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.
Please see a previous Ask MAC (Feb 5, 2014) regarding timing of Glucagon and Dextrose administration and glucose re-checking. In summary, based on the pharmacokinetics of these medications, you should give time for them to work before re-checking and potential re-treatment. Give 10 minutes for dextrose and 20 minutes for glucagon.
There would be no change to the number of maximum doses. However, note, if further glycemic treatment is required (patient still symptomatic and hypoglycemic despite appropriate dosages and after waiting the appropriate time) it is reasonable to patch to the BHP for direction.