amp of D50

  1. 0 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 D50 and how do you administer it in an emergency situation? Is it IV push or IV drip? If it is an IVP, over how many mins do you push? If it's an IV drip, for how long should it infuse into the pt?

    Thank you in advance for your responses.
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  3. Visit  happyRN21} profile page

    About happyRN21

    Joined Aug '10; Posts: 21.

    46 Comments so far...

  4. Visit  FancypantsRN} profile page
    0
    i would give 1 amp d50 iv, faster acting. 1 amp is usually 50ml's from what i have seen, i push it over a couple minutes. it's hard to push, so you can't push it too fast. i have never seen a d50 drip, only d5w or d10w. in the er, you just push it like you would on the floor. it's pretty good stuff, works fast. hope this helps...
  5. Visit  Mommy&RN} profile page
    0
    I am on a surgical unit, but here is what we do for the most part.

    1. Npo <70 with IV access = 1/2 amp D50 (12.5grams I think)
    2. Diet ordered, 4 oz of juice or regular cola. Also have glucose tabs available, but have not seen anyone choose that tx.
    3. No IV access gets glucagon IM

    D50 is about the consistancy of syrup, it takes a effort to push it.
  6. Visit  Do-over} profile page
    2
    I push the amp of D50 as fast as I can, which isn't very fast at all.

    If patient is alert and oriented and able to swallow / not NPO, I give juice followed with some protein.
    tokmom and Five&Two Will Do like this.
  7. Visit  GilaRRT} profile page
    3
    One "amp" of D50 generally means giving the entire container of D-glucose 50%. this will be a 50 ml container. Since percent solutions refer to grams/100ml, a 1% solution will be 1 gram per 100ml. Therefore, 50% will be 0.5 grams per ml or 25 grams in a 50 ml "amp."
    netglow, I<3H2O, and an2on like this.
  8. Visit  ayla2004} profile page
    0
    nurses cant push d50 in my hospital
    we give glucose tabs if can eat drink
    hypostop gel if pt perfers
    if not eating IM glucogon
    if not effective bleep medic for iv d50 i work ina teaching hosptial and IM glucagon is very effective
  9. Visit  nurse2033} profile page
    0
    If you have no IV access glucagon is the far second choice. With IV access, push that syrupy goodness as fast as you can. The IV must be as proximal and large as possible, i.e. 18 or 16 in the AC.
  10. Visit  Been there,done that} profile page
    0
    Looks like you work in Er. You must learn your standing orders.Please contact your nursing educator, don't be afraid to ask for more education.
    The D50 amp is standardized. Get familiar with all the meds, doses and equipment so you can automatically administer the drugs.
    Think about what the med is going to effect. In the case of D50,, the faster , the better.
  11. Visit  rkitty198} profile page
    1
    If you have a so so IV, don't give D50! Give the Glucagon. It is very acidic and if it infiltrates- tissue necrosis (I have seen it happen).
    I would push it fast, yet be wary of your IV guage and go accordingly.
    One amp is 50ml.

    If NPO <60 we give D50, and then continue to monitor q15 min because it is rapidly absorbed and they can quickly become hypoglycemic again.
    MunoRN likes this.
  12. Visit  himilayaneyes} profile page
    0
    Love D50, works quickly. At my hospital, we're to give D50 for blood sugar < 70. Of course, if the patient can eat and rink, I'll give them some oj with some crackers and peanut butter. But I'm not flushing oj through an ngt or anything...push that D50! If there's no iv access, then glucagon.
  13. Visit  MunoRN} profile page
    0
    D50 should be used very conservatively. It often has a pH of 3.5, which makes it a strong vesicant (anything less than a pH of 5 is considered a vesicant). Even if it doesn't extravasate it will still damage the vein to some degree due to it's acidity. There is no reason to give it just for a BG of <70 as a BG of 60 is still a normal fasting BG level. If we see severe symptoms (stroke-like symptoms, unconsciousness, etc) then we give D50, otherwise we give juice or run D5 or D10.
    Last edit by MunoRN on Apr 17, '11
  14. Visit  Do-over} profile page
    0
    Quote from himilayaneyes
    But I'm not flushing oj through an ngt or anything...
    I've done it - easier, effective, safer, and not to mention cheaper. Well, assuming a couple of juices are cheaper than an amp of D50
  15. Visit  himilayaneyes} profile page
    0
    If your patient is comatose and intubated, will you insert ngt so you can push oj (hopefully already has ngt) vs. pt has a picc and an amp of D50 is available. I'm not necessarily looking for what's cheaper for the hospital. I'm looking for what's going to help my patient the fastest. Not saying that you can't insert a ngt and push that oj, but I'm looking to treat that sugar quickly. Plus, just because pt has a ngt doesn't mean we're feeding him. If he's npo, give the D50. At the end of the day, follow you facility's policy. At my hospital, BG < 70 is to be treated.
    Last edit by himilayaneyes on Apr 19, '11


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