04 Blood Sugar Problem Suspected

STANDARD OPERATING GUIDELINES

 #4   BLOOD SUGAR PROBLEM SUSPECTED

1.                  Establish level of consciousness.

2.                  Secure and maintain airway.  Consider C-spine precautions.

3.                  Administer O2 to maintain SaO2 >95% (90% is history of COPD)

4.                  Talk to patient and reassure to decrease anxiety.

5.                  Complete Primary Survey.  Initiate BCLS as indicated.

6.                  Perform glucometry according to Glucose Meter Guidelines.

*Blood glucose less than 60 = CALL MEDICAL CONTROL to consider Glucagon Administration.

7.                  If patient is alert, with intact gag reflex, administer Oral Glucose.

8.                  CALL FOR INTERCEPT IF INDICATED.

9.                  Be ready to attach defibrillator if patient’s condition deteriorates.

10.              Obtain Secondary Survey, History, Vital Signs.

11.              Place patient in position of comfort.

12.              Contact Medical Control.

13.              Monitor Vital Signs and Condition enroute.

Glucagon Guidelines

1.                  Direct order from Medical Control necessary to administer.

2.                  Blood sugar level less than 60 via glucometry.

3.                  Determine patient’s last insulin/medication dose, type, and time.

4.                  Document specifics of IM injection.

5.                  Note response to measure taken.

Glucagon Indications                                                                Dosage

Hypoglycemia (<60) with any of the following:          1.  Add diluent to powdered medication

  Decreased mental status                                        2.  Gently shake to mix thoroughly

  Apparent stroke                                                       3.  Draw up 1 mg of Glucagon

  Seizure                                                                    4.  Administer intramuscularly (IM)

  Suspected diabetic emergency

Contraindications – consult physician

  Allergy to Glucagon

  Adrenal tumor