Paramedic Kardex

Access the blood sugar:

→If mental status, vital signs, and pulse oximetry normal AND:

 

Glucose < 250 (no other ALS intervention / transport indicated)

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BLS Transport

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Glucose > 250

is confused / lethargic, OR

has a heart rate greater than 120, OR

has a respiratory rate greater than 20 and labored breathing, OR

has history of fever, OR

O2 Saturation less than 94%

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Consider DKA 

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ALS Transport

High flow O2, Monitor rhythm, IV access, Infuse up to 1 liter of NS (if no signs of fluid overload)

 

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Glucose > 250 - 400 (no other ALS intervention / transport indicated)

▼

BLS Transport

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The following patients have a higher risk of poor medical outcomes from higher sustained glucose readings:

Active cancer

Renal failure

Liver disease

Immunosuppression

Active abdominal pain with vomiting

Congestive Heart Failure

Organ transplant

Frail Elderly

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Consider ALS Transport

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Glucose > 400 (or reading of Ketones)

▼

ALS Transport

High flow O2, Monitor rhythm, IV access, Infuse up to 1 liter of NS (if no signs of fluid overload)

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1:10,000 = 0.1mg/mL

1:1000 = 1mg/mL

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