Low blood sugar, juice or D50? - page 4
Last night I had a patient with a BS of 39. I had just finished giving report on her when she asked us to check her BS. Since the oncoming nurse still had to get report on a few more patients, I... Read More
Aug 16, '12Surely, you cannot believe that most people die with a bs of 39. Having been a type 1 for almost 20 years, I can tell you that my sugar hits the 30s at least one a month, and I am still kicking. Guess I have hundreds of lives or perhaps great luck?
Aug 23, '12After reading all the responses, I think you all are talking acute care/hospital. In LTC, I've had to fight to have appropriate snacks and juices avail. Some places only supply that phoney orange-aid punch. And good luck trying to obtain any substantial sandwiches; sometimes even sugar packs are a bene-luxury.
Some places are better than others; some lock up their kitchens at 7pm (supervisor may or MAY NOT have a key). Don't get me started on food availability for 11 - 7 shift's early send-outs, like dialysis, hosp ORs, etc.
But if I get a really brittle diabetic, I get a prn glucogen order. I also ensure the availability of glucose jelly (even if I keep my own supply). I personally check for all the meds, glucometer supplies, etc so I know my 11 - 7 staff can manage low BS episodes; and they have all become very proficient doing so. I worked with a diabetic nurses who was a stickler for other diabetics, so I guess part of her rubbed off on me. (Thank you LD!)
Aug 26, '12I'm late to this but my advise as coming from a critical care/ED and type 1 diabetic is if the pt is alert & oriented, can answer questions appropriately, and cooperative give them the oral treatment of juice, crackers and protein. At a level below 50 mg/dl I would give them the equivalent of 30 grams of fast acting carbohydrates and add some protein. If the pt is not cooperative, confused or uncooperative, then I would go right for the D50 or glucocon. The pt will forgive you afterwards. =-)
Aug 26, '12Does your hospital have a hypoglycemia management protocol? Typically if the patient is awake and alert and not NPO, you go ahead and perform a "rescue intervention" by giving them 15gm of carbohydrate. If they are NPO and/or not alert, then you go with the amp of D50. If they didn't respond to the rescue intervention, I would have grabbed the D50. You need to recheck the blood sugar, though. Our protocol is within 20-30minutes after performing a rescue intervention.