Hypoglycaemia

• What should be taken before treatment of the patient?

  A full medical history
• Why is it important to ask a known diabetic about their last meal?

  To assess risk of hypoglycaemia
• What blood glucose level indicates hypoglycaemia?

  Below 4mmol/l
• What signs may indicate a patient is hypoglycaemic?

  Tiredness, frustration, confusion
• What is the first action to take if a patient becomes drowsy and unresponsive?

  Stop treatment and remove items from mouth
• Who should be called for assistance during this emergency?

  A team member
• In what position should the patient be laid during this emergency?

  Supine position
• What should be done if the patient is wearing tight clothing?

  Loosen the clothing
• How can you attempt to wake a drowsy patient?

  Gently shake their shoulder and call their name
• What is the oxygen flow rate to be given to the patient?

  15 l/min
• What does the ABCDE approach assess in a medical emergency?

  Airways, breathing, circulation, disability, exposure
• What should be done if the patient is close to unconsciousness?

  Apply glucose gel buccally
• How long may it take for glucose gel to be effective?

  15 minutes
• What should be checked after administering glucose gel?

  Blood glucose levels
• What should you do before starting treatment on a patient?

  Take a full medical history of the patient
• If the patient is a known diabetic, what should you ask them?

  Ask if they have eaten/drank before the appointment and what their last blood glucose levels were
• What is the likely cause of the patient becoming drowsy and unresponsive?

  The patient has fallen into a hypoglycaemic state from low blood glucose levels, below 4mmol/l
• What is the first thing you should do when the patient becomes drowsy and unresponsive?

  Stop the treatment and remove anything from the patient's mouth
• What should you do after stopping the treatment and removing anything from the patient's mouth?

  Call for help from a team member
• What should you do after calling for help?

  Lay the patient in a supine position and loosen any tight restricting clothing
• What should you do to try and wake the patient?

  Gently shake the patient's shoulder and try to wake them by calling their name
• What should you do if the patient is close to unconsciousness?

  Apply glucose gel buccally which may take 15 mins to be effective
• What should you check after applying the glucose gel?

  Check the patient's blood glucose levels, which should be above 4mmol/l
• What should you do if the patient regains consciousness?

  Abandon the treatment, give the patient a glucose drink/glucose tablet, explain the incident to the patient, send the patient home and inform their GP
• What should you do if the patient remains unconscious after applying the glucose gel?

  Administer an intramuscular glucagon injection (1mg for >8 & >25kg, 0.5mg for below 8 & below 25kg)
• How long should you wait after administering the glucagon injection?

  Wait 15 minutes
• What should you do if the patient's blood glucose levels are still below 4mmol/l after the glucagon injection?

  Call for emergency help, call 999
• What should you do if the patient remains unresponsive?

  Reassess the patient using the ABCDE approach, bring a defibrillator if available, and start CPR
• What should you do when the emergency services arrive?

  Inform the emergency team of the drugs provided, time of incident, history and possible cause
• What should you do after the incident is resolved?

  Record the incident in the patient's notes and inform their GP
• What are the steps of the ABCDE approach?

  • Assess Airway
  • Assess Breathing
  • Assess Circulation
  • Assess Disability (consciousness)
  • Assess Exposure (skin/rash)
• How do you perform CPR?

  • Ensure airways are clear, tilt head up
  • Hold nose and give 2 rescue breaths
  • Perform 30 chest compressions
  • Repeat until patient regains consciousness or emergency services arrive
• What are the dosages for the intramuscular glucagon injection?

  • For patients >8 years old and >25kg: 1mg
  • For patients below 8 years old and below 25kg: 0.5mg