UNCONTROLLED WHEN PRINTED
Introduction
- A hypertonic crystalloid solution that provides a readily available source of energy (glucose)
- Onset within 1 minute
- Contains 100 mg glucose anhydrous/ml
Indications
Demonstrated hypoglycaemia where oral glucose administration is inappropriate in:
- Altered conscious state in known diabetic or of otherwise unknown cause where blood glucose level is below 4 mmol/L.
- Cardiac arrest, only if hypoglycaemia is suspected as a contributory cause of the arrest, not an early indication.
Contraindications
- Not to be used if there is no patent IV access
Precautions / Notes
- Patients should ideally be cannulated with a large gauge cannula into a large vein, with patency confirmed with a free flowing bolus (>20 mL) of 0.9% normal saline, before administering glucose 10% using a 20 mL syringe via the injection port, titrated to effect. Administration via an IO should utilise a 20 mL syringe and a three way tap.
- High concentration of IV glucose may aggravate dehydration due to its hypertonicity whereby it draws water from the cells.
- IV glucose is corrosive and IV patency must be ensured before administration.
- Careful titration of glucose in head injured patients is vital as glucose leaking into CNS tissue will aggravate the injury, resulting in cerebral oedema.
- Monitor blood glucose level carefully; beware of drop in level again after the patient has recovered.
- Even if fully recovered, patients should be encouraged to be transported to a medical facility to ensure effective follow up and review.
- IO administration is only as a last resort after all other avenues have been exhausted and the patient needs lifesaving glucose.
- Do not wait on scene for glucose to take effect.
- Note that repeat doses of Glucose 10% (Intravenous) may need to be repeated to achieve normoglycaemia.
Management
Adult:
- 15 g (150 mL) IV
- If BGL < 4 mmol/L after 5-10 minutes, give 10 g (100 mL) IV titrating to effect
Paediatric:
- 2 mL/kg (0.20g/kg or 200mg/kg) up to 15 g (150 mL) IV/IO
- If BGL < 4 mmol/L after 5-10 minutes, give 0.2 g/kg IV/IO titrating to effect
Newborn:
- 2 mL/kg (0.20 g/kg or 200 mg/kg)
- Repeat once only, if clinically indicated (BGL <2 mmol/L)
Special Considerations
- Hyperglycaemia
- Diuresis
- Tissue necrosis
- Thrombophlebitis
References
References
Presentation
500ml bag 10% glucose (10g per 100ml)
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