D10 / Normal Saline
ADULT:
Blood Sugar < 60 mg%, 60-80 mg% and Symptomatic, or PEA, Asystole with suspected hypoglycemia
25 gm/250 mL IVPB
25 gm/250 mL IO Unconscious
BS < 80 mg%, unable to start IV, no response to IM Glucagon
PEDS:
Blood Sugar < 60 mg%, 60-80 mg% and Symptomatic, or PEA, Asystole with suspected hypoglycemia
5 mL/kg D10 IV (max 250 mL)
5 mL/kg D10 IO (max 250 mL) Unconscious
BS < 80mg%, unable to start IV, no response to IM Glucagon
INDICATION:
- BS determination < 60 mg%, or between 60-80 mg% and symptomatic, or suspected hypoglycemia.
- IO - Unconscious and BS less than 60 mg% and unable to start IV and no response to IM Glucagon.
- Known diabetic in Full Arrest SO, no D-Stick needed (Non-Traumatic FA in PEA/Asystole).
PROCEDURE:
- 25 gm (D50) can be mixed in a 250 mL bag of NS to create D10.
- Administer wide open, when baseline mental status, reduce to TKO.
- Use saline lock or Piggyback for administration.
PEDS PROCEDURE:
- IVPB = calculate amount, draw off excess fluid, leaving only dose in the bag.
- IVP (100mL or less) = withdraw the proper amount in syringe, if available, and give slowly.
COMMENTS:
- Monitor IV site for extravasation.
- Piggyback; clamp off main line, connect D10 line, infuse D10, re-open main line after D10 is infused.
- Consider IV fluid bolus (250-500 mL) for known diabetic with suspected DKA if blood glucose > 400 mg% and no evidence of CHF.
- Use distal port of D-10 line for other medication administration needs followed by flush of NS.
Pediatric D10 Dosing - See I-20 Pediatric Medication Doses