Oral Glucose Gel vs Glucose Tablets.

[AZCEP]

If you are going to buy your own stuff, try some Karo syrup. Dark or light, it will absorb faster, has a higher sugar content, tastes better, and you can use it to sweeten your coffee at the station while you are waiting to use it on the appropriate patient.

Like Rid said, tablets are slow to absorb through the GI system.

Or, make them a sandwich and watch them eat it.

[Mastabattas]

anyone that has received D50W can attest the rebound is painful

R/r... can you expound on this 'rebound' thing? I have learned about the irritated vein but nothing regarding 'rebound'.

[Ridryder 911]

Rebound is the sudden "rush" of glucose. Many patients glucose levels may triple or more after the administration of D50w. This sudden increase in glucose may cause, head ache, chills, malaise. Of course some of this can be contributed to the hypoglycemia, but a sudden influx of glucose (even though needed) has its' side effects as well. Figure the body is attempting to maintain homeostasis and we change it rapidly.

Many services are changing to D10w and rechecking FSBS to appropriate level, with the patient eating a high carbohydrate meal afterward when alertness is appropriate.

R/r 911

[Mastabattas]

Thank R/r... makes total sense. I'm curious about this... I'll google myself of course but do you know any specific references that discuss this any further?

[akroeze]

Rebound is the sudden "rush" of glucose. Many patients glucose levels may triple or more after the administration of D50w. This sudden increase in glucose may cause, head ache, chills, malaise. Of course some of this can be contributed to the hypoglycemia, but a sudden influx of glucose (even though needed) has its' side effects as well. Figure the body is attempting to maintain homeostasis and we change it rapidly.

Many services are changing to D10w and rechecking FSBS to appropriate level, with the patient eating a high carbohydrate meal afterward when alertness is appropriate.

R/r 911

Just curious, but would D5W at an increased rate also be appropriate or would the rate be simply too much?

Just wondering cuz I'm not even sure at what rate the D10W would be run at.

[Ridryder 911]

D5W would take a considerable length of time as well, they may not need the fluid amount. D10w can be made with D50W and IV pushed, like D50W but without the hypertonic side effect.

I am not against D50w at all, just something to discuss with your medical director in regards to some patients.

R/r 911

[zippyRN]

Just curious, but would D5W at an increased rate also be appropriate or would the rate be simply too much?

Just wondering cuz I'm not even sure at what rate the D10W would be run at.

250 ml stat of 10 % has the same amount of glucose as 50 ml of 50% - into a good 16 or 18 g cannula how long does it take to give 250ml of a not that viscous fluid? not that long

I know some places in the Uk are using 20% as well as or instead of 10 or 50 %

[1EMT-P]

If you feel that you can manage the patient safely without doing invasive procedures like starting an IV or pushing D50, then I think you should, but I would not go out and buy supplies and use them at work due to the medico-legal issues.