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

Pharmacology Review

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 4mmol/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 (>20ml) of 0.9% normal saline, before administering glucose 10% using a 20ml syringe via the injection port, titrated to effect. Administration via an IO should utilise a 20mL 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)

Glucose 10 IV

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Responsible Manager
Head of Clinical Services

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