D50 rectal?

[mcknis]

I was looking on an EMS forum today and found that some facilities/EMS companies are now allowing their staff to admin D50 rectally in cases of hypoglycemia with unconsciousness when unable to gain IV access in severe dehydration/NPO/etc. Has anyone else used this route, and if so how effective is it. i could see some bigs pro's to it, however the only con would be enema side effects, ahem. I know this would have to be written into policy, but during a crisis, what would you do?

[Boston-RN, RN]

I have not heard of this. For those pts our facility was rolling out a glucose gel that could be given sub-buccal (sp) and can be absorbed without swallowing. Haven't seen it yet. Theres always IM injection. I would just worry with rectal admin about absorption times (and the mess)

[GilaRRT]

It is possible for rectal absorption of glucose via the mucosa. In addition, I would be quite hesitant to give anything orally to somebody with depressed mentation because of the airway and aspiration issues. Honestly, with the proliferation of IO technology and devices, the ability to obtain emergency access should not be a significant consideration.

[grace90, LPN, LVN]

We have Glucagon we can give IM or SQ if a pt is unconscious with a low blood sugar and no IV site. We also have the gel for an alert pt with no IV access. The nice thing about all this is that we have the protocol to treat the low blood sugar with any of these routes including IV D50, and *then* call the physician. In fact, they expect this.

[leslie :-D]

it wasn't a pharmaceutical product, but i have concocted sugar solutions and administered them rectally via syringe.

you do what you have to do.

and if a pt's buccal mucosa is parched/dehydrated, then intrabuccal is not a viable alternative.

leslie

[ciber-1]

it is possible to administer it rectally, and if BP is relatively normal there will be almost the same effect as of IV, and safer. But it is always better to see what are the protocols of treating hypoglycemia.

[blondy2061h, MSN, RN]

I'm with Grace. IM Glucagon is the way to go.