Managing Hypoglycemic event at your hospital

[RNCROSA]

Would like some feedback from the group. We are implementing a new CBG protocol to manage our Hypoglycemic events. I am searching the web for further nurses that may have Blood Sugar monitoring protocols in their units. Our CBG protocol is very demanding and we are not meeting our goal. I would like some feedback on the part of the protocol that we are having trouble with meeting the time constraint invovled. Would like to know your thoughts and if you have a Protocol in your unit could you share it. We are a medical internal medicine floor with census of 31 and nurse pt ratio of 8-10 to one RN, LPN work with us also and are usually 3 on per shift also.

Section of protocol that we would like feedback from:

Hypoglycemia is define as bs less than 80mg/dl. If a cbg is less than that and the person in concious than given juice, or glucose gel and repeat cbg in 15 min.

Question : Can cbg be repeated within 30min and still be reliable. If so, do you have some literature to support or a protocol in place that we can review and present to the Endocrine Committee assigned to CBG monitoring in hospital.

thanks frustrated Rosa.

[cannoli]

Maybe you could change your parameter. We don't treat until it's less than 70.

[moonchild20002000]

Have any of you used milk to treat reactions? We used to give our diabetic OB

patients a glass of milk for blood sugars of 60 or less. We would then repeat the blood sugar after 20 minutes.With this method there is a gradual rise in the blood sugar but you don't get the high readings that you do with juice.

[talaxandra]

We treat blood sugars below 3.5mmol/L (63mg/dL) with 50ml of glucatol, plus complex carbs (either a sandwich or toast and jam). The sugar is rechecked 15 minutely, with the glucatol dose repeated until the BSL is above 3.5.

We only give juice or milk (with added sugar) if the patient refuses the glucatol and seems oriented.

This protocol does tend to shoot the patient's sugar up bit - usaully no higher that 15 or so (270mg/dL) - but we get far fewer ill-efects from progressing hypoglycaemia. Our former policy (which called for 30ml of glucatol) resulted in about 5% of hypoing patients progressing to disorientation and/or unconsciousness.

Hope this helps :)