Hypoglycemia

Indications: Agitation or altered LOA or symptoms of a stroke.

Glucagon: If the patient is hypoglycemic and has no sensitivity to glucagon and does not suffer from pheochromocytoma and weighs ≥ 25kg administer 1mg of glucagon IM.

If the patient weighs < 25kg then administer 0.5mg glucagon IM.

If after 20 minutes the patient is still hypoglycemic you may administer a 2nd dose.

Dextrose: If the patient is ≥ 2 years of age and is hypoglycemic then administer D50W IV 0.5mg/kg (1ml/kg) to a maximum dose of 25g (50ml). If after 10 minutes the patient is still hypoglycemic then you may administer a 2nd dose.

If the patient is ≥ 30 days but < 2 years of age and is hypoglycemic then administer D25W IV 0.5g/kg (2ml/kg) to a maximum dose of 10g (40ml). If after 10 minutes the patient is still hypoglycemic then you may administer a 2nd dose.

If the patient is < 30 days and is hypoglycemic then administer D10W IV 0.2g/kg (2ml/kg) to a maximum 5g (50ml).

If after 10 minutes the patient is still hypoglycemic then you may administer a 2nd dose.

 

Clinical Considerations: If the patient responds to glucagon or dextrose they may receive oral glucose or simple carbohydrates.

If only mild sign and symptoms of hypoglycemia are initially exhibited then the patient may receive oral glucose or simple carbohydrates instead of glucagon or dextrose.

If the patient initiates an informed refusal of transport, a final set of vital signs including blood glucometry must be attempted and documented.