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hypo treatment -

S

stretchermonkey

Member
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5
Hi everyone

I'm a paramedic and go to hypos as part of the job. If the pt can we always start with oral glucose. What are your preferences as to how, initially liquid form other than glucogel

Cheers
 
Hello stretchermonkey.
What did the training you were given - advise you to do?
As a 'PARAMEDIC' ?
Liquid form - lucozade , cocoa cola (full sugared version) swallowed orally via the mouth... if 'able' to.
Other option(s) are dextros energy tablets if patient able to chew these and has them on them... if 'able to.
If unable to chew or swallow then squeeze gel or full sugar jam on inside of cheeks and massage into gums...
Hope this helps.
Anna.
 
Hi Anna

If pt will tolerate then its oral,if not or unconscious then its a cannula and IV glucose. If cannulating is difficult its IM Glucagon. Our guidelines are BM over 5mmol to leave at home. A lot of pts choose to stay at home once recovered , I just wondered what preferences were to the usual lucazade, often find vomiting follows too much lucazde
 
stretchermonkey said:
Hi Anna

If pt will tolerate then its oral,if not or unconscious then its a cannula and IV glucose. If cannulating is difficult its IM Glucagon. Our guidelines are BM over 5mmol to leave at home. A lot of pts choose to stay at home once recovered , I just wondered what preferences were to the usual lucazade, often find vomiting follows too much lucazde
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There should be no need for too much Lucazade! 100ml is more than enough to treat a hypo.

In all honesty though if an ambulance has to be called then you treat the patient with what you have glucogel or what ever.
Mind you I can't understand why you have to be called if the person can take oral glucose. Waste of a paramedics time imho.
 
I'm also a bit surprised that people who are able to take oral glucose need a paramedic.
I hope my OH wouldn't call one out until he's used the glucagen hypo it. Do people not use these?
 
phoenix said:
I'm also a bit surprised that people who are able to take oral glucose need a paramedic.
I hope my OH wouldn't call one out until he's used the glucagen hypo it. Do people not use these?
Click to expand...

I have had several hypos where I could take oral glucose but unable to get it for myself. In the days of MDI and Humulin Zn I woke up hypo - it paralysed my limbs. I could not get out of bed or get dextrosol out of my bedside drawer or get a straw into a carton of ribena but I could suck it up a straw once that was put in my mouth.

To answer the OP, I would choose Ribena every time. I can't swallow a lot of fizzy drinks as the bubbles hurt (never could - apart from champagne where the bubbles seem a lot more gentle for some reason!) so I can swallow a still drink through a straw much quicker. It's easier through a straw because you don't get too much in your mouth at once. Alternative would be fruit juice but this is controversial.

Another point - I'd rather you gave me glucagen than IV glucose any day. IV gives a nasty bruise and is painful. glucagen is quicker and doesn't hurt. I didn't realise that paramedics used IV glucose unless the glucagen doesn't work. I've had paramedics called to me a few times and they've always used glucagen. The only times I've had IV glucose were once on holiday in Gran Canaria and another time on a cruise, where the doctor didn't have glucagen. I was very sore afterwards.
 
Pheonix - never been called to a hypo where the pt has been given glucogen prior to our arrival.

lovaduck, I'll remember the ribena if they have some :-). As a para my first line of treatment if you can't tollerate oral gluc is always IV glucose as it's gonna be better for you, I'm normally a bruise free cannulator :-). Glucogen is ok if I can't cannulate or your too combative but once it releases your bodys glycogen supply your stuffed for a while as it won't work again if its used on you. I've been to pts who've been glucogoned in prev 24 hrs. If its EMT's who've visited you then they can only Glucogon you as they can't give IV drugs.
 
stretchermonkey said:
Pheonix - never been called to a hypo where the pt has been given glucogen prior to our arrival.

lovaduck, I'll remember the ribena if they have some :-). As a para my first line of treatment if you can't tollerate oral gluc is always IV glucose as it's gonna be better for you, I'm normally a bruise free cannulator :-). Glucogen is ok if I can't cannulate or your too combative but once it releases your bodys glycogen supply your stuffed for a while as it won't work again if its used on you. I've been to pts who've been glucogoned in prev 24 hrs. If its EMT's who've visited you then they can only Glucogon you as they can't give IV drugs.
Click to expand...

I was probably combative! Mind you that didn't stop the doctor in Gran Canaria from trying to get a needle into me, despite the fact that I was fitting. The bed looked like there'd been a machete attack!

I know Glucagen doesn't work if you've had it before and I recognise that if you are called to someone who's alone, you're not going to know that. I've also found though that IV always leaves me sky high and feeling ill, whereas glucagen doesn't.
 
I've also found though that IV always leaves me sky high and feeling ill, whereas glucagen doesn't.

Interesting, never been told that :-) Have an interest in diabetics and have found this forum quite informative
 
l0vaduck said:
I know Glucagen doesn't work if you've had it before and I recognise that if you are called to someone who's alone, you're not going to know that. I've also found though that IV always leaves me sky high and feeling ill, whereas glucagen doesn't.
Click to expand...

Glucagen, doesn't work and must not be used on anyone with adrenal problems either. It says so on the package not that medics ever read the info :roll:
 
Re: hypo treatment

I have to be honest, my preference is robot have to all paramedics in the first place! No offence. I'm sure you're all lovely people.

I usually go for Lucozade, but it's really personal preference :)
 
Ive been treated via IV for bad hypos where they tried other stuff first and it did not stabilise them much. If im at work or home i treat them with the gel or tablets first of all. I actually do not mind the gel. Never had the Glucagen so cant comment on it.
 
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