I’m seeking clarification regarding a call we attended today. We were dispatched for a shortness of breath patient who was in acute CHF and also presented with slurred speech. At the time, we were not aware that his slurred speech was baseline due to tongue CA. Out of caution, we checked his blood glucose, which returned at 3.6 mmol/L. We initiated CPAP in conjunction with nitroglycerin for the CHF, which the patient tolerated well. However, due to the CPAP, we were unable to administer oral glucose paste. The directives for glucagon and dextrose specify that the patient must have an “altered LOA” to administer these agents. In this case, the patient had no signs of hypoglycemia and no altered mental status. My question is: in situations like this, when a patient cannot receive oral glucose but does not meet the conditions for glucagon or dextrose, should we attempt to administer either of those treatments, or is withholding them appropriate?

Question: How fast can a pediatric Pt. burn through glucose stores? Scenario: Called for a 13y/o unconscious. Consumption of unknown amount of alcohol & unknown drugs or amount. AOx0, GCS 4=E2V1M1. Eyes open to pain as only response. Pt stable vital signs on Primary & throughout transport & BGL 5.8mmol/L on scene. Transport to appropriate children’s hospital code 4 CTAS 2with a 25 min transport time. On ED assessment Pt. was given an amp of dextrose as ED found BGL to be “low”…. or not able to read on meter, so possibly less than 1.6mmol/L. Crew’s service meter DID pass daily test procedure as per manufacturer’s guidelines. Thank you

Do we really need to get a blood glucose on an overdose patient prior to administering Naloxone?

I was told during my I.V. course that it is O.K. to give dextrose immediately after Glucagon if an I.V. was achieved after Glucagon administration (failed I.V. attempts – give Glucagon – try another I.V. and succeed – give dextrose). Is this true? If so, would I have to record a new sugar reading prior to dextrose administration even if Im prepared to give dextrose immediately after glucagon? Would there be any changes to the number of max doses of either drug I could administer in this case.