Hypoglycemia
Hypoglycemia
Fingerstick < 40 prior to treatment and > 80 post treatment
Symptoms resolved with administration of glucose
Type I or Type II Diabetes
Etiology determined (ie, hypoglycemia due to administration of insulin with inadequate PO intake; incorrect insulin dose)
Safe home environment for discharge
Intentional over dose of hypoglycemic agents or active mental health issue
Insufficient change in symptoms with administration of glucose
Altered mental status
Requiring a D10 drip to maintain euglycemia
Fingerstick Glucose every hour x 2 hours, then every 2 hours x 4 hours, then every 4 hours
Dextrose 50% IV solution as needed for blood glucose < 70
IV D50 1 amp if glucose <50; if glucose < 70 give ½ amp of D50 (orange juice if alert or one glucose tablet PNR)
D5 -0.9% NS at 100 cc/hr x 1 liter; continue as needed
BMP every 4 hours
Potassium replacement protocol as needed
Disposition
Improvement of symptoms
Safe home environment and adult supervision
FSG >80 x 2
Patient is tolerating PO intake
Evaluation and resolution of precipitating factor
Deterioration of clinical signs
Unstable vital signs
Altered neurologic status
FSG persistently < 80 after 18 hours of evaluation