July 23, 2017
Protocol for the emergency Rx of hypoglycaemia during ITT and glucagon tests Minimize

 Protocol for the emergency treatment of hypoglycaemia during the insulin tolerance or glucagon tests

Indication:

This procedure is a guide to the treatment of children who become hypoglycaemic (glucose < 2.6 mmol/L) during or after a glucagon test, or during an insulin tolerance test. The following equipment should be immediately available during the test procedure:

  1. liquid drink (squash/milk)
  2. food (toast/biscuits)
  3. glucose powder
  4. strong oral glucose solution (for diabetics)
  5. 10% dextrose (500 mL) and iv giving set
  6. Glucose meter and strips and lancets etc
  7. hydrocortisone 100 mg for iv use.

Emergency treatment:

 IF THE CHILD REMAINS CONSCIOUS 

Give a drink of milk/squash with 2-4 teaspoons of dextrose dissolved in it and recheck blood glucose after 10 minutes. If this is not successful, give 5-20 mL strong dextrose solution ORALLY. In most instances this will be sufficient to raise the blood glucose over 2 mmol/L. DO NOT ABANDON THE TEST AT THIS STAGE

IF THE CHILD BECOME RAPIDLY UNCONSCIOUS 

  • Do not attempt oral therapy
  • Abandon the test procedure
  • Give intravenous glucose 200 mg/kg (10% dextrose at 2 mL/kg) over 3 minutes.

Emergency iv 10% glucose bolus dose

weight 

 

 

total volume

 

 

10 kg

 

 

20 mL

 

 

15 kg

 

 

30 mL

 

 

20 kg

 

 

40 mL

 

 

30 kg

 

 

60 mL

 

 

  • commence iv fluids with 0.45% NaCl/5% DExtrose at a maintenance rate
  • if hypogklycaemia recurs then repeat the iv glucose bolus as above
  • call the paediatric medical team to review the child 

Return to Insulin tolerance test

 

 

Return to Glucagon test for GSD

 

 

 JHB 17 Oct 2011

 

 

 

  

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