NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 5306

POLICIES AND PROCEDURES

Subject: Medical Direction

Associated Policies: 5323 01/10/98

1. Class:

1. Carbohydrate.

2. Indications:

1. Suspected hypoglycemia.
2. Altered level of consciousness in the adult or pediatric patient with blood glucose reading less than 80.
3. Altered level of consciousness in the neonate with blood glucose less than 40.
4. Coma of unknown etiology.
5. Status epilepticus.

3. Therapeutic Effects:

1. Restores blood sugar toward normal.

4. Contraindications:

1. Absolute:

1. Undiluted D₅₀ or D₂₅ can cause cardiac dysrhythmias or arrest in the Neonate. Dilute medication on Base Order only.

1. Relative:

1. None.

5. Adverse Effects:

1. Severe tissue necrosis if administrated via infiltrated IV site.

6. Administration and Dosage:

1. Adult: 25 Gm D₅₀ via IV.
2. Pediatric: (< 35 kg) 0.5 - 1.0 Gm/ kg (2-4 ml/ kg) D₂₅ via IV or IO.
3. Neonate: 0.5 -1.0 Gm/ kg (3 cc/ kg) D₅₀ diluted to 10% concentration with normal saline via IV or IO. On Base Order only.

1. To facilitate mixing, use 50 cc NS bag, remove 10 cc of solution and add 10 cc of Dextrose 50% to form 50 cc of 10% concentration. Appropriate dose can be withdrawn and administered IV or IO.

7. Special Information:

1. Determine blood glucose level prior to administration of medication.