BG 50-69 in an Alert Patient

Documentation of Hypoglycemia

Treatment Protocol for Patient

Less than 14 years of age

·  Check finger stick BG if patient experiences any symptoms of hypoglycemia including Pallor, Clammy Skin, Hunger, Restless Sleep, Fatigue, Headache, Confusion, Sweatiness and Irritability

·  If bedside BG < 50, confirm by repeating bedside test immediately as per policy and Do Not Delay Hypoglycemia Treatment

Document low Blood Glucose (BG):______Date:______Time:______RN:______

BG 40-50 in an Alert patient / BG < 40 in an Alert patient
(tolerating PO) / BG < 40
NOT tolerating PO or altered mental status
1. Give one of the following
(check the one given):
4oz Orange/Apple Juice
3 Graham Crackers
1 tube Glucose Gel (if able to
swallow thickened liquids)
start IV D5/0.45NS at maintenance
Time given:______
2. Notify MD (verify IV solution,
volume, rate, and duration, if
applicable)
Time given:______
MD notified:______
3. Recheck BG in 15 min BG:_____
4. Repeat accucheck every 1-2 hours
/ 1. Give one of the following
(check the one given):
8 oz milk (or Orange/Apple
juice)
1 tube Glucose Gel (if able
to swallow thickened
liquids)
start IV D5/0.45NS at maintenance
Time given:______
2. Notify MD(verify IV solution,
volume, rate, and duration, if
applicable) Time:______
MD notified:______
3. Recheck BG in 15 min BG:_____ / 1. Give (check the one given):
D10W (5cc/kg) IV followed by
D5/0.45NS at a rate of 1.5 X
maintenance dose.
If no IV access or still hypoglycemic give:
Glucagon 0.1mg/kg for < 1 year old
(max: 1 mg/dose)
or Glucagon 1mg/dose for > 1year old
Time given:______
2. If there is a change in level of
consciousness from baseline, then
call Rapid Response Team
Time called:______
3. Notify MD (verify IV solution,
volume, rate, and duration, if
applicable) Time:______
MD notified:______
4. Recheck BG in 15 min BG:______
5. Repeat accucheck every 30 mins until sugar is >40mg/dl
1. If BG <50 at 15 minutes, then re-treat & notify MD per algorithm Document Treatment Given:______
2. Document BD 15 minutes after second treatment BG:______Time:______RN:______
1. If still < 50 after second treatment, then re-treat & notify MD per algorithm Document Treatment Given:______
2. Document BG 15 minutes after third treatment BG:______Time:______RN:______

* If glucagon is used, it should be followed as soon as possible by EITHER oral carbohydrates (if patient can subsequently eat) or by obtaining IV access and starting D5 0.45NS as indicated in the box. Glucagon should not be repeated.