Treatment of Moderate to Severe Hypoglycemia in Nil-by-Mouth Adults with Blood Glucose Below 4.0 mmol/L
Clinical Scenario
This protocol addresses adults who are nil by mouth and present with a random blood glucose confirmed below 4.0 mmol/L. Because the oral route is unavailable, this situation requires a specific parenteral management strategy.
Situation
The patient is nil by mouth. Blood glucose is less than 4.0 mmol/L. Oral glucose correction cannot be used, making a structured intravenous approach the required course of action.
Treatment Approach
Management involves intravenous glucose administration. The full protocol specifies which preparation to use, the approach for patients where volume must be minimised, and how to manage blood glucose once the initial response has been achieved.
Target: blood glucose > 4.0 mmol/L after treatmentReferences
- D. Adults who are 'nil by mouth'
- Treat with intravenous glucose (algorithm C, section 5).
- If IV access is available give 100ml of 20% glucose at 400ml/hour or 200ml of 10% glucose at 800ml/hour over 15 minutes.
- Once blood glucose is greater than 4.0mmol/L and the person has recovered consider intravenous infusion of 10% glucose at a rate of 100ml/hr until they are no longer 'Nil by Mouth' or have been reviewed by the medical team.