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EMR
EMT
AEMT
Paramedic
Extended
Hypoglycemia / Unresponsiveness
Hypoglycemia / Unresponsiveness
Universal Patient Assessment
Adult IV/IO
Cardiac Monitor
Check BGL
10% Dextrose
IV/IO
infusion if patient cannot
swallow
Titrate to mental status
improvement
Glucagon
1mg IM if no IV
access
Naloxone
2-4mg via
IV/IO/IM
May repeat to max 8mg
as necessary.
Assess
hydration status
Normal Saline Bolus
no more
than 1000mL
Consider other causes:
Head injury, overdose,
stroke, hypoxia
If CVA is suspected, go to
CVA/TIA Protocol
Return to baseline?
Reassess and monitor
EMRs may administer
naloxone 2mg via MAD
from prefilled syringes.
Food, drink, or oral
glucose
is preferred if
patient is conscious and
can swallow
Orange juice or other sugary
drinks will raise the BGL
faster than less sugary drinks.
Do not use diet drinks. Cake
frosting also works. Consider
patient food allergies.
Glucose 60-250 mg/dL
Glucose <60 mg/dL
or <80 with symptoms
Glucose >400 mg/dL
with symptoms
No
Yes
Make sure to protect the
patient’s airway. If trauma
cannot be ruled out, treat
as the cause.
Naloxone
2mg via MAD
or