Pediatric Hypoglycemia

Question 1

Pediatric Hypoglycemia - BGL < 4 and verbally responds to commands treatment

Answer 1

Oral glucose 25 g PO

Question 2

Pediatric Hypoglycemia - BGL < 4 does not follow commands or oral glucose does not cause improvement

Answer 2

Attempt vascular access x 2

Question 3

Pediatric Hypoglycemia - Vascular access successful in hypoglycemic patient < 10 kg medication

Answer 3

D10W 0.5 g/kg q 5

titrate to BGL > 4

Question 4

Pediatric Hypoglycemia - Vascular access successful in hypoglycemic patient 10 - 40 kg medication

Answer 4

D25W 0.5 g/kg to single max of 12.5g q 5 min

titrate to BGL > 4

Question 5

Pediatric Hypoglycemia - Vascular access successful in hypoglycemic patient > 40 kg medication

Answer 5

D50W 12.5 g q 5 min

titrate to BGL > 4

Question 6

Pediatric Hypoglycemia - Vascular access unsuccessful in hypoglycemia patient < 20 kg

Answer 6

Glucagon 0.5 mg IM q 15 x 1

total max 1 mg

Question 7

Pediatric Hypoglycemia - Vascular access unsuccessful in hypoglycemia patient > 20 kg

Answer 7

Glucagon 1 mg IM q 15 x 1

total max 2 mg

Question 8

Pediatric Hypoglycemia - Patient fails to improve after max dose of glucagon

Answer 8

Continue to attempt IV access and use appropriate dextrose solution

Question 9

Pediatric Hypoglycemia - Is it possible to treat and refer pediatric patients

Answer 9

No - they require transport

Question 10

Pediatric Hypoglycemia - Oral glucose indications, dose and contraindiations

Answer 10

Treats - Hypoglycemia
Give - 25 g PO no repeat
Do not give - unable to swallow

Question 11

Pediatric Hypoglycemia - Glucagon indication

Answer 11

Hypoglycemia and unable to obtain IV

Question 12

Pediatric Hypoglycemia - Glucagon dose

Answer 12

Less than or equal to 20 kg: 0.5 mg IM q 15 min x 1

Greater than 20 kg: 1 mg IM q 15 min x 1

Question 13

Pediatric Hypoglycemia - Glucagon EMS contraindications

Answer 13

Hypersensitivity to glucagon, beef or pork proteins

Question 14

Pediatric Hypoglycemia - Glucagon precautions

Answer 14

Other carbohydrates must be given to prevent relapse

Maximum effect 25 min

Question 15

Pediatric Hypoglycemia - Dextrose solutions indications

Answer 15

Hypoglycemia with IV access

Question 16

Pediatric Hypoglycemia - Dextrose dose for pt < 10 kg

Answer 16

D10W 0.5 g/kg q 5 prn

Question 17

Pediatric Hypoglycemia - Dextrose dose for pt 10 - 40 kg

Answer 17

D25W 0.5 g/kg single max of 12.5g q 5 prn

Question 18

Pediatric Hypoglycemia - Dextrose dose for pt < 40 kg

Answer 18

D50W 12.5g q 5 prn

Question 19

Pediatric Hypoglycemia - To create D10W

Answer 19

remove 40 ml from the D50W pre-load and replace with 40 ml of normal saline (0.5 g/5 ml)

Question 20

Pediatric Hypoglycemia - To create D25W

Answer 20

remove 25 mL from the D50W pre-load and replace with 25 mL normal saline (0.5 g/2 ml)

Question 21

Pediatric Hypoglycemia - Dextrose solutions EMS contraindications

Answer 21

Allergy to corn or corn products

Question 22

Pediatric Hypoglycemia - Dextrose solutions precautions

Answer 22

Ensure patency of IV site after half of dose is administered
Other carbohydrates must be given to prevent relapse
Max effect in 5 minutes