial treatment, additional Dextrose of ______ gm/kg may be given.
If blood glucose remains ≤ 60 mg/dl after initial treatment, additional Dextrose of ______ gm/kg may be given.
When administering oxygen to a hypoglycemic patient, the goal is to maintain SpO2 ≥ ______%.
When administering oxygen to a hypoglycemic patient, the goal is to maintain SpO2 ≥ ______%.
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Study Notes
Hypoglycemia
- Blood glucose level of 60 mg/dl or less
- History of diabetes
- Symptoms include: weakness, confusion, nausea/vomiting, and coma
BLS Treatment
- Supplemental oxygen as needed to maintain SpO2 ≥ 94%
- Use the lowest concentration and flow rate of oxygen possible
- Airway adjuncts as needed
- If trauma is suspected, assess for traumatic injury and/or need for Spinal Motion Restriction (SMR)
- Protect the patient from further injury if seizing
- If blood glucose is ≤ 60 mg/dl:
- If the patient is alert and oriented, consider oral glucose alternatives like orange juice sweetened with sugar, regular soft drinks, or oral glucose paste
- Have the patient swallow a small amount of water
- EMT may give glucose paste
- Transport
ALS Treatment
- Initiate vascular access and titrate to an appropriate Systolic Blood Pressure for the patient’s age
- If blood glucose ≥ 60 mg/dl, consider other causes of decreased sensorium
- If blood glucose ≤ 60 mg/dl and the patient doesn’t tolerate oral glucose, treat as follows:
- Under 2 years old: D10, 5 ml/kg
- 2-14 years old: D25, 2 ml/kg or D50 1 ml/kg. If D10 is only available give 5 ml/kg in this age group
- NOTE: if blood glucose remains < 60 mg/dl a repeat dose may be given
- If blood sugar remains ≤ 60 mg/dl, give additional Dextrose 0.5 gm/kg up to 12.5 gm
- If IV access is unavailable or delay is anticipated, treatment options are:
- Glucagon 0.5 mg Intramuscular (IM) if blood sugar ≤ 60 mg/dl
- Dextrose IO as per dosages above
- If blood sugar remains ≤ 60 mg/dl, give additional Dextrose as per the doses above
- Airway management as needed
- NOTE: Concentrations of 10% Dextrose (D10), 25% (D25), or 50% Dextrose (D50) may be used
- If IV access is unavailable and the blood sugar ≤ 60 mg/dl or decreased responsiveness continues for more than 15 minutes after administration of Glucagon, IO access should be established
- Cardiac monitoring
Hypoglycemia
- Blood glucose level of 60 mg/dl or less
- History of Diabetes
- Weakness
- Confusion
- Nausea/Vomiting
- Coma
BLS Treatment
- Supplemental oxygen as needed to maintain SpO2 ≥ 94%
- Use lowest possible oxygen concentration and flow rate
- Airway adjuncts as needed
- If trauma is suspected, assess for traumatic injury and need for Spinal Motion Restriction
- If patient is seizing, protect from further injury
- If blood glucose is ≤ 60 mg/dl:
- If patient is alert and oriented, consider orange juice sweetened with sugar, regular soft drinks, or oral glucose paste
- Have patient swallow a small amount of water, and EMT may give glucose paste if tolerated
- Transport
ALS Treatment
- Initiate vascular access
- Titrate to an appropriate Systolic Blood Pressure for patient's age
- If blood glucose ≥ 60 mg/dl, consider other causes of decreased sensorium
- If blood glucose ≤ 60 mg/dl and patient doesn’t tolerate oral glucose, treat as follows:
- Under 2 years old: D10, 5 ml/kg
- 2-14 years old: D25, 2 ml/kg or D50 1 ml/kg. If D10 is only available give 5 ml/kg in this age group
- If blood glucose remains < 60 mg/dl a repeat dose may be given
- If blood sugar remains ≤ 60 mg/dl, give additional Dextrose 0.5 gm/kg up to 12.5 gm
- If IV access is unavailable or delay is anticipated, treatment options are:
- Glucagon 0.5 mg Intramuscular (IM) if blood sugar ≤ 60 mg/dl OR
- Dextrose IO as per dosages above
- If blood sugar remains ≤ 60 mg/dl, give additional Dextrose as per the doses above
- Airway management as needed
- Concentrations of 10% Dextrose (D10), 25% (D25), or 50% Dextrose (D50) may be used
- If IV access is unavailable and the blood sugar ≤ 60 mg/dl or decreased responsiveness continues for more than fifteen (15) minutes after administration of Glucagon, IO access should be established
- Cardiac monitoring
Important Considerations
- Use the lowest possible oxygen concentration and flow rate
- If trauma is suspected, assess for traumatic injury and need for Spinal Motion Restriction.
- Consider other causes of decreased sensorium if blood glucose is ≥ 60 mg/dl.
- If blood sugar remains ≤ 60 mg/dl, give additional Dextrose.
- If IV access is unavailable and blood sugar ≤ 60 mg/dl or decreased responsiveness continues for more than fifteen (15) minutes after administration of Glucagon, IO access should be established.
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