amp of D50 - page 4

by happyRN21

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Hi everyone, I have the following questions: If a person is hypoglycemic and unconscious, do you give an amp of D50 or 1mg of glucagon IM in the ED? I also want to know what an amp actually means. How many mg/cc is an amp of... Read More


  1. 0
    I'm a nursing student so I can't speak from experience... but I can share with you all what I was taught in school last year.

    1) Each facility has it's own protocol for hypoglycemia....LEARN IT AND FOLLOW IT!
    2) If a person is awake and conscious, then most likely you will not use D50 (I've read other posts that say they do, just saying what I was taught..); if PO is possible, then PO is the way to go.
    3) D50 is a vesicant drug and cannot be pushed "as fast as possible" as most of you have said... we were taught to push it over 17 MINUTES!! This freaks me out because if my patient is unconscious from low BS, my reaction would be to push it quickly... but my instructors insist the correct way to do it is over 17 minutes.

    Please don't yell at me for this, haha, this is what I was taught in school.
  2. 4
    Quote from Samantha13
    I'm a nursing student so I can't speak from experience... but I can share with you all what I was taught in school last year.

    1) Each facility has it's own protocol for hypoglycemia....LEARN IT AND FOLLOW IT!
    2) If a person is awake and conscious, then most likely you will not use D50 (I've read other posts that say they do, just saying what I was taught..); if PO is possible, then PO is the way to go.
    3) D50 is a vesicant drug and cannot be pushed "as fast as possible" as most of you have said... we were taught to push it over 17 MINUTES!! This freaks me out because if my patient is unconscious from low BS, my reaction would be to push it quickly... but my instructors insist the correct way to do it is over 17 minutes.

    Please don't yell at me for this, haha, this is what I was taught in school.
    Thank you so much for your input. Just remember that with an unconscious pt and a good iv, you are not really worry about waiting 17 minutes to push it. A good example is when a pt is coding you really dont worry about pushing epi or any drugs slow. In the real world sometimes what's in the book and what is practical don't go together, with time you'll find your mojo. Welcome to the nursing world and thank you for sharing your knowledge.
    GrnTea, donsterRN, Unknown member, and 1 other like this.
  3. 0
    D50 push here to. Of course it's nasty to veins, but be sure you have a good IV site. It's pretty thick, so pushing it quickly isn't optional. Also, remember it will wear off soon, so be prepared for another crash, until you have IV or foods given.
  4. 0
    Quote from Samantha13
    we were taught to push it over 17 MINUTES!! This freaks me out because if my patient is unconscious from low BS, my reaction would be to push it quickly... but my instructors insist the correct way to do it is over 17 minutes.
    I'm sorry, what? D50 is a RESCUE drug. Wow. And where did 17 minutes come from...that is a very random amount of time!

    I'm not yelling at you, Samantha; I am questioning your instructors!
  5. 0
    Quote from DeLanaHarvickWannabe
    I'm sorry, what? D50 is a RESCUE drug. Wow. And where did 17 minutes come from...that is a very random amount of time!

    I'm not yelling at you, Samantha; I am questioning your instructors!

    Haha, that is okay. I know, it sounds quite ridiculous but LOOK:

    2011 Intravenous Medications by Gahart
    "50% solution, 3 mL over 1 minute"

    3 mL/1 minute = 50 mL/x minutes = 16.66 = 17 minutes
  6. 0
    Quote from Samantha13
    Haha, that is okay. I know, it sounds quite ridiculous but LOOK:

    2011 Intravenous Medications by Gahart
    "50% solution, 3 mL over 1 minute"

    3 mL/1 minute = 50 mL/x minutes = 16.66 = 17 minutes
    I checked out my health care system's formulary, and it agrees with this except in emergent use. Apparently in a continuous infusion, the 3mL/min maximum is appropriate. So no more than 180 mL/hour. (But dear heavens, I have never seen anything more than D10 given as a drip!)

    My formulary also recommends central access, and doesn't have a maximum per minute push rate for emergent use. Ugh, that is annoying! I think formularies and drug guides are sometimes written by Martians...
  7. 0
    Thanks for the reply. I work for an infusion company that teaches IV classes. I talked to the educator yesterday and asked his opinon...he said in an emergency situation, you push the first half as fast as you can, which isn't that fast because of the viscosity, then he said at that point hopefully the patient becomes conscious and you push the 2nd half slowly. Interesting.

    Maybe I'll become an IV nurse some day and become an expert on this!! haha
  8. 0
    Quote from DeLanaHarvickWannabe
    I checked out my health care system's formulary, and it agrees with this except in emergent use. Apparently in a continuous infusion, the 3mL/min maximum is appropriate. So no more than 180 mL/hour. (But dear heavens, I have never seen anything more than D10 given as a drip!)

    My formulary also recommends central access, and doesn't have a maximum per minute push rate for emergent use. Ugh, that is annoying! I think formularies and drug guides are sometimes written by Martians...

    none 'emergent' use of D50

    D50 and insulin for hyperkalaemia anyone ?

    drug guides are written by freaks - if you aren't meant to use smaller than a 10 ml syringe into IVs how can i give 10mg / ml Morphine sulphate or 100mg in 2 ml tramadol without diluting them to 1mg in 1ml or 10mg in 1ml respectively and still give slowly / titrate ...

    NEVER EVER give IV tramadol neat it gets messy as your patient does their impression of something out of a horror movie projectile vomiting across the ward...
  9. 0
    Something you might look into is the use of D10 vs. D50 for hypoglycemia ( Journal of Emergency Primary Health Care ).

    The use of D10 was found to be AS quick, as the use of D50 to correct hypoglycemia (8 minutes for both), with less side effects. The difference in osmolality is also huge (10% dextrose is about 220 mOsmol/L higher than serum, slightly less then twice, while 50% dextrose is about 2,235 mOsmol/L higher than serum, almost 9 times as high.)
    DEXTROSE (DEXTROSE MONOHYDRATE) INJECTION, SOLUTION [BAXTER HEALTHCARE CORPORATION]

    What I have been doing is removing 50ml from a 250ml bag of NSS & injecting the 25g of D50, thus creating D10 & then infusing it, rather then pushing it. Much easier to admin. this way & I also find that it generally results in less Dextrose needing to be admin. for an increase in mental status, AND also having less chance of "spiking" the pts. BG and having the rebound "fall" again.
  10. 0
    Quote from LearningByMistakes
    Something you might look into is the use of D10 vs. D50 for hypoglycemia ( Journal of Emergency Primary Health Care ).

    The use of D10 was found to be AS quick, as the use of D50 to correct hypoglycemia (8 minutes for both), with less side effects. The difference in osmolality is also huge (10% dextrose is about 220 mOsmol/L higher than serum, slightly less then twice, while 50% dextrose is about 2,235 mOsmol/L higher than serum, almost 9 times as high.)
    DEXTROSE (DEXTROSE MONOHYDRATE) INJECTION, SOLUTION [BAXTER HEALTHCARE CORPORATION]

    What I have been doing is removing 50ml from a 250ml bag of NSS & injecting the 25g of D50, thus creating D10 & then infusing it, rather then pushing it. Much easier to admin. this way & I also find that it generally results in less Dextrose needing to be admin. for an increase in mental status, AND also having less chance of "spiking" the pts. BG and having the rebound "fall" again.
    If this is approved by your hospitals formulary and it is not for the insulin/dextrose treatment for elevated K. The only time 50% dextrose need to be diluted is for peds/neonates. Although this thread is a year old there are some things always worth repeating.


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