Hypoglycaemia guideline
| Hypogylcaemia in Emergency Guideline |
Hypoglycaemia is defined as:
A blood glucose measurement of equal to or lower than 2.6 mmol/L
using an arterial blood gas (ABG) machine, iSTAT, or formal laboratory testing.
Hypoglycaemia is a MEDICAL EMERGENCY
If left untreated it can cause convulsions, irreversible brain damage and death
Intravenous access should be obtained rapidly if:
• Blood Glucose Level (BGL) recorded on a glucometer is less than 3.0mmol/L
(Glucometers do not provide accurate levels at the low end of the scale and should be used as a guide only)
OR
• BGL recorded on a formal laboratory testing or iSTAT machine is 2.6mmol/L or below
Upon obtaining intravenous (IV) access:
• Confirm hypoglycaemia on an iSTAT machine or formal blood glucose sample
• Draw 6mL of blood for further investigations
• Measure blood ketones using a blood ketone monitor
• Treat hypoglycaemia with an initial intravenous bolus of 2 mL/kg of 10% glucose
• After the IV bolus, commence an infusion of 10% glucose with 0.9% NaCl at maintenance rate
• If the child is dehydrated, commence maintenance fluids plus replacement of deficit over 24 hours
The blood samples that should be sent to the lab are detailed in the hypoglycemia guideline.
There are pre-prepared packs of the relevant sample bottles available in the treatment room of the paediatric ward.
A list of the tests required is also held in each of the iv/cannulation trolleys
A pyurate sample must also be sent and the sample bottle for this is kept in the fridge in children's ED.
The first urine passed should also be collected.
A blood glucose measurement of equal to or lower than 2.6 mmol/L
using an arterial blood gas (ABG) machine, iSTAT, or formal laboratory testing.
Hypoglycaemia is a MEDICAL EMERGENCY
If left untreated it can cause convulsions, irreversible brain damage and death
Intravenous access should be obtained rapidly if:
• Blood Glucose Level (BGL) recorded on a glucometer is less than 3.0mmol/L
(Glucometers do not provide accurate levels at the low end of the scale and should be used as a guide only)
OR
• BGL recorded on a formal laboratory testing or iSTAT machine is 2.6mmol/L or below
Upon obtaining intravenous (IV) access:
• Confirm hypoglycaemia on an iSTAT machine or formal blood glucose sample
• Draw 6mL of blood for further investigations
• Measure blood ketones using a blood ketone monitor
• Treat hypoglycaemia with an initial intravenous bolus of 2 mL/kg of 10% glucose
• After the IV bolus, commence an infusion of 10% glucose with 0.9% NaCl at maintenance rate
• If the child is dehydrated, commence maintenance fluids plus replacement of deficit over 24 hours
The blood samples that should be sent to the lab are detailed in the hypoglycemia guideline.
There are pre-prepared packs of the relevant sample bottles available in the treatment room of the paediatric ward.
A list of the tests required is also held in each of the iv/cannulation trolleys
A pyurate sample must also be sent and the sample bottle for this is kept in the fridge in children's ED.
The first urine passed should also be collected.