OBJECTIVES

To determine blood Glucose level, in an attempts to determine the etiology of the patient’s condition and provide treatment.

INDICATION OF PROCEDURE

Patient presenting with

• Altered mental status.
• Seizure activity.
• Unresponsiveness.

PROCEDURE

• Undertake universal precautions.
• Perform patient assessment.
• Place patient in position of comfort.
• Adult
  • If blood glucose is < 70 mg/dl(3.8mmol) administer 25 g 50% dextrose IV.
  • If unable to initiate an IV/IO and blood glucose is less than 70 mg/dl, administer glucagon 1 mg IM if >25 kg or 0.5 mg IM if <25 kg.
  • If blood glucose is greater than 250 mg/dl, administer 10 ml/kg LR bolus unless pulmonary rales, wheezing, pedal odema, or history of renal odema or CHF.
• Pediatric
  • If blood glucose is <70 mg/dl (3.8mmol) and patient < 2 months of age, administer 5.0-10.0ml/kg D10W IV/IO (D10W is prepared by mixing one part of D50W with four parts LR).
  • If older than 2 months but younger than 2 years of age, administer 2.0-4.0 ml/kg of 25% dextrose IV/IO (D25W is prepared by mixing D50W with an equal volume of LR).
  • If > 2 years of age, administer D50W 1-2 ml/kg IV/IO, max dose 25.0 g.
  • If blood glucose is > 250 mg/dl, administer 10 ml/kg LR bolus IV/IO unless pulmonary rales, wheezing, pedal odema or history of renal failure or CHF.

MEDICAL DIRECTION

• Adult patient with blood glucose > 40mg/dl (2.2mmol), administer second dose of D50W.
• Pediatric patient with blood glucose >40 mg/dl (2.2mmol), administer second dose of D25 or D10W.