Hypoglycaemia, hospital treatment of

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Objectives

Guidance on the emergency management of hypoglycaemia. 

Scope

All neonates, infants and children in the Royal Hospital for Children.

Audience

Medical and nursing staff in the Royal Hospital for Children.

Blood glucose < 2.5 mmol/L

1st Line:

  • If IV access not available or if Glucagon not already been given at home or in ambulance
  • Give Glucagon IM (>5yr 1mg, <5yr 0.5mg)
  • NB: likely to cause vomiting

2nd Line:

  • IV bolus dose 2ml/kg 10% Dextrose
    and
  • Start 10% Dextrose infusion at 6ml/kg/hr

3rd Line:

  • Further IV bolus dose 2ml/kg 10% Dextrose

4th Line:

  • Change infusion to 20% Dextrose

 

Blood glucose 2.5 - 4.0 mmol/L

  • Oral glucose unless vomiting
  • when IV glucose as above

 

Blood glucose >4.0 mmol/L - normal (no Rx req.)

  • If coma persists, monitor blood glucose frequently and infuse glucose as required
  • Restlessness may be due to a full bladder
  • Consider other causes of decreased consciousness
Editorial Information

Last reviewed: 01 September 2016

Next review: 01 September 2019

Author(s): Kenneth Robertson / Ian Craigie

Approved By: Other