Endocrine Post-Op Complications

Question 1

what is the most common cause of hypoglycaemia in a surgical patient?

Answer 1

iatrogenic

where they’ve either had too much insulin or hypoglycaemic drugs

Question 2

what are the risk factors for developing hypoglycaemia?

Answer 2

• diabetes
• post-gastrectomy
• alcohol excess
• renal dialysis
• beta blockers

Question 3

what are the clinical features of hypoglycaemia?

Answer 3

sweating, tingling lips, tremor, dizziness, slurred speech

Question 4

what are the clinical signs of hypoglycaemia?

Answer 4

confusion, tachycardia, tachypnoea, low GCS

Question 5

what effect does the surgical stress response have on insulin and plasma glucose levels?

Answer 5

stress response increases the activity of catabolic hormones, meaning there is low insulin activation
this leads to an increase in plasma glucose levels

Question 6

what is the management for a conscious hypoglycaemic patient?

Answer 6

oral glucose is given e.g. glucogel

blood glucose is monitored until stable

Question 7

what is the management for an unconscious hypoglycaemic patient?

Answer 7

protect their airway and give high flow O2

give IV glucose (100ml 20% stat)