DHEC EMS Division. Treatment of the Hypoglycemic Patient by the EMT-Intermediate. OBJECTIVES. TO UNDERSTAND………. The incidence, morbidity and mortality of endocrinologic emergencies related to Diabetes Mellitus and Glucose metabolism. Risk factors associated with Diabetes.
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Treatment of the Hypoglycemic Patient by the
EVERY SECOND COUNTS WHEN TREATING THE PATIENT WITH SEVERE HYPOGLYCEMIA!!
CALL FOR ALS BACK-UP!
The S.C. EMT-Intermediate MAY ONLY administer D50W to a patient who is
at least 12 years of age!!
DEXTROSE 50% IN WATER
DEXTROSE 50 %D50W, 50% Dextrose-------------------------------------------------------------------------------INDICATIONS: Suspected or documented hypoglycemia. Altered LOC, or Coma/Seizure of unknown etiology.ADMINISTRATION: IO, IV through a free flowing line.DOSAGE:ADULT: 25.0 grams slow administration initial dose. May repeat doses based upon Medical Control Order or Protocols/Standing Orders for persistent hypoglycemia.PEDIATRIC: May be used for patients at least 12 years old, or weighing at least 55 kg. (120 pounds)
Works MUCH better!!!
Desired dose divided by the dose on hand, multiplied by the volume supplied in, will give you the amount of volume you should administer.
Dose on Hand
X Volume = Amount
X 50 mL = 28 mL
14 divided by 25 = 0.56
0.56 multiplied by 50 = 28 (mL)
Give 28 mL of the solution
D50W Administration by the EMT-I
Skills Assessment Score Sheet
Name: _______________________ Date: __________ Evaluator: ______________________
Determines AMS, applies high flow oxygen _____
Performs patient assessment to include BGL test _____
Calls for Paramedic back-up _____
Determines need for the medication _____
Prepares IV equipment _____
Selects suitable site _____
Attaches tourniquet _____
Start IV using aseptic technique _____
Secures IV, runs W/O to check for infiltration _____
Prepare D50W for injection (check exp date, etc) _____
Pinch or clamp line, or run wide open _____
Administer desired dose using “push-pull” method _____
Runs IV W/O to flush line _____
Reassesses mental status _____
Reassesses BGL _____
Evaluator signature ____________________________________ Date _____________